Increasing Access to Vaccination: Extended Hours Program

Background: Parents face many barriers to having their children vaccinated, including cost of the vaccine and time and travel to local clinics. An assessment of the surrounding area of the San Antonio Metropolitan Health District (Metro Health) Goodwill Immunization Clinic revealed a population of single, working parent household with children who preferred clinic hours in the evening time. Due to the demand for extended hours in the area, an Extended Hours Program was implemented from July – October, 2011.

Setting: Metro Health’s Goodwill Immunization Clinic.

Population: Children requiring vaccinations.

Project Description: Senior public health nursing staff collaborated with nursing supervisory staff and the office of the director to determine the best time to offer extended hours throughout the week. A survey was drafted, revised, and approved by nursing and outreach staff for data collection on those who utilized the extended hours.

Results/Lessons Learned: 52% (N=152) of parents completed the survey. 73% of respondents identified themselves as Hispanic, a target population.  92% of respondents qualified for the Vaccines for Children (VFC) program by stating they either had no insurance (47%), Medicaid (29%), CHIP (14%), or insurance that did not cover vaccines (2%). The average age of the children who attended the extended hours was 10.1 years old. The most common response for scheduling the extended hours was to avoid missing work (39%) and to avoid having their children miss school (30%). Respondents responded positively to creating Saturday morning appointments (46.4%) and having a greater number of evening appointments (41.2%). Extended hours appointments were at between 78-100% capacity during each week of the intervention compared to 50-100% during the regular business hours. Survey results showed that patient populations and motivation for attending the extended hours differ throughout the year, demonstrating a year-round need for extended hours. Thus, it would be advantageous to continue these hours on a permanent basis.