Modeling the COVID-19 vaccination process using the FRAM Method

Amaral Neto, Arlindo Souza; Nascimento, Nathália Miranda do; Loureiro, Alessandra Barrias; Silva, Mônica Ferreira da; Araújo, Claudia; Rubio, Maria del Pilar Anto; Ribeiro, Sildenir Alves

doi:10.1590/1413-81232025306.03302025

person Arlindo Souza Amaral Neto

conception and design of the study · interpretation of the results · FRAM modeling · writing of the manuscript · conducted the interviews · read · approved the article’s final version

schoolPrograma de Pós-Graduação em Informática, Universidade Federal do Rio de Janeiro (UFRJ). Av. Athos da Silveira Ramos 274, Cidade Universitária, Ilha do Fundão. 21941-916 Rio de Janeiro RJ Brasil. arlindoneto@ufrj.br

0000-0002-9692-3568

person Nathália Miranda do Nascimento

conception and design of the study · interpretation of the results · FRAM modeling · writing of the manuscript · conducted the interviews · read · approved the article’s final version

schoolPrograma de Pós-Graduação em Informática, Universidade Federal do Rio de Janeiro (UFRJ). Av. Athos da Silveira Ramos 274, Cidade Universitária, Ilha do Fundão. 21941-916 Rio de Janeiro RJ Brasil. arlindoneto@ufrj.br

0000-0002-8477-1587

person Alessandra Barrias Loureiro

conception and design of the study · interpretation of the results · FRAM modeling · writing of the manuscript · conducted the interviews · read · approved the article’s final version

schoolPrograma de Pós-Graduação em Informática, Universidade Federal do Rio de Janeiro (UFRJ). Av. Athos da Silveira Ramos 274, Cidade Universitária, Ilha do Fundão. 21941-916 Rio de Janeiro RJ Brasil. arlindoneto@ufrj.br

0000-0002-5974-7120

person Mônica Ferreira da Silva

conception and design of the study · interpretation of the results · FRAM modeling · writing of the manuscript · read · approved the article’s final version

schoolPrograma de Pós-Graduação em Informática, Universidade Federal do Rio de Janeiro (UFRJ). Av. Athos da Silveira Ramos 274, Cidade Universitária, Ilha do Fundão. 21941-916 Rio de Janeiro RJ Brasil. arlindoneto@ufrj.brschoolInstituto de Pós-Graduação e Pesquisa em Administração, UFRJ. Rio de Janeiro RJ Brasil.

0000-0003-0951-6612

person Claudia Araújo

critically reviewed the text · emphasizing the interview script · read · approved the article’s final version

schoolInstituto de Pós-Graduação e Pesquisa em Administração, UFRJ. Rio de Janeiro RJ Brasil.

0000-0003-0290-4807

person Maria del Pilar Anto Rubio

critically reviewed the text · emphasizing the interview script · read · approved the article’s final version

schoolPrograma de Pós-Graduação em Informática, Universidade Federal do Rio de Janeiro (UFRJ). Av. Athos da Silveira Ramos 274, Cidade Universitária, Ilha do Fundão. 21941-916 Rio de Janeiro RJ Brasil. arlindoneto@ufrj.brschoolUniversidad San Ignacio de Loyola. Lima Peru.

0000-0003-1024-4124

person Sildenir Alves Ribeiro

critically reviewed the text · emphasizing the interview script · read · approved the article’s final version

schoolPrograma de Pós-Graduação em Informática, Universidade Federal do Rio de Janeiro (UFRJ). Av. Athos da Silveira Ramos 274, Cidade Universitária, Ilha do Fundão. 21941-916 Rio de Janeiro RJ Brasil. arlindoneto@ufrj.brschoolCentro Federal de Educação Tecnológica Celso Suckow da Fonseca. Rio de Janeiro RJ Brasil.

0000-0003-4808-1009

Chief editors:

Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva

Activity performed	Output	Potential Output Variability
Open room	Room opened	Very late: The vaccination room must be opened first thing in the morning. Acceptable
Hand hygiene	Hands cleaned	In time Precise
Check the cold room’s temperature	The cold room’s temperature	In time Acceptable: Conference errors may occur.
Perform the inventory	Inventory performed	In time Precise
Enter in the order and occurrence book	Registration of order and occurrences	In time Acceptable: Registration error may occur.
Prepare cooler boxes	Boxes prepared	Very late: Interruptions may occur while performing this activity. Inaccurate: There may be inaccuracy in the temperature, which should be between 2°C and 8°C.
Transfer vaccines to cooler boxes	Vaccines transferred	In time Acceptable: Errors may occur during transfer. The most commonly used vaccines must be transferred.
Monitor temperature	Temperature	In time Precise
Prepare inputs	Inputs prepared	In time Precise
Connect equipment	Equipment connected	In time Precise
Receive patient	Patient received	In time Precise
Start service	Service started	Very late: The person vaccinating is the same person who records the information in the system. Acceptable
Request documentation	Documentation	In time Acceptable: The patient may not have documentation, such as a vaccination card.
Consult the system	System consulted	Very late: Wait for the computer to become available or Internet connectivity. Acceptable
Perform anamnesis	Anamnesis performed	In time Precise
Register in the SI-PNI	Nominal/individualized record of the vaccine dose applied	Very late: Wait for the computer to become available or Internet connectivity. Inaccurate: Not every field in the record is filled in (e.g., adverse events after vaccination and losses of immunobiologicals) to speed up the process.
Register in the vaccination book	Vaccine registration	In time Acceptable: Registration error may occur.
Complete receipt	Receipt	In time Precise
Prepare vaccine	Vaccine prepared	In time Acceptable: An error may occur when preparing the immunobiological.
Apply vaccine	Vaccine applied	In time Precise
Deliver receipt	Receipt delivered	In time Precise

Activity performed	Upstream NAC	Downstream NAC
Open room	4	1
Hand hygiene	2	2
Check the cold room’s temperature	1	1
Perform the inventory	2	1
Enter in the order and occurrence book	3	4
Prepare cooler boxes	3	2
Transfer vaccines to cooler boxes	6	1
Monitor temperature	1	2
Prepare inputs	2	1
Connect equipment	2	1
Receive patient	1	1
Start service	5	1
Request documentation	3	4
Consult the system	3	1
Perform anamnesis	1	2
Register in the SI-PNI	4	1
Register in the vaccination book	2	1
Complete receipt	2	2
Prepare vaccine	2	1
Apply vaccine	3	1
Deliver receipt	2	1

[TFN3n] Source: Authors, 2024.