Testing, Testing: Walmart’s Plan to Stand Up a COVID-19 Testing Site in Eight Days
Testing, Testing: Walmart’s Plan to Stand Up a COVID-19 Testing Site in Eight Days
July 27, 2020
By Kane Webb, Walmart Corporate Affairs
As the first day of testing individuals for the coronavirus drew to a close, Walmart pharmacist Matthew Heishman felt exhausted...and elated…and proud. And, like the others at the testing site on a Walmart parking lot in Northlake, Illinois, he was a bit stunned at what so many working together had managed to pull off in eight days. From we’re doing what?! to we got this! in a little more than a week.
“After a week of plans, and changes of plans, and being on-call for meetings, and wondering if this could all really get going, it came together,” wrote Heishman, a pharmacy manager at a Sam’s Club near Northlake, chronicling the experience. “The world feels so uncertain for all of us right now. Humans across the U.S. and across the world are feeling fear, a fear which many haven’t ever felt before. And suddenly there we were as pharmacists doing something that it feels like none of us in our profession have ever done before. In the midst of palpable fear, there we were, taking these first nasal swabs and samples, doing drive-up testing for the novel coronavirus. … I saw legitimate fatigue on almost every face, but even more obvious was legitimate excitement over what we were each realizing we had just accomplished. We are truly trailblazing within our realm of the world.”
Not long after that unforgettable first day, Heishman watched as an individual completed his test, pumped his fist out the car window and shouted, “God bless the USA!”
“It gave me goose bumps,” Heishman recalls. “It made what we were doing real.”
By April, Walmart was opening drive-thru testing sites consistently in parking lots across the country. That same month, Walmart also added mobile testing to this critical mission, launching in Georgia, Alabama and Kansas, expanding into areas without Walmart stores to better serve rural populations. In May, another innovation of the testing model: the first of many sites opened at Neighborhood Market pharmacy drive-thru windows. All these sites follow CDC guidelines, testing anyone who has COVID-19-like symptoms, as well as any healthcare or front-line workers irrespective of symptoms.
As of July 20, Walmart had stood up 357 active sites, having tested more than 155,000 people across the country, and more are on the way.
But let’s back up a bit, to mid-March, four months ago by the calendar – although it may feel like decades – when this all started.
Late on the afternoon of Thursday, March 12 yes, the day before a Friday the 13th – Del Sloneker, senior vice president and COO of Walmart U.S. Health and Wellness, received a call from the office of Walmart U.S. CEO John Furner.
Could Del come by John’s office? Sure. How long would it take him? Five to 10 minutes. Why so long?
Why so long? Sloneker, who was working at a Walmart facility a few blocks from the Home Office, knew then that this was urgent.
He soon found out why. The White House had asked Walmart to work with the U.S. Department of Health and Human Services and other partners to put up testing sites on its parking lots around the country. The president would make the announcement the next day at a press conference in the Rose Garden. Walmart CEO Doug McMillon would be on hand. The clock had started ticking.
“John said, ‘We need to get testing sites up and going. We’re meeting with Doug in five minutes, and we need you to take the lead on it,’” Sloneker says. “Then they said some nice things to get me to say yes.” He laughs. “But seriously, whatever they ask me to do, I’ll do it as long as we can keep our associates safe. So, we found out what they were looking for and what we’d been asked to do, and we just dove in.”
What was the original timeline to get the sites up and running?
“Yesterday,” Sloneker says, without a hint of sarcasm.
What were the biggest hurdles?
“All of them.”
One of the first things he did was round up his team of problem-solvers. Included among them was David Reitnauer, a vice president of operations support for Health and Wellness, and a 28-year Walmart associate. He remembers that Thursday vividly. It was his wife’s birthday, and the family was heading out to eat when the call came from Sloneker.
“Everybody was waiting on me, and I said, ‘I’m going to be a while,’” Reitnauer says.
He grabbed a bag and headed to the office. Questions abounded: What would the sites look like? How do they go up? What are the clinical, legal and compliance challenges? The team looked up videos online. (South Korea had done something similar.) They white-boarded the process.
By 7 the next morning, hours before the Rose Garden announcement, a dozen members of the team had set up cones and tents on a parking lot, mapping out where people would be positioned and how cars would flow through.
The following Saturday, a testing site opened to serve first responders in Northlake on the outskirts of Chicago.
“We did a dry run, a dress rehearsal, then a soft launch,” Reitnauer says. “We wanted people working the site to understand what was going on. Very controlled. A confidence builder.”
The site would open for testing at 10 a.m. By 7, more than 100 cars were in line. The second day of testing, a car pulled in early to wait. It was 4:30 in the morning. The need was clear.
“This was something we had never done before, but we knew we needed to do it and do it right,” says Alex Cribley, a regional Health and Wellness director, who helped launch the first sites in suburban Chicago at Northlake and Joliet, Illinois. “It was a slow process at first as we worked through challenges like weather, working with third-party services and mapping out the process to be as seamless as possible. Ultimately, we wanted to provide a good experience to everyone coming through. Even though this isn’t [solely] Walmart’s effort, we’re the ones on the ground, and we wanted to provide the best.”
James Quach, a regional Health and Wellness director for Sam’s Club and a 12-year associate, was site lead at Northlake. For two weeks straight, he and the team there worked every day, 10-hours plus. It snowed many days. Chicago in March, after all. In the beginning, the site didn’t have heaters.
“The volume, the physical elements, the hundreds of tests a day, miles of traffic backed up – much different from what it is today,” says Quach, who has transitioned into an even bigger role, coordinating with stores and serving as point of contact for pharmacists and labs. “The team took such pride in what we did. I remember that most.”
The initial sites were staffed by several different groups: Walmart pharmacists; lab partners Quest Diagnostics and eTrueNorth; security/law enforcement from the local community or state, including the National Guard; and volunteers from Remote Area Medical (RAM), a national group based in Tennessee that was so eager to help that its members showed up in Chicago unbidden when they heard about the project.
In addition, the Salvation Army provided meals to the staff and volunteers at the testing sites.
Up to 10 people staffed the early stand-alone sites, including Walmart pharmacists who volunteer. And there have been plenty of volunteers. When the testing sites were first announced, within 48 hours, more than 700 Walmart pharmacists and health and wellness associates came forward to help.
Two main principles guide the process: Make sure everyone on site is safe; and get a quality test.
As sites stood up around the country, a common refrain came from those associates volunteering their time to help with the testing. It’s a slight variation of a familiar theme: Our people make the difference – and they sure love doing so.
“It may sound crazy, but I’m enjoying this time,” says Jennifer Dupree, a market Health and Wellness director in Shreveport, Louisiana. “At some point you feel you’re lost and trying to figure out how to make it better. It’s almost been a blessing to me because now I know that seven days a week, I have my challenge and am making a difference.
“There is so much more that can come out of this, and it’s been a huge advancement for our community. People have come by just to say thank you.”
One day, Dupree was flagged by a RAM volunteer to help a woman in her car who was visibly upset. Clearly, understandably, the emotional challenges of it all had gotten to her. She feared moving forward. Dupree walked the woman through each checkpoint, consoling her, telling her that it was okay to be afraid, sticking with her the entire process. “I appreciate the RAM team for noticing her distress,” Dupree says. “It’s our job to make this the best experience possible.”
That means continuing to evolve and improve, to learn and iterate and learn some more. So, a phase 2 of this process began in early April. Says Cribley: “Leveraging the technology from our lab partners Quest Diagnostics and eTrueNorth, we’re able to provide a more customer-facing and efficient way of testing, including the self-swab that customers could do on their own while observed.”
The process allowed individuals to register online in 5-10 minutes and significantly reduce the wait time. Prior to that, the sites were first-come, first-served, sometimes resulting in long lines and nervous waits. An appointment-based model allowed folks to show up at their scheduled time, creating a smoother experience.
One man with just enough symptoms to worry him recently went through a testing site in Arkansas. He made an appointment online the day before and showed up 10 minutes before his scheduled test. The fourth of five cars in line, he was greeted by site workers dressed head-to-toe in PPE. They held signs with instructions, a phone number to call, when to turn off the car’s engine. It called to mind a drive-thru car wash.
At the end of the line, he was greeted by a pharmacist who guided him through the test via a slightly lowered window.
A swab into one nostril as the pharmacist counts.
“ . . . 13 . . . 14 . . . 15.”
Then the other.
The sample goes into a test tube, then a clear bag, then into a bin. Within 48 hours, the lab emails with news that the man’s results are ready. Taking a deep breath, he clicks on the link.
Sigh of relief.
His biggest takeaway from the process, aside from the ever-intimidating swab, was the professionalism and kindness of those working the site. If shoving a stick in your nose could be categorized as a “good experience,” this was it. Right down to a wave “so long” and thumbs up from the pharmacist.
Since that cold, fateful day in Northlake, it’s been a light-speed evolution as the testing model has grown more efficient, faster and become more widely available. Even the tests themselves have improved, from those brain-ticklers that, Quach remembers, had even some burly Chicago firefighters watery-eyed, to a self-swab that now penetrates only about an inch into the nasal passage.
“To me, it seems like forever ago that we started,” says Quach, one of the initial architects of the testing model who now effectively runs the operation. “We scaled that Northlake model to about 30 sites, and we learned from it. We’re still learning. What we do one week is probably not the same as the next week.”
As quickly as the team launched those first testing sites, Quach recalls a mid-April challenge from Walmart President and CEO Doug McMillon: What was taking so long to stand up more sites?
Quach and his team found out, untangling red tape to see what could be streamlined. One example: the federal CARES Act required all tests to be clinician-observed, and pharmacists had to be trained properly to watch an individual perform a self-swab. Training each pharmacist individually took precious time. So, Walmart began training them en masse, thus getting more pharmacists to more sites more quickly.
Testing sites multiplied across the country, rapidly scaling and evolving to the current efficiency of the drive-thru testing sites from 7-9 a.m. at Walmart Neighborhood Markets.
“We improved processes, simplified them, eliminated a lot of things that slowed us down to help us accelerate,” Quach says. “There’s a lot we didn’t know at the time we first got the call. We learned and iterated. That model is much, much different than what we see today.”
It’s been only four months since Walmart got the call to stand up testing sites, since Del Sloneker walked into John Furner’s office, since David Reitnauer and team set up cones on a parking lot, since Matthew Heishman saw the first cars arrive at Northlake...and Jennifer Dupree helped a frightened woman through the test...and some 700 health and wellness associates volunteered within 48 hours to help out ... and more than hundreds of thousands of Americans have been tested for the virus at Walmart parking lots.
By any measure, one would think that’s moving fast – especially those first eight days from idea to launch. Right?
“Classic Walmart,” says Reitnauer, surely grinning into the phone, “we’re frustrated we didn’t get this up in five days, in three days. When you put Walmart associates together with a mission and people to serve, the extraordinary comes out of them.”