As we emerge from the pandemic, medical practices must balance the need to provide necessary services while minimizing risks to patients and healthcare providers and mitigating financial impact. Awareness of COVID-19’s progression in your community remains critical. Health care organizations must remain prepared to meet patient needs to the greatest extent possible. As the situation changes, continue planning for best utilization of your facilities, equipment, and consumables while minimizing the risk of infection.
Vaccinations, Surgery, and Preventative Care
In response to the COVID-19 pandemic, patients have cancelled preventative care appointments and surgery, and have fallen behind on vaccinations. Appointments that were cancelled as a result of previous practice closure and appointments that were postponed (possibly due to fear of presenting in person for healthcare) should be reviewed in detail to ensure patient safety. A strong follow-up and recall system will aid in this process. If your practice has not yet developed a system, this is highly recommended as a means of assuring important chronic conditions are managed, and screenings, vaccinations and other preventive care services continue on schedule.
Resources:
- NORCAL Group: Routine and Influenza Vaccination Compliance During the Pandemic
This webpage includes patient safety recommendations, vaccination strategies and additional vaccination resource links. - American Society of Anesthesiologists and Anesthesia Patient Safety Foundation: Joint Statement on Elective Surgery and Anesthesia for Patients after COVID-19 Infection
This webpage provides guidance for hospitals, surgeons, anesthesiologists, and proceduralists in determining the optimal timing of, and appropriate level of preoperative evaluation for patients who have recovered from COVID-19.
Patient Protection and Exposure
Enforcing mask-wearing, changing waiting area furniture arrangements, reducing the number of patients scheduled from the number seen pre-pandemic, and separating well-patient services and sick patient services, either by facility set-up or through scheduling are all strategies for reducing potential exposure among patients, healthcare providers, and visitors. Communicating with patients at the time the appointment is made, and closer to the time of the appointment date and time is critical for assuring patients understand infection control processes and procedures. Providing information through various mediums, such as phone calls, email, text, and your practice website may be helpful for reinforcing this information.
Resources:
- NORCAL Group: Facemask Guidance
This webpage provides guidance on mask use recommendations and patient requests for exceptions and includes a sample mask policy for patients and visitors, mask policy recommendations and resource links. - NORCAL Group: Potential Patient Exposure to COVID-19 by a Healthcare Provider
This webpage provides strategies for responding to potential exposure to patients when a healthcare provider tests positive for COVID-19. - NORCAL Group: COVID-19 Informed Consent Issues
This webpage includes recommendations for educating patients about the COVID-19 infection risks inherent in healthcare delivery and sample COVID-19 infection risk statements for informed consent forms. - NORCAL Group: Mobile COVID-19 Testing and Vaccination Units
This webpage provides strategies for deploying mobile units in a manner designed to safeguard patient safety and minimize liability risk.
Managing Operations
It is likely that the pandemic has changed the delivery of healthcare forever. Some changes are already apparent with the adoption of telehealth and virtual meetings. It is important to prepare for new challenges and learn from past successes and failures.
Resources:
- NORCAL Group: Telemedicine During the COVID-19 Pandemic: Risk Management Recommendations and Resource Links
This web page provides risk management and patient safety strategies for virtual visits. - NORCAL Group: Virtual Consultations: Risk Management and Patient Safety During the Pandemic and Beyond
This article provides strategies for managing the patient safety and liability risks associated with telehealth. - Becker's Hospital Review: A return to stability: How to safeguard elective procedure volumes in 2021
Tactics to effectively manage surgery backlog and how to be prepared for fluctuations in patient volume - AMA: COVID-19: A physician guide to keeping your practice open
This guide builds on the AMA’s "Physician Practice Reopening Guide", and includes a detailed pre-visit screening script and frequently asked questions around privacy and confidentiality concerns for practices. - CDC: Facility Planning and Operations for COVID-19
This guidance outlines goals and strategies for U.S. healthcare facilities to operate effectively and safely during the COVID-19 pandemic and provides links to CDC guidance on providing care in different settings and situations.
Healthcare Workforce Protection, Exposure, and Wellness
In addition to managing interruptions to healthcare operations and healthcare delivery, and reducing the risk of patient infection, protecting both your clinical and non-clinical staff remains critical. Healthcare Personnel providing onsite services must ensure their health and wellness for the safety of your patients and for other members of the workforce. Vaccine hesitancy among members of the healthcare workforce is a continuing challenge.
Resources:
- NORCAL Group: COVID-19 Vaccination in the Healthcare Workforce
Workforce vaccination strategies - NORCAL Group: Healthcare Workforce Protection and Exposure
This webpage provides strategies for preventing and responding to healthcare provider infection, including guidance for work restrictions. - NORCAL Group: Workforce Wellness
This webpage provides strategies for leadership and administrators to support the health and well-being of physicians and staff. - AMA: Dealing with vaccine hesitancy among health care workers
This article with an embedded video link provides strategies for boosting vaccination rates among healthcare staff.
Human Resources
The pandemic has affected hiring, firing, furloughing and/or laying people off as well as re-hiring and returning furloughed employees to work, which may implicate employee protections such as FMLA leave, emergency leave, and workers’ compensation. Accommodating additional time off for illness and dependent care and facilitating remote work strategies are new challenges that can make maintaining safe staffing levels challenging. Questions about incentivizing and mandating vaccination present additional challenges.
Resource:
- NORCAL Group: Human Resources
This webpage contains links to COVID-19 resources from OSHA, US Department of Labor, and National Law Firm analyses of relevant workforce laws.