Operations Impacts

By Paige Ricci March 24, 2020

Patient experience

As much of the nation’s workforce transitions to remote work platforms, healthcare facilities must continue to provide patient care. This time is ever more critical for patients and their family members, especially those that are facing chronic illnesses, or for patients who are unable to reschedule a critical treatment or appointment.

• Every facility should have an Emergency Plan. It is important to understand how your facility is preparing to manage COVID-19 for your community.
• Communicate any plan set forth by your facility to both staff and patients clearly. Communicating the course of action specific to COVID-19 will only strengthen the community’s trust in your organization.
• If you haven’t already, begin to think about how you will determine an algorithm to identify which patients can be managed by telephone and should remain home, and which patients are to be sent for emergency care.
• Should patients enter your facility for a necessary treatment or appointment, screen your patients and visitors for symptoms of a respiratory illness (e.g., fever cough, etc.). Should a patient present with such symptoms, you may consider creating a separate space for them in the waiting room and/or sending them home.
• Screening questions for employees entering the facility should at least include:
  • Do you have a fever of 100.4°F or higher, or are you feeling feverish?
    • If yes, ask the employee if he or she has had any of the following symptoms:
      • Recent onset cough
      • Shortness of breath
      • Chills
      • Body aches
    • If yes to any of these questions, the employee should be sent home and advised to contact a primary care physician for follow up.
  • Some hospitals are providing visitor exceptions for the following scenarios:
    • Birth partner for maternity patients
    • Parents of babies within neonatal care units
    • Family members of patients in end-of-life care
    • Patient escorts within ambulatory areas

• Similar to how organizations utilize stickers to indicate that an employee (or visitor in this case) has been vaccinated for the flu with a sticker on the employee badge, organizations should consider a visual cue to help confirm that all individuals in the hospital have been screened prior to entry. This visual cue should be something that can be updated for each day the individual enters the facility (e.g., a new, dated sticker for each day).
• In order to increase access for patients, call centers and triage teams could consider staggering the staffed hours. This not only helps limit the number of staff members in close proximity, but it will also increase access for patients. Another consideration that could be made at this time is eliminating patient penalties for cancellations and missed appointments during this time.
• For more information visit the CDC.gov website.

Disruptions to elective services

Many hospitals and health systems have made the decision to cancel elective surgeries to prevent further spread of COVID-19, as well as re-deploy resources during the response. Cancelling procedures also helps to preserve the amount of personal protective equipment (PPE) which could be required as coronavirus figures continue to climb.

• The American College of Surgeons recommends that hospitals review scheduled procedures and plan to minimize, postpone, or cancel them.
• Vice Admiral Jerome Adams, MD, US Surgeon General, issued guidelines around what constitutes “elective.” In some cases, these can be non-emergent surgery, but still include procedures that are essential for conditions that could become life-threatening if they are not addressed, including removing cancerous tumors or replacing a faulty heart valve.
• The American Hospital Association and other major hospital associations (including state level) sent a letter on March 15 to the US Surgeon General, asking for clarifications around ending elective procedures, and further guidance on classifying the levels of necessary care.
• Hospitals should re-assess their decision for deferring care at least every 72 hours.
• Click here to see a running list of hospitals canceling or postponing elective procedures.

Transitioning to a remote workforce

To assist in nationwide efforts to lessen the spread of COVID-19, many organizations are transitioning their non-patient facing workforce to a remote work status. Communication is key to a smooth transition for a staff moving to a work from home environment. If you are considering or have recently transitioned staff remotely here are a few things to think about.

• Does your organization have the required equipment to send staff home? Will they be borrowing equipment from the office?
• What communication tools are available? Staff should be expected to be available as if they were in the office. Instant messaging and virtual meeting technology are very powerful ways for employers to stay connected with remote employees. Additionally, if the office has a morning or weekly huddle, it is a good idea to keep these events as if you were still in the office.
• Given the sensitive nature of the healthcare data, does the employee have an acceptable space to work?
• Are there expectations and means to measure productivity?
• Does your organization have enough cash reserves to manage this shift?