Member Frontline Tactics
While Americans are called to socially distance themselves, AMGA believes connectedness is the U.S. healthcare community’s key to prevailing over the novel coronavirus (COVID-19) pandemic. To promote sharing of resources, tactics, and best practices by frontline health providers, AMGA has compiled a selection of operational, clinical management, and administrative guidelines, lessons learned, and tools used by AMGA member medical groups and health systems. Included is guidance specifically for leadership roles responding to COVID-19, including CEOs, CMOs, CFOs, COOs, and HR professionals.
Clinical Issues
- Clinical Research: Several AMGA members announce the launch of Truveta to facilitate large-scale analysis of patient data from 14 healthcare systems on COVID-19 and other conditions (February 11, 2021).
- UC Davis Health: Long-Haulers and COVID-19 offers resources for those with long-term COVID-19 symptoms, including the region’s first Post-COVID-19 Clinic.
- University of California San Diego: COVID-19questions.org Clinical Data Consult Portal (R2D2 Consortium 9/17/20 [announcement])
- Updated Visitor Policies: AMGA CMO Council Discussion Summary (August 4, 2020)
Council members discuss visitor policies in light of the resurgence of COVID-19. - Alternative Work Hours: AMGA CMO Council Discussion Summary (August 4, 2020)
Council members discuss alternative schedules for physicians and providers to address childcare related to schools maintaining distance learning. - Fall Planning for COVID-19 and Flu Clinics: AMGA CEO and CMO Council Discussions Summary (July 31, 2020)
Council members discuss planning for the flu season and how they are adapting. - Testing Asymptomatic Workers: AMGA CMO Council Discussion Summary (July 6, 2020)
Council members discuss how they address testing and retesting of asymptomatic healthcare workers. - Managing Telehealth Workflows: AMGA CMO Council Discussion Summary (May 26, 2020)
Council members discuss how they address technical issues that interfere with telehealth appointments. - Case Study: How a Physician Group Rapidly Deployed a Successful Telehealth Program in Response to the COVID-19 Pandemic (May 12, 2020)
Crystal Run Healthcare CQO Dr. Scott Hines shares their strategy for rapid deployment of a telehealth program, including revising workflows, sharing data, and choosing physician champions. - Pros and Cons of Video Visit Platforms: CMO Council Summary (April 16, 2020)
Council members share experiences with platforms used for video visits, including Zoom, Doximity, doxy.me, and Facetime. - Staffing Telehealth Visits from Home: CMO Council Summary (April 15, 2020)
Council members share protocols and workflows for providers who are working from home. Sample Policy: Remote Provider Telecommuting (Work from Home) for Telehealth Visits - PPE Protocols at Respiratory Clinics and Reopened Ambulatory Sites: CMO Council Summary (April 13, 2020)
Council members share approaches to use of PPE, including N95, masks, gloves, and face shields, in dedicated respiratory clinics and reopened ambulatory sites. - Telehealth Reporting and Staffing: CMO Council Discussion Summary (April 12, 2020)
Council members share approaches to report patient-reported vitals during telehealth visits, as well as staffing issues related to telehealth, including processes, rotation, and physicians conducting telehealth from their homes. - Return to Work Using Non-Test-Based Strategies: CMO Council Summary (April 10, 2020)
Given limits on COVID-19 diagnostic testing capacity, council members discuss using “non-test-based strategies” to recommend when employees should stay home and when it is safe to return to work. Sample return to work letter. - Response at the Epicenter: Quality Council Presentation Summary (March 27, 2020)
Quality leaders from Summit Medical Group – City MD and Crystal Run Healthcare describe being in the epicenter of the pandemic and share strategies, including telehealth, patient triage, staff redeployment, inpatient surge, and future planning, as well as PPE, compensation, and staff wellness - Clinical Guidelines for Ambulatory Assessment: CEO Council Discussion Summary (March 24, 2020)
Council members share approaches to detailed service scripting and clinical guidelines on the approach to ambulatory assessment of influenza-like illness, including patient and employee testing, education, telehealth, and pandemic response centers - Clinic Consolidation and Patient Triage: CMO Council Discussion Summary (March 24, 2020)
Council members share approaches to consolidating primary care clinics, triage, and respiratory clinics - Clinical Staffing Approaches for COVID-19: CMO Council Discussion Summary (March 24, 2020)
Council members share approaches to overstaffing including staff rotation, redeployment, shifting to telehealth, new roles for physicians, and compensation adjustments - APP Deployment for COVID-19: CMO Council Discussion Summary (March 22, 2020)
Council members share approaches to the deployment of vulnerable APPs during the pandemic - Testing Procedures for COVID-19: CMO Council Presentation and Discussion Summary (March 20, 2020)
Crystal Run Healthcare Chief Transformation Officer Dr. Jonathan Nasser shares strategies for testing for COVID-19, including creating outside evaluation centers, workflows for evaluation and labs, supplies, and drive-in clinics - Handling Clinical Staff with URI Symptoms but No Known Exposure CMO Council Discussion Summary (March 18, 2020)
Council members share how they’re handling staff (doctors and clinical staff) with URI symptoms without known exposure, including testing and quarantine. - Staffing and Clinical Teams for COVID-19: CMO Council Discussion Summary (March 18, 2020)
Council members share approaches to staffing and office teams - New Procedures for Managing Patients and Providers in Response to Coronavirus: CMO Council Discussion Summary (March 17, 2020)
Council members share how they’re addressing triage, patient management, telephone visits, and provider compensation issues
Operations
- UCHealth Mass Vaccination Drive-Through Playbook details logistics for mass vaccination events (Feb. 12, 2021).
- Prevea Health: COVID-19 Vaccination Clinic Planning Resources (January 2021)
- Northwell Health, Henry Ford Health System Form Alliance, Share Staff to Fight COVID-19. Strategic alliance is designed to enhance crisis preparedness through collaborative emergency and COVID-19 planning and the sharing of best practices.
- Realigning Care in the Time of COVID-19: Presentations to AMGA’s Chronic Care Roundtable (November 2020)
- Using an Innovative Care Model to Support Patients in the Time of COVID-19. Henry Ford Health System Chief Clinical Officer Adnan Munkarah offers insights on new care coordination, hospitalization alternatives, as well as virtual and home care.
- The Pandemic Unmasked Our Resilience: Care Realignment in the Time of COVID-19. Southwestern Health Resources Chief Physician Executive and COO Sanjay Doddamani explores how COVID-19 laid bare the shortcomings of fee-for-service health care.
- Realigning Primary Care in the Time of COVID-19. Advocate Medical Group ABOM Medical Director Tony Hampton discusses changes COVID-19 has brought to the primary care setting and the need for greater social support systems.
- Telehealth: Temporary Solution or Permanent Disruptor. Crystal Run Healthcare Chief Quality Officer Scott Hines explores the short- and long-term effects of telehealth as a result of the COVID-19 pandemic.
- Health Workforce: Northwell Health’s Keeping Our Team Members Safe initiative prioritizes the physical, emotional, financial, and psychosocial safety and well-being of team members and their families ( New England Journal of _ Medicine Catalyst _, Dec. 2, 2020)
- Post-Pandemic Predictions: CareMount Medical President and CEO Scott Hayworth (August 2020) In this Group Practice Journal interview, CEO Dr. Scott Hayworth explains how CareMount is optimizing care delivery during COVID-19 and makes predictions for the future of health care.
- Five Strategies for Restarting Elective Surgeries after COVID-19 (Aug. 10, 2020)
Orthopedic surgeon Amit Jain and colleagues at Johns Hopkins outline strategies for hospitals to meet clinical, financial, and ethical goals when restarting elective surgeries. - Health System CEO Outlines Seven Lessons Learned from the Pandemic (July 20, 2020)
Intermountain Healthcare CEO Marc Harrison outlines lessons from the pandemic to improve patient care, including harnessing technologies like telehealth more aggressively and putting more emphasis on prevention. - How Geisinger Health System Is Transforming in Response to COVID-19 (June 11, 2020)
Geisinger executives outline post-crisis planning efforts, including improved surveillance systems to detect a possible second wave of COVID-19 infections. - Telehealth: COO Council Presentation Summary (June 9, 2020)
Council members discuss the use of telehealth in response to the COVID-19 pandemic. - Staffing Entrances: COO/CAO CouncilDiscussion Summary (June 2, 2020)
Council members discuss how they address staffing entrances to medical facilities. - On the Front Lines: Responding to the COVID-19 Crisis (June 2020)
Group Practice Journal article highlights how AMGA members responded quickly to the pandemic by delivering coordinated, high-quality, and efficient care. - Analysis: PPE Supply and Demand May Delay Reopening (May 21, 2020)
Pulse survey reveals healthcare providers still struggling to gain equipment - Resuming Elective and Non-emergent Procedures: CAO/COO Council Summary (April 30, 2020)
Council members share approaches to reopening ambulatory and surgical services as COVID-19 cases plateau and fall, including how they will ramp up, the role of virtual visits now and in the future, capacity planning, reengaging furloughed providers, testing procedures, patient communications, and post-COVID changes to how health care is delivered. - Receiving Federal Funds and Telehealth Issues: CFO Council Summary (April 22, 2020)
Council members explore questions related to federal COVID-19 funds available to medical groups and health systems and telehealth issues, including platforms and plans for use of televisits post pandemic. - Preparing for the Surge and the Recovery: CAO/COO Council Presentation (April 17, 2020)
Holzer Health System COO Todd Fowler shares how his organization is preparing for the COVID-19 surge and planning recovery, including reopening, telemedicine, ambulatory and inpatient care, population health, screening, compensation, and ramping up services. - AMGA: Physician Compensation Considerations amid the COVID-19 Pandemic (March 27, 2020)
AMGA Consulting provides practical operational responses to the impact of the virus on provider compensation and staffing, including scenarios where revisions to compensation models may be appropriate. - Operations: Protocols and best practices for addressing COVID-19 in the hospital setting (March 26, 2020)
The EvergreenHealth Hospitalist group in Washington state offers critical early lessons learned from managing many of the first COVID-19 patients hospitalized in the U.S. - Operations: Staying Open as COVID-19 Nears Peak: CEO Council Presentation Summary (March 25, 2020)
Anthony Viceroy, CEO, Westmed Medical Group, shares how his group is navigating the pandemic as it reaches peak stage in their area, including leadership, inventory management, staffing, vendor relations, employee wellness and deployment, and compensation - Operations: Shifting HR Policies During the COVID-19 Pandemic Presentation to CHRO Council (March 25, 2020)
Leaders from Crystal Run Healthcare share how they are shifting HR policies as they move to the acute hospital phase of their response, including hospital surge planning, testing, communications, employee health, staff reduction, compliance with changing laws, pay policies, credentialing, benefits, workers comp, and expenses in labor and materials. - Playbook: Expanding ICU and Medical/Surgical/Telemetry Capacity, Kaiser Permanente Northern California (March 24, 2020)
- AMGA: COVID-19: Immediate Action Steps from the Front Lines (March 20, 2020)
Members give some tips for what they are doing and what you should be doing - Operations: CAO/COO Planning for COVID-19 Presentation to CAO/COO Council (March 20, 2020)
The Polyclinic COO Anita Geving shares how her organization is dealing with screening, segregation, PPE and supply shortages, testing challenges, telehealth, and staffing and access during the onset of COVID-19 - Playbook: Viral Control Mitigation Phase, Kaiser Permanente Northern California (March 18, 2020)
- Operations: Provider Compensation Approaches to COVID-19 CFO Council Discussion Summary (March 18, 2020)
Council members share strategies for provider compensation (both salaried/guaranteed and productivity-based) as elective procedures are cancelled, departments close, and schedules are cleared during COVID-19 - Human Resources: Coronavirus Impact on HR Policies: CHRO Council Discussion Summary (March 18, 2020)
Council members share policies for pay, leave, and child care for employees affected by COVID-19 - Operations: CEO Planning for COVID-19 Presentation to CEO Council (March 17, 2020)
Sutter Health leaders share how different parts of their organization are addressing the COVID pandemic, including communications strategies and decision-making, segregating providers who have had contact with the virus and quarantine, PPE management, staff reassignment, triage, telehealth, rescheduling appointments, child care, lab backlogs, and provider compensation - Operations: New Procedures in Response to Coronavirus: CAO/COO Council Discussion Summary (March 14, 2020)
Council members share new procedures for responding to COVID-19
Patient, Provider Communications and Resources
- Advent Health:
- Atlantic Medical Group
- Health System Launches COVID-19 Recovery Center (Oct. 9, 2020)
- Atlantic Medical Group: COVID-19 Community Conversations (weekly video series)
- Banner Health: Telehealth Deployed in All Hospital COVID-19 Units (June 3, 2020)
- Baptist Medical Group: Coronavirus Resource Center
- Baystate Health: Decision Guide for Pregnant Women on Getting Vaccinated
- Baystate Health: Provider Guidance and Communication Tools
- Brigham and Women’s Physician Organization: COVID-19 Clinical Protocols
- Cleveland Clinic:
- Cleveland Clinic: Preparing for Coronavirus; Digital Health Playbook
- Cleveland Clinic, Astrotech Subsidiary Developing Rapid COVID-19 Breath Test (Oct. 21, 2020)
- Safe at Home During the Coronavirus Pandemic (Guide for Households to Protect Against COVID-19) (Aug. 18, 2020)
- COVID-19 Curbside Consults address clinical issues in managing COVID-19 patients
- Return to Work Amid COVID-19: Guide for Healthcare Providers (May 14, 2020)
- Outpatient Services Resume with New Patient, Visitor Restrictions (May 4, 2020)
- Dartmouth Hitchcock Medical Clinic: Information About COVID-19
- “D-HH is Open and Safe” videoseries on healthcare facility safety initiatives
- Esse Health: “Covid Companion” CareSignal chatbot for community education (March 23, 2020)
- The Everett Clinic: Coronavirus (COVID-19)
- Geisinger Health: Coronavirus Resource Center
- Hackensack Meridian Health: COVID-19 Clinical Protocols
- Henry Ford Health System: Coronavirus Resource Center
- Rapid Response Team tests residents, staff at 26 nursing homes
- Houston Methodist:
- IHA: Strategies for managing families during quarantine
- Inova Health System:
- COVID-19 Vaccine Information for the Community
- Motew Minute (video blog for clinicians)
- Safe@Inova Program
- Intermountain Healthcare:
- Johns Hopkins: Coronavirus Resource Center (COVID-19 Case Tracker: Interactive Map)
- Kaiser Permanente: Coronavirus and COVID-19: How to Protect Yourself and Get Care
- Mayo Clinic
- Medical College of Wisconsin: COVID-19 Resources (Facts and Infographics)
- Michigan Health: “Not Sure About the COVID-19 Vaccine?” FAQs for Patients (December 2020)
- Munson Healthcare: COVID-19 Updates for Providers
- Northwell Health: COVID-19 Infographics Gallery; Converting BiPAP Machines to Ventilators
- Norton Healthcare: Long-Term Care Clinic to Treat Patients With Lasting Side-Effects from COVID-19 (Aug. 31, 2020)
- Novant Health: Plan to resume non-emergency/time sensitive surgeries (May 4, 2020)
- RWJBarnabas Health: Training providers on conversations with COVID-19 patients’ families (Harvard Business Review, June 24, 2020)
- Spectrum Health: COVID-19 Vaccine Information Center
- Summit Medical Group: FAQs on COVID-19 Antibody Tests, Viral Tests (updated May 18, 2020)
- Summit Medical Group: In-Office Visit FAQs (May 4, 2020)
- Sutter Health: M.D.’s Open Letter, Video on Social Distancing
- Trinity Health: 3,000 iPads Deployed to Address Patient Isolation (June 4, 2020)
- UC Davis Health: FAQs for Health Professionals (April 6, 2020)
- UC Health: Clinical Practice Documents (ICU Care, Intubation and Safety)
- UC San Diego Health:
- UNC Health:
- University of Washington COVID-19 Vaccines: What You Need to Know
- UW Health: Vaccine Scheduling Dashboard
- UW Medicine: COVID-19 Resource Site (online library of COVID-19 policies and protocols)
- Vanderbilt Health: COVID-19 Vaccines: Women’s Health and Pregnancy YouTube Video (Jan. 11, 2021)
- VCU Health: COVID-19 Resources (Face-to-Face Technologies for Inpatients)
- Wake Forest Baptist Health:
Specific Guidance
- Henry Ford Health System: UV-C Light Effective in Decontaminating N-95 Masks (Sept. 22, 2020)
- AdventHealth: COVID-19 Seven Branches Clinical Management Model (New England Journal of Medicine, April 16, 2020)
- Dartmouth Hitchcock Clinic: Sewing Masks for Donations (March 20, 2020)
- Intermountain Health Care [Clinical Guidance]:
- Inpatient Care Process/High Risk Viral Outbreak Diseases (March 13, 2020)
- COVID-19 Clinical Features (March 26, 2020)
- COVID-19 GI Presentation and Guidelines (March 26, 2020)
- Diagnostic Testing: Steps for COVID-19 (March 16, 2020)
- ED/Clinical Care Process/High Risk Viral Outbreak Diseases (March 5, 2020)
- Kaiser Permanente:
- Kaiser Permanente’s System Capabilities to Suppress COVID-19 (NEJM Catalyst, June 9, 2020)
- Pandemic readiness training for LVNs/LPNs for COVID-19 Surge
- Lehigh Valley Health System:
- Lehigh Valley Network #ShaveAgainstCovid (Safe use of N-95 Masks, March 22, 2018)
- AQ: “If You or Someone in Your Family Is Sick with COVID-19” (March 18, 2020)
- Massachusetts General Hospital:
- Telehealth in Alternative Care Sites: Ensuring Patient Care and Safety in Massachusetts
- Inpatient Clinical Guidance
- Covid-19 Patient-Specific Guidelines for 14 Conditions (March 17, 2020)
- Grand Rounds Series (video series for clinicians on treatments for COVID-19)
- Michigan Medicine:
- OU Physicians/OU Medicine Clinical and Operational Guidance:
- OU Hospital Toolkit
- Ambulatory Area Flowchart, Screening Narrative
- Adult Airway Management Protocol
- Clinic Triage
- Extended use of Disposable Face Masks
- ED, Transfer Center, and OB Triage
- Guidance for COVID-19 Patients Needing Urgent Surgery
- Imaging Operational Plan for Suspected and Confirmed COVID-19
- Phone Triage
- Surgeries & Procedures: COVID-19 Case Postponement Plan
- Partners Health Care: Building Resilience in Response to COVID-19 for Healthcare Workers
- Spectrum Health: COVID-19 Health Care Professionals Resources Detailed clinical and administrative policies and protocols include updated PPE guidelines, ED workflows, and a COVID-19 return to work algorithm.
- Tulane University Medical Group:
- COVID-19 Testing Workflow (Updated April 10, 2020)
- Vanderbilt Medical Group:
- VCU Health:
Tools
- Kaiser Permanente: COVAS Tool Helps Predict Outcomes for COVID-19 Patients (Nov. 20, 2020)
- Advocate Aurora Health: COVID-19 Symptom Checker (Online patient evaluation tool)
- Atlantic Health System: Risk Assessment Tool for Patients
- MemorialCare: SilverCloud (online therapeutic program for anxiety and depression)
- Northwell Health Creates Predictive Tool for Spikes in COVID-19
- Novant Health: COVID-19 Self Assesement Tool
- Penn Highlands Physician Network: Penn Medicine Digital Tool for Hospital Capacity Planning (March 18, 2020)
If you have any contributions to share or want to suggest a topic area, please contact AMGA.