AMGA CAO/COO Council: Coronavirus Preparations

AMGA COVID-19 Resources
 

This summary is based on a discussion via AMGA’s CAO/COO Council listserv on March 14, 2020. For more information about the CAO/COO Council, please click here.

Question on Coronavirus Preparations: Have other organizations have taken steps already or are planning to take steps to modify their operations beyond changing the patient registration script and ensuring masks are available? If so, what are those modifications and their "triggers"?

Communication

  • Send all staff messages with the latest and greatest information.
  • Have a Pandemic Committee that meets weekly but also communicates daily via email.
  • Send a weekly email to your entire organization and implement daily calls with your clinic managers to provide updates as new information becomes available.
  • Create a forum for your managers to meet on a weekly call.
  • Create a group email for the leadership response team for staff to reach out with any questions or concerns.
  • Include a message in appointment reminders to call ahead if you have symptoms.
  • Set up a hotline for your physicians and advanced practice providers to call and get answers to COVID-19 questions. For your patients, set up a system-wide nurse triage system which patients can call and get medical advice and direction.
  • Have a toll-free line for patients and employees that can help with screening patients and directing them to your designated assessment sites, or divert patients to the Department of Health information line.

Command Center

  • Create a COVID-19 Command Center/Leadership Response Team to facilitate communications and adherence to requirements, best practices, and updates. The aim is to be responsive and to address everything needed to make sure your employees and providers are healthy, the community stays healthy and informed, and ensure business continuity to the best extent possible.
  • Set up a robust incident command structure and communicate to your leadership at all sites daily.
  • Run a command center for centralized operations.

Resources

  • Take all masks out of public areas—only a staff member can give out a mask based on normal triage.
  • Get your greeters/screeners in place as soon as you can and move to a full screen before anyone is allowed in your buildings.
  • Centralize resources on your intranet for all staff to review updates, enable work-from-home policies in a HIPAA-compliant and secure manner for those who can, and work on external communications via your website, email blasts, and social media.
  • Put masks and hand sanitizers behind locked cabinets to preserve their availability for patients and your staff and providers.

Telemedicine

  • Look at alternatives such as e-visits, phone, messaging.
  • Ramp up your telemedicine efforts and convert appropriate appointments for at-risk populations to telemedicine (phone visits for those patients that don't have a computer or handheld device).

Visitors

  • Limit all non-essential visitors—only those that are needed for cognitive or behavioral or mental health reasons are allowed to accompany the patient, or interpreters for those that cannot be done via telephonic or digital means.
  • Screen all visitors via a series of questions, and if they pass the screening, the visitor/caregiver receives a sticker to be placed on their upper body.
  • Restrict visitors and accompanying caregivers to one for adults and two parents for kids. Stop and screen patients at your doors and mask them if they have symptoms.

Additional Advice

  • Review and update your Pandemic Protocol
  • Participate in state and local calls and planning meetings.
  • Take extra time to educate your physicians and clinical staff—try to keep everyone calm.
  • Halt active outreach activities for patients 60 and older.
  • Consider designating some of your clinics as "Acute Respiratory Clinics" and shift routine visits to other nearby clinics to minimize the risk to the well patients.
  • Establish a COVID-19 triage process to help with phone congestion and wait times and to direct patients to the appropriate location.
  • Don’t let the perfect be the enemy of really good.
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