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Getting Your Practice Up and Running Post Pandemic: The Logistics

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Five steps to moving forward

An important first step is to consult authorities such as Pennsylvania Department of Health, and the Governor’s official website, as stay-at-home orders and other mandates vary across the state. Additional information regarding businesses reopening in Pennsylvania can be found at Bringing PA Back. Once you’re clear on the facts, the following is a logical, five-step approach to bringing back inperson visits and a sense of normalcy in your office.

  1. Lay out a plan beforehand
    While everyone has a keen desire to get back to work, the American Medical Association (AMA) suggests opening your practice in increments. This allows staff to quickly identify and address any practical challenges that present themselves. Determine which visits can be conducted via telehealth, and continue those, while scheduling just a few in-person visits a day to start. Direct any administrative staff that does not need to be present, to continue working remotely. Consider bringing employees back in phases to reduce close contact, and work out a staffing plan accordingly.

    You’ll need to assess your PPE inventory, and order what you’ll need for the future. It’s best if deliveries can be completed ahead of opening so as not to interfere with patient visits and scheduling. Also, plan how you will manage staffing and cleaning if an employee or patient is diagnosed with COVID-19 and has been in the office. Decide on the parameters concerning employees who interacted with a patient diagnosed with the virus: How long should they stay out of work, and what is the protocol for bringing them back?
  2. Develop and implement proper safety measures
    By following best practice safety precautions, including the ones below from the Pennsylvania Medical Society, practices can help patients overcome their fears about interacting with the health care system. You’ll also be optimizing the safety of all those in the office – including patients.

    Pre-screen patients for possible COVID-19 symptoms
    When scheduling patients, they should be asked if they are experiencing any common symptoms of the disease such as a dry fever or cough. All patients should have their temperature checked before entering the office. If someone is having symptoms, they should be directed to a local testing site, available on the Lehigh Valley Health Network website.

    Use Personal Protective Equipment (PPE)
    Staff should be properly protected at all times. If instruction is needed in using PPE, refer to the Centers for Disease Control and Prevention guidelines.

    Universally require face coverings
     It should be a requirement for anyone who enters your practice – from patients to staff – to wear a face mask. This requirement should be communicated clearly, via phone call when appointments are made and with signage before entering. It’s also a good idea to provide education on types of face coverings that are effective. (Patients who are not sick do not need N95 masks.) Practices should be vigilant about those who have difficulty breathing when wearing a mask, such as young children or those with respiratory diseases.

    Maintain physical distancing
    • Ask patients to check in by phone or text and wait in the car until an exam room is ready.
    • Prohibit guests or visitors: Only parents of children should be in the office with the patient.
    • Schedule patients so that only a few are in the office at any one time.
    • Put away magazines, toys, coffee, or anything else that may be handled by infected patients.
    • If possible, arrange office flow so that patients enter and leave through separate doors. Modify check-out procedures to smoothly move patients in and out, with no from lingering.
    • Consider setting aside clinic hours for elderly and immunocompromised patients.
    • Separate patients with respiratory symptoms so they are not waiting among other patients.
    • Consider the strategies to prevent patients who can be seen at home via telehealth from coming to your office or facility potentially exposing themselves or others to germs.

    Implement strict sterilization procedures
     Even though highest standards of cleanliness are maintained in physicians’ offices and exam rooms, this virus has called for an extra level of due diligence in sterilization and cleaning to lower infection risk. Ensure your staff is familiar with the CDC’s Reopening Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes. For a list of disinfection products effective against coronavirus (COVID-19, also known as SARS-CoV-2), see the Environment Protection Agency list.
  3. Review patient consent forms and insurance
    Consult your medical professional liability carrier for guidance on updating or modifying your patient consent forms to reflect risk of COVID-19 exposure. Check to make sure your payer partners have extended coverage for virtual visits, so you can continue those as needed.
  4. Keep an eye out for potential supply chain issues
    With many businesses returning to pre-pandemic volumes at the same time, it’s possible that supplies will be affected. Try to plan for this ahead of time, by taking regular inventory and ordering early. Practices should have alternatives in mind for PPE as well as items such as medications, other medical supplies, cleaning materials, and paper goods. Practices should let their patients know if medications have become less available.
  5. If possible, prioritize patients who have delayed care
    It’s likely that most physicians and providers are seeing a backlog of patients who delayed elective and preventive care during the height of the pandemic. Many screenings such as mammograms and colonoscopies, as well as vaccinations, were postponed. These patients may be all coming back to the practice, wanting to resume their routine. If possible, try to prioritize these patients so that they do not fall too far behind in terms of getting the care they need.

If you need assistance with any issue related or not to COVID-19, please don’t hesitate to call a Valley Preferred Physician Advocacy Liaison:

Joe Candio, Jr.,
[email protected]
610-969-0479

Melissa Kuruts
[email protected]
610-969-0076

Michael Makela
[email protected]
610-969-0481

Wayne T. Stephens
[email protected]
610-969-0028

Sources:
https://www.advisory.com/-/media/Advisory-com/Research/PPR/Resources/2020/Practice-Recovery-
Checklist.pdf
https://www.ama-assn.org/system/files/2020-05/physican-guide-reopening-practices-covid-19.pdf
https://www.cms.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf
https://www.thedoctors.com/articles/reopening-your-practice-during-covid-19-resource-center/
https://www.ama-assn.org/delivering-care/public-health/covid-19-physician-practice-guide-reopening
https://www.pamedsoc.org/education-cme/public-health/reopening-office