The COVID-19 pandemic has forced the healthcare industry to confront extraordinary challenges. Healthcare providers have endured shortages in medical supplies, protective equipment, and market instability.
Amid the crisis, however, strong public health measures, physical distancing, and transitioning to online services has provided reassurance that the COVID-19 curve may be flattening as the number of new cases has decreased and the number of patients that are hospitalized has stabilized. These challenges and changes have ushered in a new era for the healthcare industry, including the transition to hybrid in-person and digital health practice models.
As we continue to move toward the transition of healthcare from pre to post-COVID-19, certain provisions can ensure the safety, efficiency, and effectiveness in healthcare delivery models.
Operations, Communication, and Security
Governments and health systems should collaborate in a coordinated and effective method of hospital utilization. They could designate select hospitals as COVID-19-only specialty care facilities. These facilities will ensure properly trained staff, adequate PPE, expertise in treating complex patients, and proper ICU capacity for patients. This allows other hospitals to continue ongoing services to non-COVID-19 patients without risking transmission.
Healthcare practices should maintain emergency management plans for practice operations that could include pandemic coordinators, risk communications, essential functions, delegation of authority, human resources, essential records management, testing and training, and reconstitution planning. They may choose to implement shift work to minimize cross-contamination of teams. In the event a staff member gets sick, contact tracing and active testing may become the new norm.
Practices should have continued access to communication via remote access to servers, email systems and/or HIPAA secure and cost-effective cloud options. Access to critical information such as CDC updates is essential.
Appointments
Providers should institute a protocol for telemedicine to reduce the risk of infection. Telemedicine appointments can include chronic care management, primary care, mental health, post-hospital discharge and post-op follow up. Patients can also utilize online patient portals for billing and co-pays. Providers should emphasize that non-urgent care be obtained through telemedicine or rescheduled for a later time following local and state guidelines. Offices should remain open for emergent needs and in-office procedures, while maintaining appropriate spacing of in-person appointments. Patients should have the option to self-check-in via a tablet or by phone and can be advised to wait in the parking area.
Physical Distancing
Continued physical distancing post-COVID is crucial to safe operations. Only patients should be allowed inside the practice. Family members, friends, and children should be restricted except in extenuating circumstances. Practices should tape off distances of six feet per CDC guidelines in waiting areas.
Hygiene Protocols
Protocols for proper hand hygiene, PPE, and sanitizing equipment should be a priority. Hand sanitizer use should be required of all patients and visitors; signage for proper hand hygiene in all restrooms. “Sneeze guards” should be installed on all diagnostic equipment that requires close contact. Proper protective wear should be available to all physicians and staff. Practices should initiate frequent, thorough disinfection of medical office and equipment.
Expansion of COVID-19 Testing
As COVID-19 diagnostic testing capabilities expand, appropriate use of testing, ideally at the point of care, should be incorporated into pre-admission requirements prior to surgery and procedures.
Timely screening of healthcare personnel with known exposure risk should be implemented in human resources guidelines. As more knowledge is gleaned regarding antibody testing for potential immunity to COVID-19, this modality could be incorporated to position personnel at lower risk of infection appropriately in critical care environments.
Summary
Government and healthcare collaboration is critical to the functioning of healthcare practices. Protocols geared toward operations, appointments, physical distancing, and hygiene and workflows that incorporate advances in COVID-19 testing can help practices transition to a “new normal” in the post-COVID era. These guidelines can help ensure the safety of patients, physicians, and healthcare personnel and allow for effective and efficient healthcare delivery.