PLAYBOOK CHAPTERS:
- OVERVIEW
- INVASIVE PROCEDURE CARE
- PATIENT SAFETY
- WORKFORCE SAFETY
- PATIENT FLOW
- CLINICAL PRIORITIZATION
- FACILITY
- CLINIC / VIRTUAL CARE
- PATIENT SAFETY
- WORKFORCE SAFETY
- PATIENT FLOW
- CLINICAL PRIORITIZATION
- VIRTUAL CARE
- NON-INVASIVE IMAGING CARE
- PATIENT SAFETY
- WORKFORCE SAFETY
- CLINICAL PRIORITIZATION
- FINANCES / REVENUE CYCLE
- REIMBURSEMENT / COST
- WORKFLOW
- METRICS / TOOLS
- STAFFING
- LEADERSHIP & GOVERNANCE
- GOVERNMENTAL FINANCIAL SUPPORT
- QUALITY PROGRAMS
- ORGANIZATIONAL STRUCTURE
- COMMUNICATIONS
- LEGAL / COMPLIANCE
- HUMAN RESOURCES
- EMPLOYEE SAFETY
- LEGAL / COMPLIANCE
- Overview
- Evidence
- Coverage
- CMS NSD
- MA Considerations
- Commercial/Private considerations
- Medicare co-insurance
- New and Pending Legislation
- Traditional Cardiac Rehabilitation
- Program Structure
- Billing/Reimbursement
- PBD Overview Implications
- Intensive Cardiac Rehabilitation
- Extended Evidence
- Program Structure
- Billing/Reimbursement
PREPARING YOUR CLINIC - NEW!
Patient safety and the messaging of patient safety should be top on your priority list. Patients will be looking to see how 'safe' you are with hand washing, mask wearing and communication of cleaning processes. Be transparent and they will be more comfortable.
The CDC provides free print resources, including signage, to help you communicate to patients.
MUST HAVE POLICIES
As you begin to transition your clinic operations to increased face-to-face patient visits, you will be reintroducing both patients and staff back into the office. There are several things to think about that we didn’t have to before. Management of both staff and patients that have been exposed, may have symptoms or test positive. The Centers for Disease Control and Prevention (CDC) offers up-to-date information on considerations that you need to work into policies and standards for your practice to keep everyone safe. This resource offers specifics for healthcare worker exposure and return to work recommendations. In addition, we will be reviewing patient screening practices and you need a plan for when the patient screens ‘in’ and needs further evaluation for possible COVID symptoms. Developing policies will provide your team with expectations and protection to assure that all are following appropriate standards.
COVID-19 SCREENING POLICIES
Another necessary policy is a screening policy for both patients and staff. The CDC keeps an up-to-date set of guidelines for you to reference.
COVID-19 PPE AND CLEANING POLICY
The cleaning policy is also important. For non-COVID patients and routine cleaning the CDC recommends the following:
In addition, you need to be aware of additional cleaning required for a COVID-suspected patient or a COVID+ patient. A great best practice is for the COVID+ patients that you saw in the hospital that now need face-to-face follow-up to schedule as the last appointment of the day allowing you to terminally clean the exam room.
After patients leave, clean frequently touched surfaces using EPA-registered disinfectants—counters, beds, seating.
NON-COVID CARE ZONES
Developing a non-COVID Care Zone (NCC) is another great best practice. Understanding the potential 'mix' of patients in all your care areas will be important to best understand how to set up flow. One program developed a 'one way' flow that allows for no crossing of people. If you are part of a hospital using a shared hospital entrance, you will have additional considerations in managing the flow and limiting the patients and visits that come into your office.
For your imaging areas that may provide both inpatient and outpatient care, developing designated rooms and developing a plan to limit any mixing of patient populations will be needed.
PATIENT FLOW CONSIDERATIONS
As you look to expand patient volumes coming through your clinics, you need to review your patient flow and each area where patients have touchpoints with staff and/or other patients. Review all tasks for each touchpoint and decide what portions can be performed virtually versus what requires patient/staff interaction. Any function that can be provided in a pre-visit phone call or portal usage should be managed virtually.
PATIENT SCHEDULING CONSIDERATIONS
As you look to build back your clinic patient volumes, you will need to review your clinic’s space capacity in regards to the 6 foot rule. You may need to extend hours in order to limit number of providers in the clinic space at a time. And don’t forget about staff and workspaces. They will also need to be practicing social distancing.
SCREENING QUESTIONNAIRE EXAMPLE
Check with your local infectious disease policies or with your COVID team on specifics for your area. If you do not have access to these types of local policies, here is an example of a screening questionnaire provided by ASNC. It is important to outline what needs to be done if a patient screens positive.
In addition, the CDC provides helpful guidance on preparing your clinic.
PERSON UNDER INVESTIGATION IN THE CLINIC
If patient answers ‘yes’ to any of the questions or has a fever:
PERSON UNDER INVESTIGATION ON THE PHONE
If patient answers 'yes' to any of the questions or has a fever:
PATIENT SAFETY STEPS
Keeping patients safe is also critical. The CDC provides steps for both pre-arrival and at arrival.
