Like patients, our team members are looking to us for guidance. It’s important to identify, acknowledge, and mitigate risk for them. This tool is from a recent perspective piece in the NEJOM. it was actually targeted toward primary care, but it provides an example for objectively assessing risk in our workforce and planning safe reentry for team members who have an elevated risk for contracting COVID-19.
CVSL leaders should establish a plan for communicating with employees – be visible, be accessible, be supportive. Mitigate rumors with facts, outcomes and strategies.
With the COVID-19 pandemic causing such a dramatic impact on workforce, staffing strategies will vary among communities and regions. Creating stability in staffing is an important strategy to assure minimal disruption in service. Staffing levels must be managed to volume to manage overhead in the restart/ramp-up period. Allocating adequate resources for cleaning is an important consideration in clinical and non-clinical areas.
Policies for testing employees will vary among regions and type of facility. At a minimum employees should self-monitor and be screened daily on arrival to work. Employees with symptoms should stay home – non-punitive policies for work absence related to respiratory illness should support self-monitoring.
CDC Guidance for employees who test positive may be found here: Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 (Interim Guidance)
Consult with you local health department to determine how potential patient exposures should be handled. https://www.naccho.org/membership/lhd-directory
Policies for the level and type of PPE used for invasive cardiovascular procedures should be established and monitored by the steering committee. This may vary from community to community, with pre-pandemic policies establishing the minimum standards – an adequate volume of PPE supplies to meet normal procedural care needs without reuse.
Healthcare providers have been advised to plan for a minimum level of PPE supplies to re-enter a mitigation phase if necessary. Until advised otherwise by local and state authorities, the demand for PPE to perform scheduled CV procedures should be managed to avoid depletion that may compromise the level needed to manage a surge in local hospitals.
The CDC provides a tool to assist in planning and optimizing the use of PPE: PPE burn rate calculator.
On May 19, 2020 Association of periOperative Nurses (AORN), American Hospital Association (AHA), and Advanced Medical Technology Association (AdvaMed) issued a Joint Statement providing guidance on the re-entry of medical device representative into healthcare facilities.
The full statement and press release may be found here:
Joint Statement: Re-entry Guidance for Health Care Facilities and Medical Device Representatives
Policies may allow employees in non-clinical areas to wear cloth masks reserving surgical masks for lab and patient care areas.
Consider limiting TEE to patients in whom it will alter short term management, otherwise deferring to a later date. Given potential for false negative testing, TEE should be managed as a potential aerosol-generating procedure.