This playbook provides guidelines for health care organizations in Greater Ottumwa, such as hospitals, clinics, dentists, eye doctors and more.
The coronavirus outbreak has had direct and lasting impacts on health care organizations in the form of financial, operational and supply chain challenges. Hospitals and clinics are seeing sharp drops in regular doctor visits, emergency-room arrivals and non-emergent surgeries that are vital to most organizations' financial position. It's not just the large, urban hospital systems that are struggling. Doctors with their own independent practices in small to mid-size towns are suffering these same severe revenue cuts. Safety-net clinics, who serve the nation's poorest residents, have also been hard hit. Perhaps the most dramatic impact has been on rural health care. As the crisis drags on, health care organizations will be presented with tough choices and potential furloughs. Amid the uncertainty, initial shortages of personal protective equipment (PPE) have put health care workers at risk of infection.
Telehealth Visits Surge
The rise of telehealth has brought about increased access to health care across the country, especially in rural areas. However, addressing cybersecurity concerns will be paramount in the future. Hospitals, health care systems, providers and payors will all have to accelerate digital transformation plans. These plans will likely be contingent on a resolution to the payment issue of telemedicine and telehealth.
Non-Emergent Procedures Resume
Non-emergent procedures are resuming in all Iowa counties, assuming hospitals, ambulatory surgery centers or outpatient surgery centers can meet the requirements outlined in the Governor's proclamation. This will help reduce the level of financial loss during the pandemic. Patients scheduled for a procedure resulting in an overnight stay should be tested for COVID-19 prior to their procedure.
Mental Health Effects
Demand for mental health services will increase substantially due to the pandemic, including the health care workforce and the general population. Hospitals and other organizations must prioritize the mental health of their employees, ensuring they have the proper resources and support to continue their work effectively and safely.
Leverage Culture to Build Resilience
An organization’s ability to thrive during COVID-19 is directly related to organizational culture. COVID-19 has threatened to introduce negative elements into the organizational culture across healthcare organizations due to strains on employee physical and psychological safety and its medium- to long-term financial impacts. Leaders must leverage culture to overcome COVID-19 impacts by understanding the unique needs of groups across the organization and adapting leadership styles where required.
Health & Sanitation
- Implement a pre-appointment phone screening process for patients.
- Take temperature of patients, staff and visitors on-site.
- Require patients and visitors to wear a cloth face covering when possible.
- Take every effort to conserve PPE.
- Ensure there is an established plan for thorough cleaning and disinfection of spaces used for care.
- Regularly screen staff for COVID-19 when adequate testing capability is established.
- Provide masks and gloves for all staff.
- Provide accommodations for vulnerable populations.
- Maintain a strict visitor policy.
Process & Space Modification
- Establish COVID Care zones and screen all patients, visitors and staff for symptoms of COVID-19.
- Divide workforce into COVID-19 care and non-COVID-19 care groups to conserve PPE.
- Designate separate floors, buildings, or entrances to non-COVID-19 patients and treatment.
- Minimize time in waiting areas and ensure social distancing by spacing chairs at least six feet apart or asking patients to wait in their vehicle instead of a lobby area prior to an appointment.
- Maintain low patient volumes in waiting rooms.
- Visitors should be prohibited unless they are necessary for an aspect of patient care.
- Prepare to cease non-essential procedures in case of another surge in COVID-19 cases.
- Waive last-minute cancellation policies due to illness.
- Provide hand sanitizer throughout the building for use.
- Encourage telehealth where possible.
- Consider installing plexiglass guards for registration areas and entrance screening locations.
- Consider establishing COVID-19 urgent care clinics along with primary care clinics for preventative wellness and chronic care management.
- Establish an employee resource center to address the needs of staff, including mental health support, meals, care essentials, onsite sleeping arrangements or additional assistance of any kind.
- Encourage use of 2-1-1.
- Post signage throughout the building clearly identifying COVID-19 care zones and non-COVID-19 care zones.
- Post relevant information throughout the building in multiple languages.
- Provide relevant instructions on a website for procedures inside the health care facility.
- Provide patients with communication devices to reach family members not allowed in due to visitor policy.
- Request patients report coronavirus symptoms to your facility within the next 14 days.
- Physicians should consider verbalizing actions by scripting when delivering care.
- Consider using telehealth for virtual patient visits and hospital rounds.
- Conduct regular staff communications to ensure the organization is apprised of procedural updates and pertinent information during the COVID-19 outbreak. Provide staff with outlets to voice questions or concerns about protocols and procedures and suggest innovative ideas.
In early May, Delta Dental of Iowa Foundation announced $360,000 in grants to community health centers. To support Iowa dentists directly during the COVID-19 situation, Delta also introduced the Advance Claims Payment Program (ACPP). This program will allow dentists to receive up to 50% of their average weekly claims payment in an interest-free advance for four weeks with repayment beginning in July.
- American Dental Association Toolkit: Returning to Work
- American Medical Association COVID-19 Guide for Physicians
- American Optometric Association Guidance: Returning to Work
- CDC: Returning to Work After a Suspected or Confirmed COVID-19 Case
- Centers for Medicare and Medicaid Services Guidelines: Reopening Elective Procedure