Patient Management | Practice Reopening What steps should be in place for patient arrival in order to prepare for the reopening of the practice? Consider establishing Non-COVID Care (NCC) zones to screen all patients for symptoms of COVID-19, including temperature checks. Require patients to complete Pre-screening COVID-19 Tool. Routinely screen staff and others (physicians, nurses, housekeeping, delivery, and all persons who will enter the area). Review and prepare for what to do if COVID-19 exposures occur. Review CDC recommendations for minimizing chance for exposures and using universal source control. Consider using the following COVID-19 consents when appropriate: In-Office Visit During COVID Patient Authorization & Consent Surgery During COVID Patient Authorization & Consent Radiology Visit During COVID Patient Authorization & Consent Use extra precautions for people who are at high risk, such as scheduling them for visits at specific times (early morning) separate from sick patients (especially if screen positive for COVID-19) exposures. High-risk individuals include: Older adults People with asthma People with HIV People who are at risk for severe illness Plan for steps if staffing is reduced due to resurgence of COVID-19 exposures. Establish administrative and engineering controls to facilitate social distancing. For example, minimize time in waiting areas, space chairs at least six feet apart, and maintain low patient volumes. Consider using strategies to separate well visits from sick visits (e.g., schedule well visits in the morning and sick visits in afternoon). If possible, separate patients, such as sick in one area and well in another area. Consider having patients check-in using their phone once they arrive in parking lot, waiting until notified by practice by calling or texting when ready for them to come in the office. Ensure there is an established plan for thorough cleaning and disinfection prior to using spaces or facilities for patients with non-COVID-19 care needs using an EPA-approved disinfectant. Provide hand sanitizer, if available, at entrances and exits. Healthcare providers and staff should wear surgical face masks at all times. Staff involved in procedures on the mucous membranes, including the respiratory tract, with a higher risk of aerosol transmission should utilize appropriate respiratory protection such as N95 masks and face shields. Inform patients to wear a cloth face covering that can be purchased (surgical mask) or homemade if they do not possess a surgical mask. The practice should have supply of surgical masks available for patients who present without face covering. Implement a paperless check-in system that patients can complete before arrival. Avoid the use of shared pens/clipboards. Consider a virtual check-in process prior to visit occurring, such as having patients call or go online to confirm their visit, update information prior to arriving, and receive any instructions. Have patients call using a cell phone on arrival while still in car to check in and receive instructions. Use this customizable letter template to help address any patient concerns surrounding new safety guidelines implemented by the practice during the COVID crisis. Resources https://www.ascassociation.org/resourcecenter/latestnewsresourcecenter/covid-19-cms-recommendations-for-reopening http:sambahq.org/wp-content/uploads/2020/04/SAMBA-Return-of-ambulatory-care-guidance-Final-version-with-logos-2.pdf https://www.cdc.gov/infectioncontrol/tools/index.html#anchor_1551975023 https://www.facs.org/media/press-releases/2020/resuming-surgery-041720 https://www.cdc.gov/coronavirus/2019-ncov/hcp/steps-to-prepare.html https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html https://www.eeoc.gov/newsroom/eeoc-issues-updated-covid-19-technical-assistance-publication-addressing-antibody-testing In-Office Visit During COVID Patient Authorization & Consent Surgery During COVID Patient Authorization & Consent Radiology Visit During COVID Patient Authorization & Consent SHARE News & Knowledge All Curi recommendations are based on current CDC criteria at the time of publication. CDC guidance for SARS-CoV-2 infection may, or may not, be adopted by state and local health departments to respond to rapidly changing local circumstances. Providers should always check with their local health department to see if the CDC’s guidance on any given topic has been modified (particularly if more restrictive) from the CDC’s recommended guidelines. Follow this link https://www.cdc.gov/publichealthgateway/healthdirectories/index.html for contact information to your state/local health department. If local recommendations vary from those of the CDC, and you are unsure what recommendations to follow, then it is safer to follow the more restrictive guidelines/recommendations.