Reopening Healthcare & Safe Environments for Non-COVID-19 Patient Care

By Gigi Acevedo-Parker and Jim Burke

While it’s challenging to think beyond coronavirus case numbers and death counts, there’s more to healthcare than emergency rooms and respirators. The non-emergent, non-COVID-related aspects of care in hospitals and other settings shouldn’t stay in a holding pattern forever while the pandemic runs its course.

That’s even more apparent given the unnecessary tragedies that have resulted from people neglecting their own care due to fear of the environment. It’s led various organizations to strategize best practices for reopening healthcare beyond COVID-related care. There’s a long list of considerations – from securing/modifying environments to keeping people safe – and there are variations according to setting – a hospital or senior care center or more, and if urban, suburban or rural. Here’s an overview of some key points:

General considerations for resuming non-emergent, non-COVID clinical care (NCC):

• Maintain the capacity to manage potential surges in COVID-19 patients.
• Account for the fluctuating availability of clinicians.
• Determine if care is really necessary and prioritize most necessary for at-risk populations.
• Establish patient and clinical staff screening processes.
• Perform viral testing 24 hours prior to procedures or admission or require a patient self-isolate for 14 days beforehand.
• Report test results following state guidelines.
• Use N95 respiratory masks within the context of an OSHA respiratory protection program, including medical exams and fitness training, and for any procedures involving mucous membranes or the respiratory tract. They must meet CDC guidelines for extended use.

Guidelines for keeping people safe during reopening:

• Patient considerations: The motivating factor is ensuring that patients (residents or clients) don’t inadvertently contract COVID-19 – and that a quality patient experience is consistently delivered.
• Manage your reopening checklist. Start with timelines for reopening various services and specialties, and ensuring COVID-19 testing capabilities are set up. Nurse staffing ratios need to be planned out given the impact on patient safety.
• In-person care protocols. Design a safety-first routine for in-person appointments, where patients wait in their cars until they are notified via phone and granted access to the office/building. Access points should be limited and monitored. Once inside, the patient is screened for COVID19; and social distancing protocols are followed.
• High-risk patients. Provide these individuals with a care plan that shares specific information on accessing urgent care, provides remote care options for non-urgent needs when possible, and limits surgical procedures.
• Safety for employees: Refresh your pre-COVID-19 protocols, but don’t forget that the coronavirus hasn’t gone away.
• Basic safety measures. Pay attention to the engineering controls necessary for safety hazards in the healthcare environment (like better exhaust systems or warning signs). But administrative controls, work practices and PPE must also be moved back to the front burners. Many of these basics (and education and training around them) may have been relaxed with the pandemic, but as we move back to more normal circumstances, everything’s back on the table again. That includes adherence to OSHA regulations.
• COVID-19 safety basics. These measures are as relevant today as they were in March, but must continuously be reinforced among all staff. They include: social distancing, regular hand washing, regular/enhanced cleaning and sanitizing of exposed and especially high traffic areas, and face coverings.

Reopening considerations for property, facilities and the “environment of care”:

An expansive checklist of stakeholder interests, staffing considerations, space modifications, maintenance strategies and more must be tended to in order to return space to normal. Among the aspects to look at:

• Are the facilities in the right condition to accept patients?
• If modifications were made for patient safety during COVID-19, are the measures up to regulatory requirements on issues like access that may have been temporarily suspended?
• If HVAC systems or water towers were shut down and are now restarting, do you need to schedule thorough examinations and treatments, if necessary, for microbial hazards?
• Have you communicated post COVID-19 safety rules to employees and patients, including face-masks, hand-washing, and enhanced cleaning/sanitizing?
• Do you have social distancing floor plans for NCC patient waiting and screening areas?

HUB International’s team of healthcare experts is ready to help your practice assess its risks and liabilities in today’s environment, especially while opening healthcare facilities to non-COVID patients.

Get the latest information, guidance and resources on Coronavirus (COVID-19) to help you protect what matters most on our Coronavirus Resource Center.