Safe resumption of ambulatory care is a key priority for supporting the US health care system’s capacity to manage and recover from the COVID-19 pandemic. ACP has published clinical and public policy guidance on “Partial Resumption of Economic, Health Care and Other Activities While Mitigating COVID-19 Risk and Expanding System Capacity.” This guidance provides a series of recommendations based on best available evidence. The ACP guidance supports rapid expansion of health system capacity to diagnose, test, treat, conduct contact tracing, and conduct other essential public health functions, while doing so in a manner that mitigates risk by slowing and reducing the spread of COVID-19 and its associated harm to patients.
The following practical resources support ACP guidance on resumption of health care activities. They are designed to help ambulatory practices resume care in the face of clinical uncertainty, limited evidence, and functional limitations (e.g., PPE availability). These resources were also developed in response to feedback received from ACP members and general internal medicine leaders regarding their needs and priorities for clinical re-opening.
- Innovative Staffing Models. Implementing innovative staffing models will be key for your practice’s COVID-19 recovery plan. Innovative staffing models help to ensure the safety of your office staff, offer flexible options for your staff in the time of a pandemic, help to identify core functions that can be done in the office versus remotely, and help you to prepare in the event of staff shortages due to staff or family member illness. The following resource is available to help you get started with creating a new staffing model for your practice
- Workflow Modifications to Ensure Patient and Clinician Safety. Workflows and procedures should be evaluated for needed modifications to ensure the safety of patients and office staff by limiting contact and physical interactions between clinical and office staff and patients. Workflows should also maximize the value of the in-person visit. Within this resource, practical suggestions for adjusting your office workflow to ensure patient and clinician safety include:
- Patient Scheduling Considerations
- Check-in and Rooming Procedures Considerations
- How to Maximize the Value of the in-person Visit
- Integrating Telemedicine into your Practice Workflow
- Optimizing Telehealth During Recovery From Coronavirus. The following ACP information sheet provides general practical tips for medical practices considering video visits, telephone visits, and remote patient monitoring. It also provides a checklist of actions to take to adapt your practice work flow to integrate Telehealth.
- Preparing Your Office for Re-Opening – Ambulatory Infection Control Checklist. Your practice will need to implement infection control procedures to reduce risk of transmission from known or suspected COVID patients as well as asymptomatic or pre-symptomatic carriers. The following checklist is designed to help your practice reduce risk and guard the safety of your patients and clinical and office staff.
- COVID-19 Testing Strategy for Practices. Developing a strategy for COVID-19 testing is critical to re-opening your practice. While availability of testing varies, it is important to have a testing plan in place. This resource provides practical tips to help your practice develop an approach to COVID-19 testing, including:
- Coordinating Community Testing for COVID-19
- COVID-19 Testing in Your Practice
- COVID-19 Testing Criteria
- Team-based Care and Flexible, Adaptable Leadership. Effective team-based care and leadership support is critical to helping your practice manage the unprecedented challenges of the COVID-19 pandemic. Leadership and clinical teams must work together and communicate effectively in order to keep up-to-date with evolving information, to implement new safety protocols, and to work closely with local and state public health departments in managing COVID-19 response. This resource provides a menu of recommendations to help you develop a plan for effective team-based communication and leadership in your practice.
Resources for Communicating With Patients
- Template for practice communication to patients about reopening or resuming care. The communication template below is available for practices to personalize into a communication with their patients about office re-opening plans. Practices are encouraged to download this template, modify it based on your specific practice protocols and procedures, and share it with patients via email, electronic patient portal, or printed letter. The template includes:
- What the practice is doing to keep patients safe
- Information on scheduling in person and/or virtual visits
- Protocols being implemented to reduce risk of infection
- FAQs for patients on seeking non-COVID care during the pandemic. This document is designed for physicians to share with their patients. It addresses common questions regarding seeking non-COVID care during the pandemic, explains the importance of resuming care, clarifies differences between in-person versus telemedicine visits, addresses safety precautions, and answers other personal and logistical concerns patients may have about seeking care at this time.
- Infographic on where and when to seek non-COVID care during the pandemic. This infographic provides color-coded and simplified guidance for patients regarding where and when to seek non-COVID care during the pandemic.