Patient Safety Considerations for Reopening Non-Urgent Care Access

Patient Safety Considerations for Reopening Non-Urgent Care Access

During the height of the healthcare industry’s COVID-19 response, healthcare organizations across the country shuttered their doors to non-urgent or elective medical care and procedures. But as the nation cautiously begins to observe a plateau of coronavirus cases, medical practices are considering the key patient safety protocol necessary to open up care access again.


Toward the end of April, the Centers for Medicare & Medicaid (CMS) issued guidance for healthcare organizations with regard to reopening their doors to non-urgent care access. The agency explained that these organizations should be in Phase 1 of the Opening Up America Again guidelines, should look at workforce and resource numbers, testing capacity, and sanitation protocol.


This announcement was met with applause from many in the medical community. Following the CMS statement, the American Hospital Association (AHA) praised the move.


“This CMS guidance is clearly focused on addressing important health care needs for non-COVID patients, with decisions being made by providers in collaboration with local and state public health leaders,” AHA President and CEO Rick Pollack said in a statement. “CMS also rightly expects hospitals and health systems to maintain the flexibility needed to quickly respond to a surge should one occur in their community, and to maintain separate caregivers and locations within a facility for non-COVID care.”


The CMS guidelines built on what AHA and partner organizations had already discussed, Pollack added. Just a few days earlier, AHA was joined by the American Society of Anesthesiologists (ASA), the American College of Surgeons (ACS), and the Association of periOperative Registered Nurses (AORN) in outlining reopening protocol.


“When the first wave of this pandemic is behind us, the pent-up patient demand for surgical and procedural care may be immense, and health care organizations, physicians and nurses must be prepared to meet this demand,” reads the joint statement.


Central to that notion will be implementing key patient safety protocol that not only puts patient wellbeing first but also makes the patient feel comfortable visiting a care facility to access healthcare.


For the groups issuing the joint statement, this effort to promote patient safety encompasses a few key areas:


  • Timeline for reopening the facility
  • Ability for COVID-19 testing within the facility
  • Establishment and enforcement of key social distancing policy, such as facility visitors and family members who may accompany the patient


Other key considerations include facility environment and cleaning schedules, patient outreach and messaging about both the availability of services and assurances for safety, and adherence to pre-COVID patient safety protocol.


Other leading trade groups are offering their patient safety recommendations, too. After all, patient safety is both a critical part of providing a quality patient experience and a moral imperative for medical professionals.


Having the ability to drive patient safety and ensure potential patients that accessing care will not be dangerous will be essential to reopening facility doors.


The American Medical Association (AMA) recently released guidance outlining best practices for previously closed facilities to reopen services.


“With some physicians beginning the process of reopening their practices, this essential resource supplies them with guidance to do so while keeping patients, staff and the general public as safe as possible from a COVID-19 resurgence,” AMA President Patrice Harris, MD, MA, said in a statement. “The AMA remains focused on ensuring the viability of physicians’ practices that have been seriously impacted by this public health crisis and will continue providing support while aggressively advocating on physicians’ and patients’ behalf.”


Harris also added the caveat that healthcare organizations should make the decision to reopen based on science, not other motivating factors. Placing the focus on science ensures that patient safety and actual clinic readiness remain top-of-mind.


To that end, the organization reiterated the four benchmarks espoused by national policymakers that mark when an organization is ready to reopen for non-urgent or elective care:


  • Minimal risk of community transmission based on sustained evidence of a downward trend in new cases and fatalities
  • A robust, coordinated and well supplied testing network
  • A public health system for surveillance and contact tracing
  • Fully resourced hospitals and health care workforce


The AMA’s patient safety tools hinge primarily on ensuring safe physical distancing, a continuation of the social distancing protocol that has been the center point of public health messaging. Organizations need to consider how many visitors patients may have, who will accompany patients visiting the facility, and how staff will maintain adequate distance during a care encounter.


This comes as medical providers also work to communicate compassionately with patients. To that end, AMA offered some scripted materials to use while screening facility visitors about potential COVID symptoms.


AMA also recommended all facilities implement a requirement for wearing masks or face coverings, a protocol for staggering appointment scheduling, creating “sick” and “well” sections in waiting areas, and restricting the number of non-patient visitors to the facility.


These recommendations come as the healthcare industry grapples with balancing both patients who do and who do not have COVID-19.


When the pandemic initially broke out, industry reaction pushed COVID-19 cases to the forefront. But the industry is beginning to adjust, and considering how to promote care access for those without the virus — while keeping all parties safe — has become a high priority.




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