As the COVID-19 pandemic forced widespread adoption of social distancing and shelter-at-home norms, it has also heightened public anxiety about visiting healthcare facilities. An American College of Emergency Physicians poll found that 70% of consumers say they are very or somewhat concerned about contracting the coronavirus if they go to facilities to receive care for issues not related to COVID-19, and 29% of U.S. adults said they have delayed or avoided seeking medical care, citing fears of exposure to the virus.
Worry is increasing among healthcare professionals about patient fears keeping even people with serious medical issues from seeking care. According to a Gallup poll, people with serious medical conditions such as diabetes, heart disease, and hypertension express especially high concern—80% or more say they are “very concerned” or “moderately concerned”—about their risk of COVID-19 exposure at medical offices.
This anxiety is not limited to hospital and emergency department visits, but is impacting outpatient care as well. Outpatient visits were down 60% from mid-March to mid-April according to research from Harvard University and healthcare technology company Phreesia.
The statistics are daunting, so what will it take to make patients feel safe and comfortable again?
While much of this outpatient visit decline is attributable to cancellations and deferments of elective procedures and preventative visits, facilities resuming services need to start immediately amplifying awareness of the precautions they are taking to reassure patients and keep them safe. Education and transparency will be key to easing patient anxiety and reconnecting them with the care they need.
Outpatient care facilities will need to tailor internal and external communication around the steps they are taking to safeguard patients and staff. This messaging should focus on the wide range of safety measures they are implementing to deliver the highest quality of care in the safest possible environment. For example, healthcare system Health First is taking measures that include everything from limiting visitors, to increasing adoption of virtual services, to universal masking policies.
Outpatient facilities should also ramp up education efforts around the extensive disinfection protocols they follow to safeguard patients and staff. In high-traffic areas such as waiting rooms, protocols should include having all employees wear Personal Protective Equipment (PPE), ensuring the area is adequately ventilated, high-touch surfaces such as door handles, armchairs and counters are regularly sanitized, and hazard signs are displayed.
A typical cleaning process begins with a seven-step standard operating procedure to ensure high-quality cleaning and disinfecting. However, during times when a contagious virus such as COVID-19 is prevalent, standards are increased to conduct what is called a terminal clean.
The terminal clean process is conducted in addition to standard cleaning and is carried out every night when facilities are closed. The meticulous procedure looks like this:
- Thoroughly wash and disinfect all partitions, walls, light switches, doors and doorknobs.
- Dust and disinfect X-ray view box
- Dust and disinfect light source box
- Wipe, disinfect Suction Regulator System
- Wipe and disinfect AC vents (exterior)
- Wipe and disinfect light fixtures
- Empty and disinfect trash containers, and replace liners
- Wash and disinfect the kick bucket and the rolling stand – inside and outside
- Empty, wipe and disinfect linen hampers – replace liners
- Wipe and disinfect rolling chairs and stools
- Wipe and disinfect chair rails
- Wipe and disinfect overhead lights and arms
- Wipe and disinfect step stools
- Wipe and disinfect mayo stands
- Thoroughly wipe and disinfect exam tables
- Dust and disinfect electrosurgical generator
- Wipe and disinfect IV poles
- Dust X-ray equipment
- Wipe and disinfect countertop and computers at the nurse and doctor area
- Wipe and disinfect supply cabinets
- Remove iodine stains on floor surfaces
- Dust mop and wet mop floor surface(s) using a disinfecting solution
Outpatient facilities should also highlight other efforts they are implementing to ensure patient safety. Measures that help with safety and can reassure patients might include screening visitors for temperature and symptoms before entering, removing magazines and toys from waiting rooms, and redesigning waiting rooms to comply with social distancing. Facilities can also give patients the option to wait in their car and text them when an exam room is ready.
As “Opening Up America Again” guidelines allow outpatient facilities to resume services, addressing patient fears and making them feel safe will be a significant challenge. Healthcare professionals can and should reassure patients by educating them about the sanitizing, disinfecting and sterilization processes that have been and always will be among the core competencies for their daily routines.
These educational efforts will help instill the confidence needed to reduce fears of visiting healthcare facilities during and after this unprecedented crisis. Educating patients and their loved ones about safety procedures and policies will also be critical to getting patients scheduled for necessary procedures that were previously delayed.
The safety measures care providers have put in place are extensive – and it is important patients know that. Making the public aware of these and the many other ways facilities work to provide safe, accessible care can help ease fears and reconnect patients to healthcare.