The last two months have taken us a wild, scary ride, and all the while, healthcare professionals have stayed the course, continuing their hard work to help patients and take care of our neighbors and communities.
As a new era begins and states begin to relax their COVID-19 quarantine measures, hospitals and clinics are looking ahead to what comes next. With elective procedures coming back online in many areas, imaging and surgery departments will soon be welcoming patients back in for procedures, screenings and other non-urgent exams.
Patients will undoubtedly experience a very different care environment from the pre-COVID world. We’ve been consulting with a variety of facilities about their reopening plans, and those conversations have informed some potential best practices that all healthcare leaders will want to keep in mind.
Here are a few things to think about as your facility comes back online.
You already know this by now, but on the heels of possibly the largest health crisis the country has ever confronted, infection control is more important than ever.
As you prepare to open your doors for routine imaging scans that have been put off in recent months, your team will need to formulate new policies for proper disinfection of equipment. While these policies previously existed, they deserve to be carefully re-analyzed. For example, you’ll need to consider air exchange rates, EPA-approved disinfectants and adding 30- to 60-minute windows in between exams for proper cleaning—all of which impact staffing and workflow.
Other solutions that go a long way toward infection control: imaging patients with portable equipment in separate, isolated rooms; installing plexiglass barriers between staff and patients where possible (at check-in, the pharmacy, etc.); continuing virtual meetings; and adding new hand sanitizer stations.
We recently released a resource dedicated to exploring the many ways imaging professionals can help ensure the cleanliness of their equipment and the room where the screenings take place. Check it out for more hints on how you can protect your team and facility from the further spread of COVID-19.
Supply Chain Concerns, PPE & Rapid Testing
Pressure on your supply chain is likely to increase as you prioritize safety while coming back online. Not only do techs and patient-facing employees need to wear masks, gloves, etc., most facilities are mandating Personal Protective Equipment usage throughout the entire organization. This is not only a safety requirement, but even the perception of inadequate PPE supply could be a potential public relations nightmare.
You’re likely having patients fill out pre-exam questionnaires designed to identify if they’re symptomatic or have been potentially exposed to COVID-19. In addition, some patients must submit to COVID-19 tests 72 hours in advance of certain procedures, and then either a rapid test the day of or a temperature check (which also applies to your team), and wearing PPE themselves.
How do you decide which patients should come back first? Some organizations are creating an internal task force or governance council dedicated to this very cause. Ask your physicians or referring providers for feedback on what is most essential based on acuity. Make sure that Supply Chain is at the table so that you can effectively deploy resources where they’re needed most. If you utilized your EHR to note cancellations with specific reasons, such as COVID, you should be able to pull that data and start from this list.
Consider Separate Outpatient Facilities for Non-COVID Patients
An additional way to prevent infection is to host imaging procedures in outpatient locations away from the hospital. By concentrating and sequestering imaging volume in a separate department or facility, you eliminate one of the biggest threats to safety.
For larger health systems with numerous outpatient facilities to choose from, a best practice is to assign each facility to different types of patients, such as by procedure type or level of acuity. Routine screenings ought to take place in one outpatient area while potential COVID-19 cases can take place at the hospital or elsewhere. Only as a last resort should a facility alternate scans and equipment between both patient populations.
For hospitals or imaging centers that don’t have the benefit of separate outpatient locations, consider partnering with a mobile imaging company to set up a temporary solution for certain modalities or exams. It won’t be as big of a bolster to revenue, but it would help to retain those patients. You could also consider the installation of a modular building on your campus, where you can add or move equipment there to scan patients without fear of cross-contamination.
The creation of an office-based facility is another consideration, although it will take time and thus won’t address the immediate situation. However, with the possibility of a second wave, we’re predicting that the new normal may require healthcare organizations to bring additional facilities on- and off-line to deal with fluctuations in demand as we experience the peaks and valleys of re-infection. Building an office-based lab can help in that regard.
Communicating to Patients…
Not only do you need to significantly bolster your infection control plans, you also must spend equal, if not more energy, explaining these new processes to patients.
You’ll need to communicate your plans and other COVID-related education in a variety of formats well in advance of exam day to explain changes in protocols. A patient may not understand, for instance, why their spouse or child can’t come into the building or waiting area. You’ll need signage that starts before patients even turn into the parking lot, as well as digital information sheets dedicated to your new policies and the “why” behind them. You’ll need to train your frontline personnel on how to communicate these guidelines to patients too.
It’s not just in and around your facility where you’ll need educational materials. Your entire external marketing effort will look different. Right now, we’re seeing a lot of inspirational and educational types of messages from providers, and with good reason. But as society returns to the routine medical care patients rely upon, that messaging will need to cede ground to, or at least co-exist with, communications centered on safety.
Patients will likely be reluctant to reschedule, say, their annual mammogram if they’re worried about the risk of COVID-19. Your marketing will have to carry a lot of weight in reassuring patients that they’re safe when they come to your facility for an exam. Across all media, from traditional outlets like radio and billboard advertising to digital platforms like social media and your website, you’ll need to emphasize your new infection control procedures and your dedication to patient safety.
…Without Leaving Providers Out of the Equation
It’s not just patients who need to hear this message. Providers also need to know the emphasis you’ve placed on safety and that their patients are in good hands before they start referring people your way for scans. You should be sending daily digital resources—or even mailing posters and other stand-out material—to these providers in order to get your safety messages to them as well.
This is also smart because we can’t assume that referring physicians will automatically know imaging centers are back online in the area. Your communication needs to happen early on, and it needs to be steady so that you don’t lose patient volume as you adjust to the new flow of patients.
In addition to physicians, take stock of the various partners that promote your services and send patients your way. From community centers to local non-profits, even the hospital foundation, make sure you are including them as recipients of your ramped-up communication efforts.
Be Prepared for a Surge in Demand…and a Slow Trickle of Patients
There’s a lot of pent-up demand for routine and advanced imaging care. People have put off elective procedures during the lockdown, but those scans still need to take place. In many instances, the need is even greater precisely because the screening was put off for longer than was ideal.
However, just because the economy is opening back up, that doesn’t automatically mean consumers are on board, and the same may hold true for imaging and surgery providers. You could be ready to reignite routine or elective care, but patients might not be.
How do you reconcile these two extremes? It’s not an ideal situation, but you do have options. If you’re planning to reopen soon, now is the time to reach out to providers and patients and actually schedule future appointments. The physician relationship is critical to preserve, so take extra care to be flexible with your referring providers’ requests and accommodating of their offices’ plans. It may mean you’re using several processes simultaneously, such as different grading systems to prioritize patients. Fill out scheduling blocks, again keeping in mind that a routine scan might take twice as long with the additional infection control procedures in place.
To alleviate the fears of reluctant patients, have messaging and a script ready to go explaining the new steps you’re taking to protect them. Don’t forget to re-check pre-authorizations, offer self-pay options when applicable and implement COVID questionnaires.
In this way, you can fill in your schedule and see whether your facility is about to experience a boom or a more gradual increase in demand. Dealing with each will necessarily have different solutions.
If your patients do in fact rush back, you might consider expanding hours, hiring additional staff or, if you’re a larger health system, reallocating staff from other locations (something particularly appealing as the demand for COVID-19 treatment subsides). Remote workforce solutions and even remote scanning can help alleviate some of the staffing burden too, ensuring you have imaging capabilities in place when members of your clinical team are unavailable. If your radiologists’ time is in short supply, consider partnering with a telerad company for short-term remote read services to handle the surge. This and other telehealth services have the added benefit of further reducing exposure.
If, however, demand is lower than normal, you’ll have to double down on the communications tactics mentioned above. Marketing to patients and referring providers becomes even more important, and you may need to consider allocating more budget to outreach than you’ve been accustomed to in the past. You could also consider new platforms you previously haven’t branched out to. For example, if you’ve never had much of a social media presence, now might be the time to get one.
The New Normal?
This is uncharted territory for all of us. But that doesn’t mean we can’t be prepared for what’s to come.
By putting the focus on patient and staff safety, communicating that message to the outside world, and then doing the proactive planning work necessary to gauge future trends and allocate resources accordingly, your organization can begin the long and winding process to something resembling normal operations.
Questions? Comments? Reach out to us at any time, or leave your own tips and feedback in the comments. And, as always, stay safe.