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Restart Planning Guidance Update

Posted on by CATALYSIS

We are working with organizations in our healthcare community to understand the process and needs for restarting business lines in healthcare organizations as many healthcare organizations are thinking into the future. Here is the most recent guidance and thinking.

Update 04-28-20

  • How much COVID-19 space is necessary?
    • Are the expanded spaces held in reserve or put back to prior use?
    • Do you prepare the expanded spaces with things like permanent oxygen and sinks?
  • Meet with front-line staff to get ideas on
    • New huddle topics
    • Safety standards
    • Remove new processes implemented that are not adding value
    • Adjustments to staffing
  • How do you safely restart your cafeteria service?
  • How will ancillary services safely deal with COVID & non-COVID patients?
    • PT, OT, Imaging, etc.
    • Waiting areas need to be sanitized regularly
  • Communicate COVID scheduling changes with referring and admitting practices
    • Do you need a dedicated communications person/team for partners?
  • Establishing a Governance Council for decision making still harder than it seems

 

 

Update 04-27-20

  • Create a staffing plan six weeks out. Your team will need a break. Even those coming off a furlough will find stress in the new COVID-19 environment.
  • Collaboratively create a “Go/No-GO” checklist.
  • Staff are experiencing trauma and it is incumbent upon all of us to provide counseling and needed care.
  • New sanitation processes need standards.  Staff need to be trained.  Inspection is mandatory.
  • Create messaging & signage on why patient PPE is important
  • Plan the Command Center wind down.  Do not totally dismantle
  • Get back to SAFETY.  Many safety processes have been bypassed or ignored for all the right reasons.
    • Prioritize and stabilize versus solving all the problems at once.
  • Set new goals and targets.  Track and measure.  Celebrate successes
  • Closely monitor the supply chain.  Validate delivery dates and accurate received quantities. Do not let safety stocks diminish.
  • Identify skills that were in short supply during the last surge.  Create a plan to train up and expand capacity
  • Leadership get involved: What is your safety stock quantities and how were those calculated?

 

 

Restart Planning Notes 04-23-20

  • Number 1 priority: Establish a Governance Council
    • Becker’s recommend 6 P’s for the Governance Council
      • Plan (Develop one)
      • Policy (Know policy & regulations)
      • Procedure (Track backlogged procedures/visits)
      • Process (Design new processes and protocols)
      • Place/PPE (Set Place & PPE standards)
      • Patient (Engage the patient)
  • Number 2 priority: Apply for PHSSEF Grants ASAP
  • Priority 3: Restart plans have to include the fact that COVID-19 will be here for a while
  • How do you bring back furloughed staff?
    • Some may now have daycare issues trying to send their kids back
    • HR coordination necessary
    • Union seniority a consideration?
    • License/certifications current and not elapsed?
    • Training on new procedures
    • Training on COVID-19 Patient Care
  • What are the new procedures for patients?
    • Patient arrival
    • Patient waiting room distancing
    • Family/visitors
    • Recovery
    • Discharge
    • Communication plan for patients, family & staff
  • Scheduling
    • How to deal with COVID-I9 testing prior to surgery
    • How to get pre-authorizations done ahead of time
    • How to validate patients still covered by insurance (laid off?)
    • Do you have enough schedulers and phone call capability?
    • How to communicate with surgeon’s clinics
    • How to communicate new safety procedures
  • Safety
    • Intubation may require less staff around patient
      • What are the new processes/standards?
      • Will it take longer for each procedure due to new safety protocols?
    • PPE Stocks
      • COVID-19 PPE needs for patient flow will continue for ambulatory, drive-thru clinics, inpatient procedures and now outpatient procedures
      • What are your safety stock percenages?
        • How did you arrive at that? Hopefully using standard deviations
      • Built the appropriate safety stock for:
        • Current patient flows
        • New patient flows
        • A fall pandemic
      • What is your forecasted PPE usage vs your actual PPE usage each day?
        • PDSA
      • Increased PPE demand beyond historical use for outpatient procedures
        • Staff sanitizer including office staff
      • Are dominant areas appropriately sanitized for the restart?
      • Is all equipment current for calibration and certification?
      • Is a local Safety Officer necessary for the initial restart?
      • How do you communicate to patients about safety and their concerns?
      • Surgery Centers & clinics: if a patient has to be admitted, are you familiar with the hospital’s new protocols?
  • What is the plan if a “spike” or “mini-surge” occurs and you must defer again?

 

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