While the Coronavirus Disease 2019 (COVID-19) has created a lot of disruptions and uncertainty, we at Integrated Oncology Network want to reassure you that we are carefully monitoring and assessing the situation. Please know that our top priority is to ensure the health and safety of our team members and the communities they serve.
As more information becomes available, we will be sure to communicate important updates to our team members as it pertains to necessary precautions or potential changes in day-to-day operations. While we continue offering our help and service to those in need during this time, please exercise caution and contact your leader if you have any questions or concerns.
Below are recent updates and key items/resources to keep in mind to ensure your safety as well as the safety of those around you:
CMS expands telemedicine benefits to Medicare patients – announced Wednesday, March 25.
- Our teams are now scheduling qualifying patients for telemedicine so they will not have to travel to the center.
- Each physician should have received an email with specific details.
Key changes to the CDC Interim Infection Prevention and Control Recommendations for patients with suspected or confirmed COVID-19 in healthcare settings:
- Increased emphasis on early identification and implementation of source control.
- Screen patients ahead of time if possible for symptoms (fever, cough, difficulty breathing), travel history particularly to an area of widespread ongoing transmission, or close/direct contact with a person with confirmed COVID-19 infection – as you are currently doing today.
- Put a face mask on patients presenting symptoms of respiratory infection.
- Masks need to only be worn by patients who present respiratory infections, fever, etc. – unless directed by your center’s physician and/or leadership team.
- Updated PPE recommendations for the care of patients with known or suspected COVID-19:
- Eye protection, gown and gloves continue to be recommended (if there are shortages of gowns, they should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of healthcare personnel).
With our screening procedure, we should be able to catch any suspected positive patients who will then be directed to the emergency room and/or health department.
Key Items to Keep In Mind
Best Practice Ideas:
- Ask patients the symptoms / travel / close contact questions prior to them coming to the center for their appointment.
- Have patients wait in their vehicle until their appointment time and have a team member escort them to the designated patient area to avoid contact with other patients, team members and minimize high-touch surfaces. Have them fill out necessary paperwork during this time.
- Remove magazines, books, puzzles and other shared items from waiting rooms to avoid spread of germs.
- Remove waiting room coffee pots / water dispensers or limit the access to team members only to obtain beverages for the patients.
- Alternate/rotate or stagger team members where possible – team members can share on-site responsibilities but not all members would need to be on site every day. Re-evaluate on a weekly basis and if one method does not work, try another.
Keen initial intake/screening must be done on each patient and any family member or support person ahead of time and again upon entry to the facility.
- Assess for fever, cough or acute respiratory symptoms.
- Obtain a detailed travel history with key emphasis on out of country travel, particularly to an area of widespread ongoing transmission.
- Ask about close/direct contact with a person with confirmed COVID-19 infection.
- Patients with suspected COVID-19 symptoms will need to be rescheduled until they receive test results, unless it is a life threatening circumstance.
- For patient/family member or support person with these symptoms already at the facility, please ask them to wear a face mask as soon as they are identified.
- Quarantine and implement airborne infection control.
- If COVID-19 is considered, notify the patient’s physician, your local health department and your leader.
- A directory of local health departments can be found on the National Association of County and City Health Officials website.
Practice good hygiene to protect yourself and others from the virus.
- Wash your hands often with soap and water for at least 20 seconds (sing the “ABC” song until the very end!).
- Ensure gel sanitizers are in the lobbies and throughout the center.
- Use hand sanitizer with 60% or more alcohol until you can wash your hands with soap and water.
- Avoid touching your eyes, nose and mouth without washing your hands first.
- Be as healthy as you can. Get plenty of sleep, eat healthy, exercise, and manage your stress.
- Eliminate/minimize contact from handshakes and hugs – use the “elbow bump.”
- Have masks, gloves and protective eye wear readily available.
- Be conscious of inventory and usage of masks, gloves and protective eye wear. All of these items are currently on backorder with many vendors.
- Strategies for optimizing the supply of PPE can be found on the CDC website.
- NOTE: The CDC does NOT recommend that people who are well wear a face mask to protect themselves from respiratory illnesses, including COVID-19. A face mask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected.
PPE – how to don and remove them:
- Instructions for donning PPE can be found here: CDC recommended sequences for donning and doffing of PPE.
- It is important for Health Care Providers (HCP) to perform hand hygiene before and after removing PPE. Hand hygiene should be performed by using alcohol-based hand sanitizer that contains 60-95% alcohol or washing hands with soap and water for at least 20 seconds. If hands are visibly soiled, soap and water should be used before returning to alcohol-based hand sanitizer.
- “HIGH TOUCH” surfaces should be disinfected frequently/after every patient (door knobs, light switches, treatment chairs and tables, etc.).
- Routine cleaning and disinfection procedures are appropriate for COVID-19 in healthcare settings, including those patient-care areas in which aerosol-generating procedures are performed. Products with EPA-approved emerging viral pathogens claims are recommended for use against COVID-19.
- A list of EPA-approved disinfectants for COVID-19 can be found on the EPA website.
Practice social distancing.
- Maintain at least 6 feet (2 meters) between yourself and others.
- Avoid mass gatherings of more than 10 people in public; ideally no more than 3.
If you feel as though you are getting sick, please stay home and seek medical attention as soon as possible.
- Symptoms for COVID-19 can be found on the CDC website.
Key points from the White House / CDC Coronavirus Plan – 15 days to slow the spread and flatten the curve:
- Social Distancing – avoid social gatherings of 10 or more people, maintain a distance of 6 feet (2 meters) between yourself and others when possible, particularly those that are coughing, sneezing and demonstrating symptoms.
- Use drive-thru, pick-up, or delivery options – do not eat at bars, restaurants or food courts.
- Avoid discretionary travel – shopping trips, social visits, etc.
- If you feel sick, stay home!
- If your children are sick, keep them home and call your medical provider.
- If someone in your household has tested positive for COVID-19, keep the entire family at home. Do not go to work. Do not go to school. Contact your medical provider.
- Stay informed:
We hope that you find the above information helpful and encourage you to reach out to your supervisor should you have any questions or concerns.
Stay safe and healthy during this time.
– The Integrated Oncology Network Team