Resources and Guidance for Reopening Medical Practices

By COPIC’s Patient Safety and Risk Management Department

Health care is facing a continual changing environment surrounding COVID-19. As medical practices reopen, they are looking for support and information to help them navigate these changes. Below are some general guidelines and expert resources to provide assistance for physicians and medical practices during this time.

Practice considerations

Prior to reopening, medical practices should implement necessary steps to assure patient and staff safety. Assessing current and future PPE needs, sanitizing procedures, modifying schedules, and limiting visitors to minimizing contact are important considerations. The following are helpful links to guide a safe return:

• The American Medical Association’s (AMA) A Physician Practice Guide to Reopening provides an informative checklist of areas to look at and things to consider as you reopen.
  www.ama-assn.org/system/files/2020-05/physican-guide-reopening-practices-covid-19.pdf.   

• The AMA also posted a fact sheet that focuses on state directives ordering a delay in elective procedures and related guidance from the federal government and the American College of Surgeons (ACS).
  www.ama-assn.org/system/files/2020-05/state-elective-procedure-chart.pdf 

• The Centers for Medicare and Medicaid Services (CMS) has released recommendations related to Phase 1 of reopening for medical facilities that provide non-emergent, non-COVID-19 care. www.cms.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf

• The Medical Group Management Association (MGMA) published a detailed checklist for reopening practices that covers areas such as financial management, human resources, and operations. 
  www.mgma.com/MGMA/media/files/pdf/MGMA-Practice-Reopening-Checklist.pdf?ext=.pdf

Patient considerations

The practice should develop a policy for prescreening patients prior to presentation into the practice, usually through phone triage. The triage call script should include the recommendation for wearing a face mask, information on what the practice is doing to assure social distancing, and limitation of non-patient visitors when appropriate.  

• The AMA has developed a prescreening template which practices may use.
  www.ama-assn.org/system/files/2020-05/physican-guide-reopening-practices-covid-19.pdf  

• The Centers for Disease Control and Prevention (CDC) guidelines can be used to ensure compliance with face covering recommendations.
  www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html. 

• In addition, providers should have knowledge of available COVID-19 testing sites in their location using available local and state public health guidance.  

Staff considerations

Education and ongoing communication are integral to staff knowledge of changing COVID-19 recommendations to promote a safe working environment. Staff should be educated on signs and symptoms of COVID-19 and the importance of not presenting to work if signs and symptoms are present or if they have had direct contact with persons who have tested positive for COVID-19. 

Staff should be screened regularly, and screening should be kept in a file separate from employee file. Office administrators should be aware of reporting requirements and the obligation to protect health care professionals during a pandemic.
www.ama-assn.org/delivering-care/ethics/obligations-protect-health-care-professionals  

Operational challenges

Decreased revenue and employee costs during the pandemic has been a challenge to many practices. AMA has developed resources to help navigate workforce reduction, compensation changes, benefit modifications, and legal compliance during COVID-19.
www.ama-assn.org/delivering-care/public-health/making-tough-decisions-managing-practice-s-employee-costs  

Please note that the information provided above was current at the time of submission of this article. Due to the ever-changing guidelines and regulations related to COVID-19 and variations on how different states are approaching this issue, please be sure to review the websites of the resources mentioned above to determine if updated information has been posted.