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Weitzman ECHO: Coronavirus


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Weitzman ECHO: Coronavirus

  1. 1. Weitzman ECHO on Coronavirus March 18, 2020
  2. 2. A Further Primary Care Perspective Stephen J Scholand, MD Infectious Disease Consultant 18 March, 2020
  3. 3. Objectives - Review latest information on novel coronavirus (2019- nCoV, SARS-CoV-2) epidemiology in the USA - Heighten awareness of clinical clues and laboratory features of this disease - TEST, TEST, TEST - Coordinate healthcare delivery in partnership with local health department and healthcare leadership - Advocate and practice protection: Patient, Family, Staff, Self - Remain highly vigilant - Take care of oneself!
  4. 4. As of March 18, 2020 -
  5. 5. Avoiding the Surge
  6. 6. What to do if you have a potential patient? Person Under Investigation (PUI)?
  7. 7. Is it a “real case”?
  8. 8. Can the patient stay at home? • Stay at home except to get medical care • Stay away from others ‘sick room’, separate bathroom • Wear face mask; cover coughs/tissues • Avoid visitors; avoid sharing (cups etc) • Clean surfaces • Call ahead if going to PCP • Avoid NSAIDs (Motrin), use Tylenol
  9. 9. Keep in mind…
  10. 10. Real World vs
  11. 11. Test every suspected case • “You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: test, test, test. Test every suspected case. ” - WHO Director-General Dr. Tedros Adhanom Ghebreyesus
  12. 12. Summary • New virus spreading – Expect to see patients – ECHO Public Health messages • Make sure preparations are in place – Office / Clinic protocol – PPE: Masks! Gloves… – TEST, TEST, TEST! – Hand Hygiene; surface disinfectant; equipment • COMMUNICATION – Colleagues, other health care facilities – State and local health departments Dr. Li Wenliang
  13. 13. Staying up to date – Trusted sources • • coronavirus-2019
  14. 14. NEMS COVID-19 Preparation Jerry Jew, MD, MBA Given: 3/12/20
  15. 15. Contents Entrance Screening Workflow Live Chat/ TeleVisit HR Policy – Multi Tier Contingent Plans Education/ Communication to Staff Controlling Inventory and Supplies
  16. 16. Entrance Screening Workflow Patient Goes to NEMS Entrance Security conducts: - Questionnaire - Patients sanitize Hands If Positive, Patient Will Proceed To MA Screening If questionnaire confirmed, patient will receive a mask and proceed If patient is deemed at highest risk, they will be directed to isolation room Follow NEMS procedure for isolation If Negative Patient Will Proceed Inside
  17. 17. Live Chat/ TeleVisit To better serve patients and protect Staff, NEMS has started LiveChat/TeleVisit options: NEMS has a virtual Live Chat platform on their home page Live Chat with patients to allow for screening and ability to schedule patients with a provider for Televisit.
  18. 18. HR Policy - Multi Tier Contingent Plans Tier 1; In Full Effect •All employees should follow PPE guidelines and was hands frequently. •Increase physical spacing between our staff •Employees will stay home if they are sick and have a fever. •If employee has respiratory symptoms but does not have a fever, they must wear a mask •Employees may return to work fever free after 24 hours without the use of medication •NEMS may require employees returning from travel to self- quarantine for 14 days. Tier 2 and 3 (if needed) by Executive Team discretion with guidance from CDC and DPH • Certain clinics will close, and employees may be rotated based on patient needs. • Policy for Non-patient facing staff and working from home: • No more than 1/3 of each department will telecommute at the same time. • Tier 3 discusses furlough and order of operational closures.
  19. 19. Education/Communication to Staff •Communication as needed with at minimum of weekly announcements •Formed COVID 19 internal team meets daily – Lead by our Chief Health Officer •Transparency to all employees about current number of patients tested and results •Updating staff on all local and larger picture news •Reminder on our policies Weekly announcements to staff •Testing best practices and workflows •Running drills and trainings for staff ( proper PPE, workflows for pt isolation) COVID-19 Preparations
  20. 20. Controlling Inventory and Supplies Centralize Requests/Ordering Distributions Goal for sensible and timely distribution while increase need for accountability Usage Rates Calculating burn rates of various departments/clinics Inventory Replenishing Rates Modeling projections at various replenishing rates
  21. 21. Nurse Interview Guide Mary Blankson, DNP, APRN, FNP-C
  22. 22. COVID-19 Nurse Interview Guide • All Patients who answered “Yes” for Symptoms or Travel should be triaged by a Nurse • Travel Risk: Traveled outside of the state – If yes: where? Consider highest risk areas – If highest risk area, assess • Have you been implementing social distancing? • If yes, please describe efforts • Contact Risk: Contact with someone who is ill? – If yes: What were their symptoms? Official diagnosis? – If COVID-19 contact, were you within 6 feet? Contact with secretions?
  23. 23. COVID-19 Nurse Interview Guide • Symptom Discussion – Describe Symptoms you are having – When did they start • Confirm if symptoms started before or after any potential high-risk contact for COVID-19 – Are you treating your symptoms currently with medication • If yes, what medication, when was last dose? – Proceed as per selected protocol for symptoms while also considering above documented risks, if any
  24. 24. COVID-19 Nurse Interview Guide • Disposition by phone – No red flags, advise patient to stay at home – Progressing symptoms that may not warrant hospitalization, but may require medical intervention, patient may need evaluation. Consult with PCP – If emergent symptoms, call 911 to transport to nearest emergency department, call ahead to alert the facility of PUI • Disposition in person – No red flags, advise patient to return home and remain at home – Progressing symptoms, consult with PCP – Emergent Symptoms, call 911 to transport to emergency department, call ahead to alert the facility of PUI
  25. 25. 26 Free COVID-19 eConsults • Web-based portal • Free to all Safety Net Primary Care Practices – FQHC, FQHC-look alike, Migrant Clinicians, Healthcare for the Homeless, Free Clinics • No Protected Health Information (PHI) • Consults Addressed by: – Infectious Disease Specialists – Public Health Nurses • * This initiative is supported by
  26. 26. Thank You! For questions or to join our mailing list: Contact us at