As states begin to re-open and hospitals are given clearance to resume elective services, it is a necessity to have a well thought out plan to ensure the safety and wellness of your patients. It is after all, what hospitals and providers do…care for individuals. While the government and several industry organizations have released guidelines and recommendations to consider when re-opening, below are practical operational considerations to evaluate and contemplate in order to facilitate a smooth transition into the ‘new norm.

Pre-registration

Patients should be encouraged to process their registration online as their primary method in order to limit exposure to other patients. If online registration is not available or accessible for the patient due to technical limitations, consider the utilization of telephonic registration and as a last choice, establish patient encounters with an in-person pre-registration event. Online appointments are being leveraged in multiple settings and in other industries as the concept has been utilized in healthcare for some time now.

Pre-authorization

With the return of elective procedures and the associated pre-authorization process, most facilities are expecting a backlog of work across the clinical continuum of care. This potential high volume could cause bottlenecks in the pre-authorization process should your facility and associated payors not be prepared in a timely manner. Current policies/procedures should be reviewed and updated for any modifications in the various processes to support successful authorizations during this time.

Scheduling procedures and/or visits

  • Understand the importance in procedure type and service when operations resume. Consider the questions to be answered below:
  1. Are there certain surgical procedures with a lower chance of infection, and should certain procedures take precedent over others? Consider the Joint Statement from ACS, ASA, AORN and AHA.
  2. Block scheduling – Consider temporary block scheduling policies and the impact thereof. If established policies are not in place, schedule time with appropriate providers and leadership to discuss and develop a plan.
  3. Pre/Post-operative visits – With the temporary guidelines for telehealth, evaluate your approach to pre/post-operative visits and which could be conducted via tele-programs.
  4. Outpatient services – With the continued regulatory changes from CMS, evaluate and initiate tele-health services to support patient treatment in physical therapy, occupational therapy and speech. See reference to CMS release here.

Staff and patient infection prevention

  • Your organization should develop and/or broaden policies for use of patient protective equipment (“PPE”) while patients/staff are on-campus (hospital, clinics, outpatient service locations). Key questions to consider:
  1. Will your facility require staff/patients to wear masks? If required to wear masks, will the hospital provide them, or can patients bring their own? Consider what other businesses are doing in your region, and if different, be prepared to explain why.
  2. Will staff/patients have temperatures checked upon arrival?
  3. Will the number of loved ones/family members be limited in a waiting room (i.e. those waiting for surgery)?
  4. Will you require patients to complete a survey on the day of treatment requesting them to share if they have experienced COVID-19 symptoms and/or been around an individual with symptoms in the last fourteen days?

Staff scheduling/ availability

With many children now out of school through the end of the current school year and some staff returning from furlough, facilities should understand the importance of communication and planning for this date to ensure that appropriate workforce is available. If childcare is not currently a service offered by your system, is this a service that can be stood up and/or contracted for staff in a timely fashion to support your staff?

Materials management of supplies and pharmaceuticals

Continued special focus in this area is a must. For elective procedures, be diligent with physician preference items and understand the impact on availability. If items are not available, have early discussions and plans on how this will be addressed at time of need.

Restart/re-shape strategic planning

The COVID-19 pandemic has given all of us experience in short-term planning and intervention. However, it will be paramount to resume or, in some instances, re-shape your strategic plan. Financial concerns will be top of mind for many, but long-term sustainability cannot be forgotten. With the telehealth regulatory changes of the past several months that many anticipate will stay, initiating plans to solidify, strengthen and secure your market will be paramount.

Additional guidance from CMS can also be found at this link.

Michael Corbett is a Senior Manager in LBMC’s Healthcare Consulting group. He can be reached at michael.corbett@lbmc.com

Jenny Harvey is a Manager in LBMC’s Healthcare Consulting group. She can be reached at jharvey@lbmc.com.