Important Details on New Office Procedures!

• Gradual reopening: As it is right now, we are reserving just one-third of our total time to in-person visits and keeping two-thirds as virtual visits (phone and video). Healthy acute or follow up visits, labs, injections etc, will be done in the morning. Testing of any potential COVID patients will be done late morning (11:30-12 pm or early afternoon, 1:30 pm). Any patients with acute respiratory symptoms or COVID consistent symptoms should continue phone triage initially as we have been and await further instructions.

• Patient communication: Please know that we are doing our best to keep you as safe and healthy as possible as we begin to see more patients. We have cleaning and triage protocols to minimize interaction with others and separate everyone from any potential sick patients.

• Scheduling and triage: In general, in-person visits will be prioritized for complex chronic care management and patients with acute illness other than COVID symptoms. We would encourage patients who are healthy and only coming in for routine visits to strongly consider moving their appointment out. If you want to keep your appointment, we may ask to adjust your appointment time to the morning hours, however, if you cannot make this change or have concerns with any further movement of your appointment, we will keep it in place. In addition, we may ask to covert your appointment to a phone or video visit. We greatly appreciate your patience and working with us in this way as we do our best to keep you safe and maintain time to care for everyone who needs us.

• Physical distancing: Staff and patients will practice physical distancing, staying at least six feet from one another unless closer interaction is required for patient care (examination, lab draws, etc.). Attached are sample floor decals we will be using that you will see in the office.

• Screening: Upon arrival, please wait in your car, then notify us via phone or text of your arrival. Upon our direction, you will then be screened for any COVID consistent symptoms and especially respiratory symptoms and have your temperature checked preferably outside the front door before entering the building. We will have these instructions posted via outside signage as well as on our door. To ensure safety, this initial screening can take place via phone before coming to the outside entrance area. See attached posters.

• Common areas: The patient lobby will remain closed for now. We will be escorting patients directly to an exam room, after screening as above.

• Patient separation: As per our scheduling above, we will do our best to separate healthy patients from sick patients by time of day. Healthy patients without respiratory symptoms will be assigned to a regular exam room. Patients with respiratory symptoms or concerns of COVID will be treated via telehealth or evaluated/tested in their cars.

• Personal protective equipment (PPE): All patients and staff are required to wear facemasks regardless of the reason for the visit. Patients may wear their own cloth face coverings, which is preferred. However, we do have a limited supply if you should need one. Clinical staff will wear facemasks, gowns, eye protection, and gloves when caring for patients with suspected COVID-19. Facemasks and gloves will be used when treating non-ill patients as well because of concerns about asymptomatic COVID-19 patients.

• Hand hygiene: Hand hygiene supplies are readily available to patients and staff. Staff will perform hand hygiene before and after all patient contact, after contact with potentially infectious material, and before putting on and after removing PPE, including gloves.

• Sanitation procedures: Exam rooms will be cleaned and disinfected per Centers for Disease Control and Prevention (CDC) guidance (www.cdc.gov) after each patient. We will disinfect frequently touched surfaces such as doorknobs after each visit and light switches at least daily. Limiting the surfaces that staff and patients must touch, will help cut down on the need to sterilize these surfaces. At a minimum, the patient exam table, chairs, and all counter tops will be cleaned after each patient. We are also considering the use of UVC sterilization lighting after each patient visit as well (to be determined).

• Visitors: It is preferable that no one accompany adult patients when not necessary. Common exceptions would be pediatric patients and our elderly with caregivers. If a caregiver or parent is needed, they must wear a facemask and follow all protocols as above applicable to patients.

Again, these simple steps are in place for now to keep all of us as safe and healthy as possible.

If there is anything we can do better or if you have any questions, please do not hesitate to contact us!

Author

Steven Manning, MD Dr. Manning is lead physician and owner of AccessMedicine, our areas first Direct Primary Care medical practice.