At the start of the 2019 Coronavirus Pandemic (COVID-19), the Centers for Disease Control and Prevention (CDC) recommended that healthcare systems prioritize urgent visits and delay elective care to reduce the spread of COVID-19 in healthcare settings. " one
However, one unfortunate consequence of these guidelines was "the inadequate use of essential medical services for patients with urgent and emerging health needs not related to COVID-19". 1 For this reason, the CDC recommends that health systems "compensate for the need to provide the necessary services and minimize the risks to patients and health workers". 1 This focus on "reopening" is part of a larger effort to reopen the state, with specific guidelines developed at both federal and state levels. 2 And since other states have relaxed restrictions, medical practices that have previously been closed for non-emergency visits or operated by telemedicine are under increasing pressure to reopen. 3 "However, contradicting information is confusing because practices carefully evaluate the resumption of personal visits." 3rd
To illuminate the complex and often delicate process of reopening, we have He spoke to Dr. Ada D. Stewart, a family doctor at Cooperative Health in Columbia, South Carolina, and elected president of the American Academy of Family Physicians (AAFP).
"The general guiding principle, before you even start implementing the reopening process, is to make sure that you have a safe environment not only for your patients, but also for your employees," says Dr. Stewart. "All the steps that I take must be carried out against this background and put into practice before I can open the doors for patients again."
1. Train your employees
The AAFP recommends that all employees be informed about COVID-19. Although most are aware of the main aspects of the disease and its impact on patient care, "update" training is helpful.
The review outlines policies and practices to minimize exposure to the virus that causes COVID-19, including changes in scheduling, patient flow, cleaning procedures, and COVID tests. 19 and respond to patient concerns.
It is helpful to review the procedures regularly and take into account any changes that may occur during this new process.
2. Implement comprehensive cleaning and hygiene procedures
"We make sure that our office is constantly cleaned," said Dr. Stewart. Before COVID-19, night cleaning was sufficient, but now Dr. Stewart and his staff 2-3 midday cleanings, disinfect the waiting room, clean chairs and door handles and you too disinfect all surfaces in the examination room between the patients.
"Hand disinfection is an important part of our protocol. We not only practice hand washing for at least 20 seconds, we also encourage our patients to do the same. And we distribute small bottles of hand disinfectant to patients, especially if they don't use the disinfectant at home or in the car, "he added.
The AAFP advises discontinuing the use of toys, magazines and similar items in waiting areas, as well as office materials that patients often share, such as pens, clipboards and telephones, and providing non-contact waste containers with disposable bags in the office areas. Limit as far as possible areas that can be touched, e.g. B. Keep doors open or use sensors. Devices such as stethoscopes and thermometers should be cleaned with suitable cleaning solutions before each patient, and disposable devices should be used if possible.
"Wherever possible, we use disposable items so no laundry needs to be washed," said Dr. Stewart. They recommended that the CDC guidelines for dealing with sheets and , if necessary linen to follow.
Ensure that standard precautions are followed, including airborne precautions and the use of eye protection. Assuming every patient is potentially infected and can transmit the virus, said Dr. Stewart.
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