There has been a lot written recently about how to handle the pandemic in imaging departments and hospitals. How do we deal with crisis management, decreasing volumes, closures, surges and hot spots? But what does our world look like as we start to reopen the country? What does “normal” look like, and how will our behaviors need to change? There are many things that the COVID-19 pandemic has uncovered that demonstrate just how poorly prepared we, as a nation, were for such a crisis.
Despite our unpreparedness, our frontline heroes, our grocery store staff, delivery people and first responders have done a great job to get us through a tough time. One thing is certain – we need to get used to uncertainty. We need to be prepared to adapt to changing circumstances and innovate. We need to be flexible and open minded as we embrace a new world dynamic. So what will change?
A post-COVID world will require new policies affecting screening staff, patients, vendors and standards for disinfecting and training.
- Policies regarding health screening for staff and responses to staff that self-identify as being ill
- Screening policies for all people (staff, vendors, patients, family members) approaching a facility
- Policies to identify patients who test positive and to guide communication of this to stakeholders
- Education policies that focus on safe imaging of patients and proper personal safety precautions
- Equipment disinfection policies and procedures
REALLOCATION OF RESOURCES
What is unknown is how imaging will be hit when “stay at home” measures are lifted. Will the pent up backlog of patients rush back to the hospital or will patients stay away until they gain confidence that the hospital can be a safe place, resulting in a gradual return to pre-COVID imaging volumes? Preparing for the surge will require a look at how we can reallocate resources.
How we utilize the knowledge workers, where they work from, and what preventative measures we can put in place to prevent massive spreading of this and any future diseases will become a focus for providers, if not already implemented. Ensuring we don’t relax some of these measures will be the key.
Some considerations should be given to:
- Extending the hours to include nights and weekends to best manage any increased surge in volumes
- Staff scheduling so that extended hours can manage the influx while not burning out staff
- The possibility, where feasible, of dedicating modalities to treat infected patients
- Reallocating outpatient staff to help cover in-hospital services and extended hours
- Leveraging students wherever possible
How we perform procedures, how we separate patients and what is best for the patients will impact how we carry out our imaging responsibilities. Protocols, patient flow into the department and even disinfecting methodologies will all change in a post-COVID world.
- Prepare provider financial departments for the burden of reassessing patients who were previously insured and may now be self-payers
- Redesign waiting rooms and patient areas to prevent unnecessary spread of disease
- Create an ongoing culture of infection control and best practices such as hand washing and surgical mask use
- Reduce the movement of patients to optimize flow and reduce congregation of patients
- Develop new imaging protocols that shorten scan times, minimize patient times in hospital
- Increase usage of portable or mobile modalities including portable CT units
PERSONAL PROTECTIVE EQUIPMENT (PPE)
PPE will become a new “normal” for the majority of healthcare workers. This will also apply to patients, and best practices will be established as to how and when the use of equipment is appropriate.
- Gowns, masks, gloves and face shields for any suspected COVID patient
- Masks for transporting patients or movement throughout the hospital
- Maximum efficiency in the utilization of these valuable resources
Social distancing is here to stay. And nowhere more than in healthcare is it more important. How many times have you gone to the doctor for a checkup and been seated next to a sick patient? Hospitals are one of the most dangerous environments and will need to adjust to social distancing protocols.
- Increase in virtual consultations to reduce the chance of exposure for patients, physicians and staff
- Increased use of “separation” at reception, prep areas and anywhere there are interactions with patients
- Redesign of waiting rooms, radiologist reading rooms and reception areas to encourage social distancing
Many facilities have been reluctant to deploy teleradiology solutions but the onset of this crisis identified just how ill-prepared we were to manage such a contagious disease. Teleradiology will no longer be just for after-hours work.
- Continue to enable radiologists to work from home, remote reading
The reduction in patient volumes not only speaks to the stoppage in elective imaging procedures but statistics also show that patients are not seeking medical advice for more serious conditions. This fear will keep some patients away and efforts to bring patients back for their annual checkups and other imaging procedures will require additional marketing efforts. Patients not happy with the answers to key questions about their safety will take their business elsewhere. This will require some additional efforts:
- Prepare reception and scheduling staff with talk tracks about protections in place to ensure patients are not exposed to possibly infected patients
- Prepare patients in advance for additional screening upon arrival
- Create procedures for check-in procedures that ensure wait times are minimized and social distancing is maintained
- Promote extended hours and locations for patients to have their procedures performed
Scientists believe that there may be a reoccurrence of COVID-19 later in 2020, if it follows the similar patterns of other pandemics. While we are still digging out from the spring crisis, facilities should also be looking forward to prepare for the next round and take actions reflecting lessons learned. What is certain is that the world will be a different place.
Stay safe and healthy! Learn how Hitachi is helping customers deal with a post-COVID world.