Read Part 1 ‘A COVID-19 “Time-Out” for your Practice’ here
Once the leadership team of a health care organization has settled on a shared vision of the dimensions and ramifications of the crisis, it is time to shift to the task of attending to business continuity1. This is an important phase of the “Time-Out.”
Business Continuity Management (BCM) Planning and Required Workflow Changes
A well-thought-out BCM program allows an organization to continue functioning during a disaster and, ultimately, to fully recover normal business operations in a timely manner afterward2. This is a complex task in a healthcare organization as it must include contingency planning for clinical personnel and workflow to assure patient care continuity, critical infrastructure system continuity like IT, including electronic health record (EHR), network and communication functions and clinical facilities planning. The plan must also address the financial viability of the practice by assuring billing functions, cash flow and critical vendor relationships will continue in a crisis.
During this unprecedented COVID-19 pandemic, it has been reassuring to see practices large and small activate their business continuity plans to minimize disruption in the availability and quality of clinical services to their patients. Practices have changed the designations of buildings to “sick buildings” utilized for the evaluation and treatment of patients with febrile illnesses or suspected of having COVID-19 and designating other buildings as “healthy buildings” where patients not suspected of COVID-19 can be seen safely. Across the country, practices have initiated new check-in procedures that allow check-in from the safety of the patient’s car, obviating the need for time spent in the waiting room altogether. Clinical teams from specialty offices that have seen significant decreases in visit volumes were reassigned to other areas to relieve overtaxed personnel. IT systems have been added in a matter of days to support telehealth/virtual visits to substitute for in-person visits and EHR access has been expanded to allow remote access for clinicians and care teams from home. Practices have begun exploring novel reimbursement opportunities for telephonic or video visits to mitigate the impact of decreases in office visit volumes. At a time when personal protective equipment is in short supply, organizations have implemented creative procurement initiatives to secure the necessary supplies.
It appears that organizations that had business continuity plans in time, or those who have used the time building up to this crisis to create and refine plans are faring better in this rapidly evolving situation.
Plans for Patient Engagement and Retention
During the COVID-19 pandemic, it is essential for organizations to maintain close and frequent contact with their patients utilizing various communication methods. For example, patients need to be informed of changes to care locations, office hours and check-in procedures. Guidelines regarding evaluation of patients with suspected COVID-19 have to be clearly and effectively communicated. Even a single infected patient who presents at the wrong location where staff are not prepared, could cause infection and harmful spread of the virus. Patient portal messages and other modes of communication need to be used extensively to educate and communicate with patients about the new reality. As organizations rapidly implement telehealth capabilities, the availability of these services needs to be communicated to patients along with training and support so patients can use these tools when necessary. Patient engagement is critical to mitigating the negative impact of this pandemic. Patients greatly appreciate the efforts that practices are making on their behalf and have universally endorsed the convenience and effectiveness of telehealth visits. These positive sentiments will likely assure practices that patients stay loyal to the practice and return to the practice for care when the pandemic has subsided.
Forging New Collaborations and Partnerships
This last item on the COVID-19 “time out” check list is to ensure that an organization is seeking out and participating in collaborations and partnerships locally, regionally and even nationally. A crisis of this dimension is best tackled in collaboration with other organizations. The ability to procure supplies jointly, flex staffing needs, or learn and adopt best practices could be factors that assure an organization weathers the current storm and is able to emerge from it intact and even strengthened. In many communities across the nation, it is gratifying to see that organizations are breaking down competitive barriers to create new collaborations and partnerships that are advancing efforts to stem the pandemic and save lives.