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Leadership Strategies for Potential COVID-19 Admissions

Lisa Thomson
Chief Strategy and Marketing Office

Today, I had the opportunity to interview Pathway Health’s Chief Executive Officer, Peter Schuna, for his thoughts on how post-acute care providers can prepare for potential COVID-19 admissions, based upon surge capacity needs in your community.  Read his insights below on how we should T.H.I.N.K Ahead and prepare now!

I witness every day how healthcare leaders show their innate abilities, especially in times of great need. Healthcare leaders have the ability to adapt to any situation that is presented, communicate effectively and compassionately, collaborate at all levels to achieve the outcomes needed for residents and staff, and always remain calm, courageous and positive in the midst of change. Thank you for all you do! I am so proud to be surrounded by amazing leaders and caregivers.  You are the true heroes of healthcare.

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T.H.I.N.K. Ahead

Peter B. Schuna, LNHA, HSE
Chief Executive Officer

These are certainly unprecedented times. Our hospital partners are experiencing the continued surge of new COVID-19 cases and the healthcare industry is problem-solving alternative sites to provide care and services. As the increase in the need for care is rapidly developing across the country, it is time for leaders in all aspects of healthcare to collaborate and determine strategies to meet your community’s needs.

We are all navigating the waters on alternate care sites, keeping in mind the vulnerability of post-acute care residents, whether in a skilled nursing facility, assisted living facility, campus or community-based setting. Knowing that COVID-19 is rapidly spreading across the county, it is time for all post-acute care leaders to think ahead and prepare for the potential increase in COVID-19 patients.

Below are a few Leadership T.H.I.N.K. Ahead Strategies that provide a foundation for preparation. (A more detail Guide is available for download – see below)

T – TEAM

  • Determine a COVID-19 task force with specific responsibilities for COVID-19 admissions and dedicated physical plant location
    • Review your COVID-19 pandemic plan
    • Review your current facility capabilities to take individuals with COVID-19
    • Complete the COVID-19 Focused Survey for healthcare providers
    • Review your facility policies and procedures including: Infection Control, Outbreak Management, Transmission Based Precautions, staffing/contingency during an outbreak
  • Review your physical plant for a potential dedicated unit/wing or set of rooms that could be set up for receiving COVID-19 positive residents
  • Review organization’s preparation strategies with Medical Director, clinicians, pharmacy, laboratory, diagnostics, emergency medical services, vendors for their insight and expertise
  • Review and revise temporary COVID-19 admission policy and procedures. Designate leader for admission oversight and decisions
  • Collaborate with facility Compliance and Ethics Committee as indicated
  • Review facility intent with corporate counsel if indicated
  • Incorporate into the facility QAPI program

H – Human Resources

  • Develop a plan for dedicated staff (work only on the designated unit) – reducing the potential for introducing the virus into other areas of the facility
    • For the dedicated team, you may consider:
      • Special location for breaks and meals
      • Separate entrance to the unit, if possible
      • Time clock alternatives
      • Communication plan for this team
      • Ongoing staff screening before each shift per guidelines
      • Process if an employee develops s/s of COVID-19
        • Proactive plan with human resources
        • Discussion with all shift supervisors as to roles and responsibilities

I – Infection Prevention and Control

  • Review required screenings, line lists, logs for adherence to COVID-19 and Infection Control requirements
  • Hand Hygiene, Cough Etiquette and Respiratory Hygiene
    • Review policies and procedures
    • Monitor staff performance
    • Review availability of supplies – ABHR, soap, paper towels
  • Personal Protective Equipment
    • Complete a PPE Burn Rate Calculation which assists in planning and optimizing PPE – identifying current and future supply needs
    • Secure PPE
    • Provide PPE to each employee following their symptom check (i.e. mask for each employee based upon state/local health department recommendations)
    • Educate and reinforce proper use and reuse of PPE per new guidelines
  • Medical Equipment and Supplies (other than PPE)
    • Dedicate equipment or process to disinfect between residents and use
    • Determine equipment and other supply needs for the unit – reviewed daily
  • Cleaning and Disinfection Protocols
    • Review plan for cleaning and disinfecting high touch areas, cleaning of rooms, nursing stations, high touch equipment (telephones, cell phones, pens, computers, etc.)
    • Review and utilize the EPA Registered List N
    • Follow manufacturers guidelines for disinfection and use

N – Notify

  • Develop and implement a communication plan and strategy
  • Develop or download from your provider association, templates for written and verbal communications
  • Potential Audiences for communication needs:
    • Residents
    • Families/Representative
    • Employees
    • Medical Director
    • Medical Team and Clinicians
    • Acute care partners
  • Notify Public Health of facilities intent to accept COVID-19 positive patients in order to identify specific instructions and guidance prior to admission
  • Develop daily and routine communication channels with acute partners and clinicians

K – Knowledge

Protecting our residents and staff is post-acute care leader’s top priority. Planful preparation is key to reducing risk and navigating these challenging times together.

Download the Leadership T.H.I.N.K. Ahead Strategy Guide for your use with your team in preparing for the potential change. Pathway Health is your partner for preparation assistance. Please stay safe, be well and know that you can count on Pathway.

Contact us for COVID-19 preparation and response assistance.

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Resources: 

Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). Information for Healthcare Providers. https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html

 

Centers for Disease Control and Prevention. “Healthcare Personnel Preparedness Checklist for 2019-nCoV that can be downloaded and completed by the Infection Preventionist at: https://www.cdc.gov/coronavirus/2019-ncov/downloads/hcp-preparedness-checklist.pdf

 

Centers for Medicare & Medicaid Services. QSO-20-14-NH. Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes: https://www.cms.gov/files/document/3-13-2020-nursing-home-guidance-covid-19.pdf

Centers for Medicare & Medicaid Services. COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers.  March 30, 2020.  https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf