March 10, 2020
Subject: COVID-19 Information for Forefront
Over the past week, many physicians and employees throughout our group practice have been requesting more direction from our Physician and Executive Leadership Teams on managing the COVID – 19 (Coronavirus) outbreak in the Forefront Dermatology communities.
We have assembled a task force to support our group practice and we are sharing some recommendations and guidance to assist you in managing the rising incidence of COVID – 19 in Forefront Dermatology communities.
We are making these recommendations because we are worried about unnecessary quarantine more than infection.
These recommendations are not Forefront policy or mandates or requirements and each physician team should decide which of these measures he/she wants to implement in their clinic and review with his/her staff.
Our goal is protect you, your staff, and our patients from infection and take the necessary precautionary steps to avoid a future quarantine requirement from your state health department or CDC. We have organized task force recommendations by group affected below.
- We recommend the use of a N95 mask and glasses with side protection during clinic with glove use and frequent hand washing.
- Your RCM will be ordering N95 masks every few days from Henry Schein. If you do not have N95 masks for all staff, we recommend “level 2 or level 3 masks” as these offer more protection than standard masks.
- We recommend no hand shaking at this time as a precautionary measure. This has been communicated to patients in our signage.
- If wearing the aforementioned PPE and practicing above guidelines, the State Health Department will likely deem you low risk and thus not quarantine you or your facility. Closing clinics for two weeks for “suspected contact” is our primary concern for you, your staff and patients and we believe this recommendation is the best way to combat over-reactive Health Department quarantines.
- We recommend that any clinic staff presenting with a fever, cough, or respiratory symptom not report to work or be sent to a PCP for clearance with a written note of clearance.
- We also recommend no airline travel during personal time, if possible.
- The state health department is now demanding quarantine for even asymptomatic suspected patients, thus personnel with symptoms should have clearance to work. In one state, the health department issued a warrant for an individual who violated quarantine, even though he had no symptoms. Once again, this policy is to protect you from unnecessary quarantine.
Our SCS/MCS teams are asking the following questions of all patients prior to scheduling an appointment. (Any patient that answers “yes” will be schedule for an appointment in 4 weeks):
- “Have you traveled to China, South Korea, Japan, Italy, or Iran within the past 14 days?”
- “Have you been in contact with someone under investigation, or with a confirmed case of COVID-19 (2019 Novel Coronavirus)?”
- “Do you have a fever, flu-like symptoms, and/or lower respiratory illness such as cough or shortness of breath?”
- Two types of signage have been provided to all clinics (attached) and are recommended in clinic settings and/or provided to patients, a fever/cough do not enter and explanatory document concerning mask/glasses use in clinic.
- We recommend the front desk staff screen patients and accompanying family members for fever and/or cough. Anyone with a cough or fever should put on a mask immediately and staff notifies the Physician/PA/NP before allowing any further contact with MA/nurse/physician.
- We recommend accompanying family members, if possible, stay in the waiting room rather than accompanying patient to the exam room.
- We recommend wiping work surfaces, door knobs and computers every two hours with COVID-19 approved wipes/cleaning products. As a reminder, it is important to honor the kill time. Many wipes have to remain wet on surface for 2-3 minutes to kill most viruses
- We recommend wiping all courier boxes at the beginning and end of the day.
- We recommend minimizing outside visitors. This includes drug reps and delivery personnel. For packages, we recommend displaying a sign at the front door to have packages dropped in the entryway rather than have the deliverymen bring inside clinic.
Regional Clinic Managers
- RCM’s will be working remotely as much as possible, but available to you for your clinic’s needs. They also will ensure you are up to date on communications from the task force.
Keeping You Up To Date
- Our taskforce will be issuing updates on a regular basis to keep you and your staff informed. We encourage you to check your email and the Facebook Workplace app for written and video updates.
- If you suspect a potentially infected/exposed patient in your clinic, immediately quarantine the patient in a room, provide them a mask and restrict access to that room, then act according to state guidelines published in your clinic.