Peer Questions

  • We have made changes to our policy about masks for patients.  Staff were already wearing masks.  We posted a sign on the door that is pretty clear about the need for a mask.  All of our reminder calls and texts for appointments and when an appointment is made get the information that a mask is required.  However, if a patient comes without one, we are not going to refuse to see them at this point.  We have discussed putting them in a different room if they are here for a well check.  This way they do not potentially infect the “Well” room for the next patient.  Some staff are not happy with having to work up a patient in an exam room if they do not have a mask.
  • Pros – Families and employees are thankful that we are doing our best to keep everyone safe.
    • Cons – 1. Change! 2. We’ve had 2 parents refuse to wear masks. We offered one the opportunity to reschedule the well visit and the other chose to wait in the car for her teenager.
    • New policies – Yes. All employees and doctors must wear masks at all times. All parents and patients ages 2 years and older must wear a mask in the office, including exam rooms. We used the mayor’s mandate for guidance in our communication to staff and families.
  • We have not since the new mandate. However, we have required employees to wear them everyday since April. We have been requiring patients to wear them in the clinic if they do not have one we give them one.
  • We require our workers to wear masks. We have not required the patients/parents to wear masks. We have moved all “sick” visits to the afternoon. We ask them to call us from the car. A nurse will meet them at the car to begin the assessment.
  • We are primarily doing telehealth visits. For the summer we have implemented a one-week-on, one-week-off policy where we are only seeing patients in office every other week.  For those patients being seen in office, they are required to wear a mask the entire time they are in the office, and we are also wearing masks.  If a patient does not have one, we do provide a surgical mask.  So far, we have had zero push-back on this policy.  We have had a few patients who misunderstood and believed it was okay for them to take off the mask once in the exam room, but we asked them to put it back on without issue. We do not currently utilize the waiting room and ask patients to arrive at their scheduled appointment time, to call or text the office letting us know they have arrived, and the provider gets them from their car and takes them straight back to the exam room.
  • We have mandated masks for everyone and majority of our patients are understanding and appreciate the precautionary steps taken.
  • We began requiring masks for all patients and guests a couple of weeks prior to the mandate.  The thing that made the difference was our ability to get PPE from TEMA.  Without the additional PPE, and with so many patients coming without their mask, we needed more PPE than we were able to purchase ourselves.  Now that the mask mandate came out, at least more patients are arriving with their own masks, which helps us not deplete our mask supply so quickly. No other process changes were required.
  • We currently request that all patients and parents wear a mask to appointments if over 2 years of age. When booking appointment we tell them to bring and wear mask to appointment. If they still arrive without a mask we will provide one for them.
  • While our county has not yet implemented a mask mandate we encourage our patients to wear masks.  When scheduling their appointment our staff asks several questions which help us determine if the patient needs to wait in their car and be given a mask before entering. Anyone with a cough, fever, or exposure to any sickness are required to wear a mask upon entering our facility.  So far patients have been compliant.
  • We will do it in their vehicle outside the clinic if absolutely necessary.  We have transitioned to MDI in office for albuterol.
  • If we need to give a nebulizer treatment, we have a portable one that plugs into car and will give to them in the car.
  • We are not doing nebulizer treatments in the office at all during COVID.  The risk of aerosolized disease is too great (even with a HEPA filter). The patient most likely already has a nebulizer at the house and we just ensure they have their medication. If the patient does not have a nebulizer, we can dispense a DME nebulizer to them and instruct on home use. Alternatively, if medically appropriate, we can prescribe an inhaler…but not always medically appropriate.
  • We have a treatment room, where the nebulizer is set up at.  We use a different mask and tubing for each patient.  At this time, the room is sanitized and not used for 2 hrs.
  • Administrator and Clinical Manager with direction from the MD

 

  • We are doing most of our testing curbside. We have protocol for who is allowed in our building. We have our walk in NPs taking care of all curbside testing. They must have full PPE before leaving the building and it is placed in a biohazard bag before returning to the building.

 

  • Our Nurse Manager keeps track of all exposures as well as reporting to the state.

 

  • We are still wearing full PPE gear and seeing potential or exposed COVID patients in our drive-thru so we don’t have to notify anyone. We are still not allowing sick children in our well side. We also have separate office space and entrance for sick kids. Any COVID symptoms go into those rooms only and employees should be in full PPE gear. All vitals are taken in those rooms as well to limit exposure.
  • Our school district gave parents an option to choose which method of returning to school was best for them. So we have not had any requests to provide letters of exemption.
  • We are not providing any letters. We tell patients/parents it is up to them as a family to decide based on their individual circumstances. Otherwise we would be doing letters all day. Example: we had a request for information on how long should my child wear a mask and when should they get a ‘mask break.’
  • We are telling folks to go back to school if their school is open. If they are concerned that their child’s medical condition puts them at higher risk of covid19, then we are having them discuss that with whatever subspecialist helps manage that condition. For the most common issues [such as asthma, eczema, adhd, h/o prematurity], we aren’t writing exemption letters.
  • We upgraded from Tag2 thermometers to Tag 3 thermometers and activated the text message function thru Berlinger.  It texts us any hour of the day if the frig or freezer goes out of range. So it was the additional cost of the Tag 3 plus texting service thru AT&T that I think is $120 per year per device.

    Prior to that, we used TempAlert who had wireless devices and those also texted us.

  • We have data collectors on our refrigerators and freezers that alert me and the clinical supervisor by text and email if they become out of range.
  • We have a device called Sensaphone. We have been using it for about 6 months. It has worked very well for us so far.
  • We have sensors that were installed by our security company.
  • Our IT person has something hooked up to notify us in the event of power failure.  It goes to several people within the company.  We would respond appropriately if notified.
  • We use Refrigerator and Freezer 2 Tag data loggers and someone checks them each day.  We have a backup on each unit.   We are in the process of installing alarms that will notify a designated phone when the unit is out of range. 

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