Dec. 16, 2020
We were expecting 2020 to be the year highlighting optometry’s essential role in primary healthcare. Instead, it quickly became the year of COVID-19. The pandemic continues to raise many questions, including how best to incorporate Personal Protective Equipment (PPE) into your practice moving forward. Here are top tips from a recent roundtable discussion on how best to purchase and use PPE, so patients and staff are protected, and your practice keeps its investment in these essential supplies manageable.
How Do I Educate Patients on What to Expect?
Amanda Nanasy, OD: Since a visit looks so much different for our established patients, we made a video that patients receive prior to their exam, detailing changes to protocols, equipment and experience. They not only know what to expect, but also are shown the efforts we are making for their safety.
Julie Schornack, OD, MEd: Like Dr. Nanasy, we enhanced all of our communications. We found most people did well wearing masks and washing hands; however, social distancing is a bigger challenge. We created a distinctive graphic for signage everywhere. We added a significant amount of detailed information to our web site about COVID-19.
Maurice Wilson, OD: We posted signs at the entrance stating no entry without a mask. Our schedule has not changed, but we did put in place multiple new protocols and procedures for PPE, cleaning and safety.
How Do I Minimize Person-to-Person Encounters During Office Visits?
George D. Shida, OD: We schedule fewer patients per hour, and increased cleaning and disinfection protocols. Staff are all cross-trained in case of unplanned extended absences. And we minimized the number of different rooms that a patient enters. We are looking at investing in some new equipment so that an exam room contains all equipment needed versus separate pre-testing/special testing rooms.
Dr. Nanasy: We are looking for the “sweet spot” of having the most patient encounters possible, without becoming too busy juggling new procedures and extended wait times. We were wasting time dealing with the awkwardness of educating patients about keeping their masks on and dealing with the phoropter and glasses fogging, but have since found ways to overcome those obstacles.
Dr. Schornack: Minimizing potential changes in schedules, staffing and examination flow are critical to keep everyone moving. Clear and consistent safety protocols help minimize absences. People out for quarantine pending testing results can wreak havoc with scheduling and continuity of care.
How Do I Keep My PPE Investment Manageable?
Dr. Nanasy: We need to find ways to cover these increased costs. We are integrating retinal photos and OCT scans for every comprehensive exam. We are covering our PPE costs by the higher number of patients that now do the additional testing. We do need to cover our costs, and patients seem more open to a higher overall examination fee than paying for a separate PPE fee.
Dr. Wilson: At this point we have not yet increased fees, but this issue is something we need to evaluate further. One thing we are doing is more screening retinal images, and that helps to offset the increased costs of PPE and safety and cleaning protocols.
Dr. Shida: We have not added the cost to our patients, but recognize that it is an important decision for our practice. At the end of the year, we are planning to increase our fees across the board and add it in at that time.
Dr. Schornack: Most people underestimate the cost of the PPE in terms of just not the cost of the physical equipment, but inventory, and also staff ordering time. We need to evaluate it as part of the overall cost of providing services to patients.
What PPE Innovations Will Help My Patients, Staff and Myself the Most?
Editors’ Note: The VisibleBliss Phoropter Mask is now available in the U.S., being launched exclusively by ABB Optical Group. It serves as a non-gas permeable barrier between the doctor and patient, and provides additional protection for both. The disposability helps to minimize staff contact with a potentially contaminated surface such as might occur with cleaning of a reusable breath shield.
Our roundtable participants shared their insights on this innovation and their clinical experience with this product. They each counted this innovation as among the most important PPE currently in their practices.
R. Max Raynor, OD:: The VisibleBliss Phoropter Mask has been a godsend for reducing fogging of the phoropter lenses and examination efficiency. It provides an extra measure of safety and protection and allows for a fog-free refraction. Patients leave with the impression that we did everything possible to ensure their safety.
Dr. Nanasy: Patients are now coming with higher expectations regarding safety and office protocols. Patients have been impressed that we are using the disposable VisibleBliss Phoropter Mask for every exam. We make sure every patient sees us not only install it but then also toss it into the recycle bin. It often prompts patients to also discuss all our other safety protocols. It’s definitely leaving a lasting impression on our patients.
Dr. Wilson: Those patient sneezes, coughs, and breathing on the back of your hand (even with a mask) are virtually impossible to avoid. The VisibleBliss Phoropter Mask creates a much needed barrier, which allows me to focus on providing the highest quality of care. It also helps reduce lens fogging, which is a huge bonus. It really strikes you that the fogging is actually due to potentially contaminated breath droplets, which don’t come off quickly or easily. The amount of condensed aerosol breath that is captured by the single use VisibleBliss Phoropter Mask is astonishing, and that means it is not being spread toward me!
Dr. Shida: We tried everything to stop phoropter lens fogging. Patients had to sit back and wait 1-5 minutes for the lenses to clear up. Using a cotton tipped applicator to clean the lenses created a hassle, as the fog is very dense and concentrated. It just was not a smooth experience. Everyone would get frustrated, lose confidence in the refraction, and slow down the examination flow. I tell patients as I put the VisibleBliss Phoropter Mask on the phoropter, that it reduces the fogging of their vision and is designed to protect them from me and me from them. It increases patients’ confidence in the results and allows them to see the extra steps and precautions taken to ensure a safe and comfortable examination.
Dr. Schornack: Patients and staff appreciate taking every precaution possible to protect their health and safety. A disposable breath shield for the phoropter offers the advantage of minimizing the potential of touching a contaminated surface.