Practice Management

Reopening Ramp-Up: Our New Procedures & Protocols

By Clint Taylor, OD

May 20, 2020

As many of us reopen, we are finding a changed practice environment, one requiring unprecedented safety checks. Here is how my practice is approaching this challenge, and how it will change our patients’ experience.

Stocking Up Ahead of Time on Needed Supplies
We have just reopened for routine eyecare. In Illinois, where my office is based, optometrists are considered essential. However, when the Centers for Disease Control (CDC) advised against routine eyecare, most offices chose to only see emergent patients while that recommendation was in place. With the CDC lifting that recommendation, we have been given the green light to resume non-emergent patient care as long as specific safety measures have been put in place.

We are limiting the number of patients we see in the office at first. There is no question that adding the extra procedural and cleaning/disinfection steps listed below is going to affect our efficiency. But we don’t know how much yet. Once we get into the flow with patients for a couple of weeks we should have a better handle on how many patients we should have on the schedule.

In anticipation of increased safety measures, we began to order supplies (hand sanitizer, EPA-registered cleaning and disinfection products and other items) approximately two weeks prior to our anticipated reopen date. We began training personnel on our COVID-19 safety protocol approximately one week before our anticipated reopen date.

Our safety protocol is based on three documents: an executive order by the governor of Illinois, information from Centers for Medicare & Medicaid Services regarding reopening and a document put together by the Illinois Optometric Association (IOA) regarding responsible reopening.

The IOA and American Optometric Association (AOA) have been terrific throughout this entire crisis. From information dissemination, to advocacy, and encouragement, they have done a wonderful job guiding us through this difficult time. I have been proud to be a member of the IOA and AOA during this, and have felt like my dues have been worth every penny.

On the business side, I have also received guidance from IDOC throughout the COVID-19 crisis. Their guidance on finance and human resources has been instrumental in helping our office weather this storm.

3 Categories of New Hygiene Procedures
Our new hygiene practices fall into three categories: procedural, cleaning/disinfection and physical barriers/social distancing.

In Illinois, our governor has ordered that everyone wear a mask in public when a six-foot distance between people cannot be maintained. So, we will at least be wearing masks while that order is in effect.

Procedural

  • Screening patients for symptoms of COVID-19 during appointment confirmation calls
  • Asking all patients to bring their own mask to their appointment (we will provide one if they do not)
  • Providing hand sanitizer at check-in
  • Limiting guests that come into the office with patients
  • Taking patient and guest temperatures at check-in and staff temperatures at the beginning of every work day.
  • Limiting patient wait time in the reception area or bypassing the reception area altogether
  • Disinfecting each frame that has been touched by patients
  • Continuing curbside adjustments, repairs and pick-up when possible
  • Direct shipping contact lens supplies when possible
  • Encouraging sick employees to stay home
  • Taking employee temperatures each morning and screening them for COVID-19 symptoms
  • In the short-term, limiting the number of patients seen

Cleaning/disinfection

We have developed a written protocol stating which areas of the offices need sanitized, how often they need sanitized, what cleaning/disinfecting agents to use and which employee is responsible for each area.

Physical barriers/social distancing

  • Rearranging reception area furniture to ensure six feet between seats
  • Installing plexiglass screens at check-in and check-out
  • Installing larger slit lamp breath shields
  • Posting signage throughout the office promoting the six-foot separation rule
  • Requiring that all staff and patients wear masks
  • Providing access to gloves and protective eyewear for staff

Protective Shields for Exam Room Equipment
We obtained shields for each of our slit lamps. One of our vendors, Topcon, showed great social responsibility by providing them for their slit lamps – that was much appreciated. For our non-Topcon slit lamps, we purchased universal breath shields that fit most models.

Keeping the Payment Process Hygienic
We are currently trying to decide between giving each patient their own pen and having them keep it or disinfecting each pen in between patients. We have also contacted our credit card processing company to see what contact-less payment systems are available.

New Procedure for the Optical, New Sales Opportunity
In the optical, we are disinfecting each frame after it is touched by the patient. We are using two different color trays – red and blue – to help with this process. After patients touch a frame, the frame goes into the red tray instead of back on the board. All frames on red trays get disinfected and then placed into blue trays. Frames in blue trays are ready to go back on the board.

We also plan to limit the amount of “browsing” patients do on their own. This could create an opportunity, by allowing our opticians to custom select and recommend frames for each patient. Our opticians are experts at picking the right frame for each patient – hopefully our new process will enable them to better use their expertise.

Highlighting Safety Measures for Patients
It’s important that patients know that our office is a safe environment. The only way they will know that before their visit is if we tell them. We are highlighting many of the specific safety measures we are implementing on social media, in patient letters and in appointment and confirmation calls. Once the patient is in the office, it will be obvious to them that we are taking COVID-19 very seriously and that we are taking precautions against it.

 


Clint Taylor, OD
, is the owner of Taylor Eye Care in Carmi, Ill., a one-OD, one-location practice with eight support-staff members that delivered about 3,000 comprehensive eye exams in 2019. To contact him: doctor@tayloreyecare.com

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