By Amanda Barker-Assell, OD
May 20, 2020
Practice reopenings come with many needs, from patient and staff communication, and new safety protocols, to revised scheduling. As my office plans how best to reopen, we are finding great support from the technology we have implemented.
Primed for Reopening
Like most practices, we have been closed for many weeks. I furloughed some of my team for two weeks while we waited for the Paycheck Protection Program loan we had been approved for, and our other employees have remained on payroll the entire time. Due to the level of uncertainty with the PPP funding, we had to make decisions that would ensure the viability of our practice long term. We were focused on ensuring that our team would have a practice to return to after COVID 19 stay at home orders.
Pre-pandemic we had 2-3 doctors scheduled every day. In a normal work day we would see approximately three patients per hour per doctor. With re-opening post-pandemic, we are starting with a reduced number of doctors per day, which reduced our patient levels by one-third to half of our normal level. Our plan is to slowly build up our schedule over time as we learn to manage patient flow and maintain social distancing.
We have modified our pre-test work up to take patients directly to exam rooms as quickly as possible. After the examination is complete, our patients wait in exam rooms until they are ready to be escorted to the optical or are ready to leave the building, which limits our patients in the clinical department to only six at any given time. We have embraced virtual terminals which now allow us to check patients out in exam rooms and adds another touch-less component for the patient. Once a patient is escorted from an exam room, that room is properly disinfected, labeled via signage outside the door that the room has been sanitized, and then the next patient is texted by a scribe to enter our office and begin their examination.
We have been planning daily about how to properly reopen our practice, and we are prepared to make changes swiftly as we see needs or concerns. We have secured personal protective equipment and written protocols for every position and area. Training on these protocols is important because we want our team and our patients to feel comfortable and confident that we are doing everything possible to both protect everyone and continue offering the highest standard of care and products.
We are considering office-hour expansion to accommodate our patients over the next few months. By closely monitoring our availability of open appointments, we are prepared to both expand evening hours and open on Saturdays. It is important to develop strategies to ensure that all overdue/missed patients are contacted and worked back into our schedule.
In our frame gallery, we are limiting the number of patients at any time to socially distance. During this time, we are asking patients to allow us to bring frames to them at each dispensing table. We have added the Philips TUV25W T8 lamp, in which UV radiation is a short-wave with a peak at 253.7nm (UVC). Any frame that is touched goes in the unit before going back on the board. The UV unit is not our only method of disinfection, but we added this unit as an additional step in our germicidal disinfection. This has also been a perfect time for us to begin scheduling dispense visits for patients to pick up their new glasses. This new protocol not only helps to control foot traffic but sets clearer patient expectations and reduces our overall call volume.
It is our mission to protect our team and our patients while continuing to provide a high-level patient experience.
Creating Videos for Patients
Continuing to engage with our patient base and community is important to us. We created videos to use on our web site and social media. We are also sending a video personally to patients with upcoming appointments for “What to Expect at Your Next Appointment.” This is to help ease concerns over what we are doing to protect our team and patients. Every week or two, I send an e-mail blast to patients with an update and a short video message to keep them informed of changes. I plan to continue communicating in this way in the future as well.
Other Pieces to Explore
Enhancing Use of Patient Portal & HIPAA-Compliant Text Communications
One feature that we have learned to use with greater efficiency is our patient portal. We are utilizing our portal to a higher degree for pre-check-in paperwork and updated health questionnaires. Additionally, we are asking that patients send us their insurance cards as an image either via the portal or through our HIPAA-compliant text feature. This has been a tremendous help in preparing for check in and streamlining our pre-test procedures. Patients complete a curbside check-in process when they arrive. One of our team members is now operating at a concierge desk in our foyer where we greet patients, screen with proper COVID-19 questions and check temperatures using touch-less thermometers. Scribes then text their patient when ready and move them directly to pre-test devices or examination rooms.
Zoom Meetings & Webinars
Webinars and Zoom meetings have been offered in what seems like an overwhelming quantity. I try to attend as many as possible to glean any information and strategy that will help our practice.
I am part of a study group that has been my most valuable resource. Practice owners across the country are having a dialogue over what to do in a variety of scenarios and brainstorming problems and strategies. It has been amazing to see how our profession has come together to help one another survive this disaster and push ourselves forward from here.
Google’s Business G-suite
While our office was closed, we used our EHR, Uprise, to run reports for all scheduled patients that had to be cancelled due to COVID 19. We exported this list to Google spreadsheets within our Google drive to allow team members from home and in the office to help work through the patient list and start rescheduling our patients for June, July and beyond. Our team members contacted patients by phone to reschedule them and answer questions about our new protocols.
By uploading spreadsheets to our Google drive within our Business G-suite account – multiple staff members could work through the list in real time to avoid duplicating work and wasting time when everyone was not able to be in the office. Our call center regularly discusses our appointment availability over the coming days, weeks and months to strategize on how to accommodate patient needs. We are prepared to make changes as needed to best meet the needs of our patients.
During our downtime, we focused on projects that are often hard to complete when the office is busy. One area of focus was our overdue patients. We again used our EHR to run reports by month for overdue patients. These lists were used to address postcards organized by month to mail out as we move forward. Because we cannot predict what the future holds, our plan is to mail the postcards strategically based on the availability of appointments on our schedule from month to month. It is certainly a balancing act to manage your team, your patients and ensure the health and stability of your private practice. One thing for sure, we have missed seeing our patients and look forward to our return to something that resembles normalcy for us.