Covid-19 Update Practical tips for a DMEPOS day to day operations……… Sandra Canally RN April 2020 Founder & CEO
The Compliance Team Process in all we do! Simplification leads to clarity and clarity allows the provider to focus on what matters most……to your patients & families Safety, Honesty, Caring !
The Compliance Team Wishes you Happy Holidays during this crisis
What Matters Most to you! ➢ Your Employees ➢ Your Patients/customers ➢ Your community
3 Important traits influencing daily practices as a Leader that have carried over throughout my healthcare career to use in time of need ➢ Organization ➢ Observation ➢ Anticipation
Organization Assess your Risk ➢ Type of Provider – DME, Pharmacy ➢ Type of services – Bracing, Respiratory, Complex rehab, supplies ➢ In what environment – Retail, Mail order, Home Delivery
Every type of provider is at risk and must do what is necessary to prevent the spread of infection!
Organization – Training What is COVID-19? ➢ A large family of viruses ➢ This version from China suggests a likely single, recent emergence of this virus from an animal reservoir. ➢ From there it spread people to people which we call community spread. ➢ Mild for the most part but severe in 16% of the cases, mostly older people or those with other conditions or immune suppressed. ➢ Declared a Pandemic on March 11, 2020 ➢ Meaning an outbreak of a disease that occurs over a wide geographic area and affects an exceptionally high proportion of the population
Symptoms Develop 2-14 days after exposure • Fever 83.9% of patients • Cough 76.82 % of patients • Shortness of Breath 11.44% of patients
New coronavirus stable for hours on surfaces The scientists found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable in the following: ➢ In aerosols for up to three hours, ➢ Up to four hours on copper, ➢ Up to 24 hours on cardboard ➢ Up to two to three days on plastic and stainless steel. People may acquire the virus through the air and after touching contaminated objects. https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours- surfaces
How to Deal with this Pandemic???? Don’t Panic or overbuy!!
Power of Social Distancing
How to Deal with this Pandemic? The 4 Ps ✓ P rotect yourself First: prepare and be ready ✓ P rotect your staff Second: detect, protect and treat ✓ P rotect your patients Third: reduce transmission ✓ P revent spread Fourth: innovate and learn
DME/Pharmacy ➢ Review your infection control/prevention policies ➢ Review and update your emergency preparedness policies ➢ Perform Training of all staff on all of the above
Quality Improvement -DME/Pharmacy Quality improvement plans serve vital roles at times like these. If you don’t know where you are today operationally, your chances of acting fast and thoughtfully in time of a crisis are compromised. During normal business cycles, your QI plan will help you identify areas in need of improvement, and then fix them. Every DMEPOS provider needs to have a written Quality Improvement Plan which is developed and implemented by key personnel of the organization representing management, the warehouse and service delivery. The plan should include the following: -Plan for new products/services if appropriate. -Goals for improving patient outcomes (e.g. patient satisfaction and equipment failure as appropriate) -Operational areas identified in need of improvement. -Monitoring of human resources including staff development & training -Patient satisfaction and dissatisfaction
DME/Pharmacy ➢ Determine Staffing levels necessary to operate and who has higher levels of risk ➢ Perform Training of all staff ➢ Any non-essential employees should work from home when possible • If staff need to work in setting other than home, then social distancing should be applied.
Recommendations for an Infectious Disease Outbreak Response Plan: ➢ Identify possible work-related exposure and health risks to your employees. OSHA has more information on how to protect workers from potential exposures external icon to COVID-19. ➢ Review human resources policies to make sure that policies and practices are consistent with public health recommendations and are consistent with existing state and federal workplace laws (for more information on employer responsibilities, ➢ Identify essential business functions, essential jobs or roles, and critical elements within your supply chains (e.g., raw materials, suppliers, subcontractor services/products, and logistics) required to maintain business operations. ➢ Plan for how your business will operate if there is increasing absenteeism or these supply chains are interrupted.
Recommendations for an Infectious Disease Outbreak Response Plan: ➢ Altering business operations (e.g., possibly changing or closing operations in affected areas), and transferring business knowledge to key employees. ➢ Work closely with your local health officials ➢ Plan to minimize exposure between employees and also between employees and the public, if public health officials call for social distancing. ➢ Establish a process to communicate information to employees and business partners on your infectious disease outbreak response plans and latest COVID-19 information.
Put the plan into action!
““A bend in the road is not the end of the road … Unless you fail to make the turn.” ― Helen Keller”
Providers with walk in Patient Access Please place on your door!! If you are experiencing any of these symptoms: Cough Fever Shortness of breath Please go back to your car and call us. Enter Phone Number We will come OUTSIDE to you.
DME, Pharmacy Staff should be screening calls ➢ Do they have symptoms ➢ Have they been exposed ➢ Is their visit to your operation a MUST! ➢ If not, they should not come in person
Hand Hygiene for All • Staff should perform hand hygiene using ABHS before and after all patient contact, contact with potentially infectious material. • Hand Sanitizers must be at least 60% alcohol. • Staff should preform hand hygiene before putting on and upon removal of PPE, including gloves. • Hand hygiene can also be performed by washing with soap and water for at least 20 seconds. If hands are visibly soiled, use soap and water before returning to ABHS.(sing the alphabet) • All providers should ensure that hand hygiene supplies are readily available in every care location.
Patient with symptoms ➢ Do Not let them in your retail operation ➢ Instruct them to go home and call their primary care provider
Strategies for Optimizing the Supply of PPE ➢ Eye Protection ➢ Isolation Gowns ➢ Facemasks ➢ N95 Respirators hcp/ppe-strategy/index.html https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html
Clean and Disinfect • Alcohol solutions • Ensure solution has at least 70% alcohol. • Other common EPA-registered household disinfectants. • Products with EPA-approved emerging viral pathogens pdf icon [7 pages]external icon claims are expected to be effective against COVID-19 based on data for harder to kill viruses. https://www.epa.gov/pesticide-registration/list-n-disinfectants- use-against-sars-cov-2 • Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
MASKS ➢ CDC states mode of transmission is droplet so technically any coverage of the nose and mouth protects you. ➢ Home made masks can provide SOME protection, better than nothing. ➢ They do not protect the eyes but by strictly maintaining the 6 ft social distancing you would technically safe from any droplets ➢ Yesteryear masks like this were used
Important sources for PPE https://www.ahrmm.org/ahrmm-covid-19 advancing healthcare thru supply chain excellence https://www.cov.care/surgical-masks https://www.hnmmedical.com/medical-supplies/
DMEPOS Provider Assess your risk ➢ Products/services offered ➢ Retail, Mail order, Homecare
DMEPOS Low risk ➢ No direct patient contact ➢ Products are shipped ➢ Do tele-instructing ➢ e.g.via facetime, check with manufacturer for video/web instructions Questions to address Your risk that would then increase Patients return used equipment ➢ You then must have cleaning & disinfectants and segregate dirty ➢ Also need personal protective equipment Wash-Glove-Wash
DMEPOS High Risk Homecare ➢ Perform screening prior to delivery ➢ Use good hand hygiene ➢ Use PPE (Gloves) if touching equipment ➢ Use mask if entering patient’s home and coming close to patient’s air space ➢ Bag and tag equipment for delivery as well as pick up ➢ Ensure you use disinfectant ➢ Utilize telehealth measures in place of delivery if appropriate ➢ To keep number of deliveries down evaluate your ability to Give additional supplies, portables etc. Do more follow-up calls to stay in touch with patients
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