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Important Connecticut Physician Office Reopening Guidelines and Tips

Posted on June 27, 2020 by Karin • Filed under:

As businesses and service providers in Connecticut and around the country reopen, each faces unique challenges and must follow specific guidelines in order to resume operations safely. Needless to say, these guidelines and procedures are especially important for medical offices.  

The American Medical Association (AMA) has stated that four milestones must be achieved before governments can relax or eliminate stay-at-home orders:

  • Low risk of transmission within the community based on an ongoing trend of fewer cases and hospital admissions
  • Adequate, well-coordinated testing
  • Appropriate surveillance and contact tracing capabilities
  • Hospitals and other health care providers that are prepared for the results of the reopening

The AMA has also developed a guide, checklist, and other resources to assist medical practices as they reopen. These items are based on guidance from The Centers for Medicare & Medicaid Services (CMS) on reopening facilities to provide non-emergent, non-COVID care.

Having designed medical office spaces, Patriquin Architects is able to provide some insight on space layout and operational flow. 

 

Building on the AMA’s Recommendations

Resources from the AMA provide general recommendations for reopening a medical practice that include:

  • Adhering to all government directives
  • Crafting a comprehensive reopening plan
  • Opening in phases
  • Implementing well-defined safety measures for patients
  • Ensuring a safe work environment for staff 
  • Launching or augmenting a call-in triage program 
  • Screening patients before in-person visits
  • Collaborating with nearby hospitals and clinics on testing
  • Keeping non-patient visitors to a minimum
  • Talking with your medical malpractice insurance carrier
  • Ensuring that patient information is kept confidential
  • Reviewing and understanding the legal ramifications of reopening

Beyond those recommendations, there are steps you can take to modify your office to help minimize the risk of disease transmission. One is to develop a COVID-19 office management plan that covers triage, patient flow, and treatment. This plan should minimize the interactions/encounters patients have with your staff and with other patients. 

For example, if possible, you should designate an area at the entrance to your office as a “respiratory virus evaluation center.” Patients with a fever and/or respiratory symptoms will be directed to proper care, without entering the main medical office.

Another helpful modification is to install environmental controls that help minimize exposure. Translucent barriers between the welcome desk and patients is one such modification. Medical offices should also make handwashing stations and/or hand sanitizer available throughout the space and encourage patients and other visitors to use them frequently. 

In this primary care office, patients call in once in the parking lot, where they wait until there is an available room for them. At the front door, the patient, who must wear a mask at all times, is greeted by a medical assistant who takes their temperature and asks questions from a questionnaire. The patient sanitizes their hands, proceeds to the reception desk for any paperwork to be signed, then goes directly to an exam room. The waiting room is not available at this time. Following their visit, the patient leaves through a dedicated exit door, further avoid cross-flow in the hallway. Medical staff is reduced to 50%, working in shifts with tele-medicine from home. Exam rooms are sanitized after each patient.

If an evaluation center isn’t implemented, waiting areas should be reorganized to keep patients with respiratory symptoms at least six feet away from others. This might involve removing some of the seating from the area. Better yet, a separate waiting area should be used if possible, and a separate entrance for symptomatic patients is also helpful. 

In this medical office, one point of entry is established, with multiple exit-only doors ensuring one-way hallway circulation for patients. Occupancy is reduced in the waiting area and all enclosed rooms have only one occupant. A plexiglass barrier has been added to the reception desk. Patient temperature is taken at the front door. Sanitizing stations have been located at key locations for both staff and patients. Exam and treatment rooms are sanitized after every session.

As much as possible, no-touch devices should be used throughout the space. This includes touchless waste containers with disposable liners, contactless payment systems, etc. Medical practices should also remove shared items like toys, magazines, brochures, pens, and clipboards. 

In this primary care office, extra care must be taken to reduce hallway traffic, as there is no back door for exiting. Patients’ temps are taken at the door and they are escorted to their room. Only essential caretakers can accompany them. Only one staff member should be in an enclosed room at a time. Staff escorts their patient back to the front door and the exam room is sanitized immediately after each patient exam.

Once changes are implemented, patients and visitors should be notified about what to expect. 

 

Get a Fresh Perspective on Your Medical Office Space

As a busy medical professional and one who’s grown accustomed to the office’s layout, it can be challenging to identify all the potential areas for improvement in terms of decreased disease transmission risk. Our team of design experts can provide an outsider’s assessment of your facility and process flow coupled with our experience helping other physicians design or renovate their space. 

As your practice prepares to reopen or looks to improve operations, we’re happy to share our ideas on medical office design in general and COVID-19 modifications in particular. Please contact us at your convenience. 

You can also check out projects we’ve completed, including our work with a plastic surgery center and medspa in Guilford, CT.

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