As President of Envision Physician Services’ Emergency Medicine Services group and chair of our National COVID19 Task Force, I have been working with a multispecialty team to monitor and address the growing concerns posed by the coronavirus (COVID-19). Together, we are leading efforts to bring assistance, best practices and resources to our clinicians, hospital partners and patients as we work to combat this disease.
On March 11, 2020, the World Health Organization designated the 2019 novel coronavirus as a global pandemic, and the U.S. government declared a national emergency, heightening concerns and anxieties of our patients and communities. Envision is experienced in responding rapidly to public health emergencies, such as natural disasters and yes, even viral infections like the Ebola outbreak in 2014-2015. With hundreds of emergency departments and more than 11,000 clinicians across the nation, we are drawing on our experts and those experiences to develop and disseminate best practices to appropriately manage and treat COVID-19.
I have outlined our organization’s key recommendations for clinicians and hospital leaders on how to manage and treat the escalation of COVID-19.
Recommendations for Mitigating the Effects of the COVID-19 Pandemic
- Hospitals should prepare now for surge capacity both in the emergency department and in inpatient units; intensive care units are expected to experience significant strains
- Identify areas outside of the emergency department to triage and intake possible respiratory infection patients to preserve personal protective equipment (PPE) and protect staff and patients from exposure
- Take precautions to ensure your facility has a detailed infection control protocol and follow the CDC guidelines for personal protective equipment use
- Utilize the CDC Hospital Checklist to ensure your hospital has the appropriate supplies and secondary supply sources
- Limit healthcare worker and other patient exposure risk by utilizing clear signage to direct patients with symptoms to appropriate intake areas of the hospital
- Limit hospital access points and visitation especially for most vulnerable patients (elderly and immuno-compromised)
- At the time of check-in in the emergency department, ensure patients are asked about the presence of respiratory infection, contact with possible COVID-19 patients or travel to areas with high COVID-19 transmission
- Patients with viral respiratory symptoms or suspected COVID-19 should be given a mask to prevent transmission to others
- Use telemedicine resources to replace face-to-face triage and evaluations
- Be prepared for significant staffing disruptions and strains with rising patient volumes and as healthcare workers become ill or quarantined
- Be prepared to utilize other physicians and caretakers across service lines and specialties to support efforts in areas of high volume
- Medical staff offices should create a rapid process for emergency credentials and privileges
- To conserve PPE and available hospital capacity, hospitals should consider plans for entire COVID-19 units: www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html
- Healthcare workers should use respiratory isolation precautions, personal respiratory protective devices, such as face masks and eye protection, when treating suspected COVID-19 patients: www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html
The CDC’s guidance for treatment and evaluation is rapidly evolving. Continue to follow the CDC guidelines at www.cdc.gov/coronavirus/2019-ncov/index.
As you move forward to manage and treat COVID-19, I encourage you to keep these recommendations in mind. Working together, we can safeguard the health of our communities by protecting patients and the clinicians who are putting their health and safety at risk to respond to this virus.
To access the most current and accurate information about COVID-19, visit www.envisionhealth.com/Coronavirus.
Adam Brown, MD, MBA, FACEP
Dr. Adam Brown is the President of Emergency Medicine for Envision Physician Services and leads the National Coronavirus Task Force for Envision Healthcare. He is a board-certified, practicing emergency physician living in Washington, D.C.