Part 2 of 3: Operations
What to Consider When Reopening Your Practice After the Current COVID-19 Crisis
By Eric Schulz, MBA
During normal times, medical and dental practices are relatively well-oiled machines. They are built to safely and effectively see the right number of patients in a workday while maintaining patient, provider, and employee satisfaction. When done right, patients get the best care possible, as safely as possible, and everyone involved feels great about the experience. There are numerous examples of health systems and independent medical and dental practices that have done this well.
What happens when a natural disaster, such as COVID-19, brings these systems to a screeching halt? Our experience so far tells us that the operational systems that worked so well pre-COVID were fragile and volume-dependent. When patients stayed away, the machinery broke, and new (generally reduced) operations had to take their place.
We have experienced this across the healthcare sector. Practices have closed, reduced days, temporarily paused services, and changed their operations to meet their reduced need. Reducing operations hasn’t been easy. However, numerous experts agree, ramping up could be even harder.
Restarting operations will not be as easy as turning the lights back on. Your practices will need to continuously assess its operations to ensure they are working for your organization as you increase patient volumes. The following are some operational areas that every practice should watch to successfully ramp their operations back up in the next few weeks.
As your practice is thinking about restarting its operations in the next few weeks, think first about getting your providers and their clinical support staff schedules ready to go. When possible, focus on the side of provider efficiency (and happiness). However, don’t let your providers force you into making bad financial decisions to rehire their personal nurse or MA. Find a happy medium through appropriate provider and clinical support staff scheduling.
- Providers: All providers will want to return to their pre-crisis schedules. However, if patient volumes return gradually, this may not be immediately possible. Work closely with your providers to create new schedules that use their time effectively and reduce the need for unneeded staff and operations. Remember, no provider wants to come into the office to see a couple of patients. A few busy days a week are much better than a full week with weak schedules.
- Clinical Support Staff: As patient volumes your practice will need to consider rehiring clinical staff. Ensure that your clinical staff schedules are optimized before pulling that trigger, but not at the expense of making your providers unhappy. Work with your providers to ensure that the right clinical support staff are there at the right times to match their schedules and meet their needs.
- Telemedicine: Many practices have made the successful transition to telehealth as a bridge duringthe COVID-19 lockdowns. However, telemedicine can be more than a bridge. Your practice may benefit from permanently adopting telemedicine for certain types of patients. Now is a great time to review your current telemedicine operations to find what is working and what can be improved.
- Survey Your Patients: Start by surveying your patients to learn how they think and feel about telemedicine. The COVID-19 crisis will have gone on long enough that many patients will have personal experience with telehealth in your practice. Find out what they have liked and disliked.
- Inform Your Providers: Meet with your providers to present them with the data from your patient survey. Then ask your providers how telemedicine has worked for them and if they have any improvements to the process.
- Protect Your In-Person Operations: Determine if continuing a significant telemedicine presence in your practice will affect your other operations. Will your need to dedicate specific staff to telemedicine, or can it work within your other operations? Know your operational needs before making any decisions.
- Ensure Appropriate Reimbursement: Telehealth reimbursement was a moving target before the COVID-19 crisis, and there has been even more movement since. Talk with your payors and use tools like DataDx’s Telehealth Coding Application to ensure that you are not reducing your income by retaining a significant telehealth presence.
- Inventory Current Supplies: Take an inventory of the supplies you have in stock. Ensure all supplies are in good order, without defects, and ready to use. Waiting until patients begin to return is not a good time to find out that some supplies are damaged or out of stock.
- Order Supplies and PPE Now: The supply chain of medical supplies and PPE has been significantly disrupted. It may take weeks to receive gloves, masks, gowns, and other supplies that your practice will need to care for an increasing number of patients. Order 2-3 weeks ahead to ensure your practice has what it needs to reopen successfully.
- Maintain a Strong Relationship with Your Supplier: Every practice will find themselves short of needed supplies at some point as patient volumes increase. Having a strong relationship with your supplier is critical. Keeping in constant contact and paying your bills on time gives you the best shot of solving problems in short order.
- Don’t Hoard Supplies and PPE: As patients return, all practices will need to restock. To prevent hoarding, many suppliers will have order limits. Understand how these affect your practice and understand the supplier is doing its best to help the entire community.
PHARMACEUTICALS AND VACCINES
Drugs and vaccines are a unique type of supply that often have short expiration dates. They are also harder to manufacture and ship than other medical supplies. As a result, they require some special attention.
- Vaccines: Inventory your practice’s vaccine supply to ensure that they will not expire before they can be used. Pay close attention to seasonal vaccines, such as flu vaccine that must be ordered now for use in the fall. It may be difficult to estimate the number of seasonal vaccines needed by your practice if further outbreaks of COVID-19 occur, so ensure you can return any unused doses to the manufacturer for cash or credit.
- Pharmaceuticals: Closely inventory essential drugs used by your practice. Ensure none have expired. Assume there may be shortages of essential drugs in the months ahead. Know what your practice’s alternatives are including secondary suppliers and acceptable substitutions.
- Communication: Patient volumes are driven by patient and provider referrals. As you reopen your practice it is crucial that your patients and referring providers know what you are doing and how you are doing it. Use emails, faxes, social media, and phone communication to let everyone know that you are restarting your operations and what you are doing to keep your patients safe as you serve them.
- Vendors: Now is a good time to contact your vendors to ensure they are ready for increased patient volumes and ensure they have an appropriate COVID-19 plan in place. If you rely on laundry and janitorial vendors, ask them how they plan to spin back up while keeping their employees, your employees, and your patients safe. Like others in the healthcare economy, they may have laid off employees and reduced their operations, so giving them a heads up on your plans will grease the skids of success.
- Space: It is not predicted that we will return to pre-COVID-19 patient volumes immediately. As this may take time, consider opening your office’s space back up intentionally. Rather than having your entire space open partially, consider having only part of your space open fully. This will save your practice money and resources until patient volumes return completely.
Acting with intention will be critical to successfully reopening your practice’s operations. Planning now will help you act with intention ensuring you are ready to meet the need that is expected as society reopens. If you have any questions, contact Eric Schulz at firstname.lastname@example.org.
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