White House urges healthcare facilities to open, but safely

By A.J. Plunkett (aplunkett@decisionhealth.com)

The Trump administration is urging healthcare facilities to resume elective surgeries, diagnostic tests, and other non-emergency care and is encouraging patients to tend to healthcare needs postponed because of the coronavirus pandemic.

However, the White House is also cautioning hospitals and other facilities to check with state and local authorities to ensure your area meets the “gating criteria” of fewer reported symptoms, fewer confirmed cases and hospital capacity to handle potential new patients with COVID-19 along with non-emergent care.

“Guidelines for Opening Up America Again are still applicable to all areas, and can be found at the following link: https://www.whitehouse.gov/openingamerica/#criteria,” said the White House statement encouraging reopening. “As such, if states or regions have determined with their public health officials that they passed the Gating Criteria (symptoms, cases, and hospitals) announced on April 16, 2020, then they may proceed to Phase I, and subsequently to Phase II of re-opening. Consistent with those recommendations, facilities should check with their state and local authorities to confirm if Gating Criteria have been met in their area.”

The effort is also heavily dependent on testing and hospitals’ ability to respond to a sudden increase in COVID patients, notes the White House.

“Non-emergent, non-COVID care (NCC) should be offered to patients, as clinically appropriate, in localities or facilities that have the resources to provide such care, as well as the ability to quickly respond to a surge in COVID-19 cases, if necessary,” according to the statement. “Decisions should be consistent with federal, state, and local orders, and CDC guidance and made in collaboration with state and local public health authorities.”

The statement continues: “Careful planning is required to safely deliver in-person care to patients requiring NCC, and all aspects of care must be considered — for example:

• Adequate facilities, workforce, viral testing (https://www.cdc.gov/coronavirus/2019-ncov/testing/diagnostic-testing.html) for SARS-Cov-2, PPE, and supplies across all phases of care in the healthcare system.
• Adequate workforce across all phases of care (such as availability of clinicians, nurses, anesthesia, pharmacy, imaging, pathology support, and post-acute care).”

Hospitals and other facilities are still being encouraged to optimize telehealth service when possible. If opening doors to patients, recommendations also call for, among other things:

• Thorough screening of patients for COVID symptoms
• Partitioning of facilities to keep non-COVID care away from potential or actual COVID patients, and maintaining social distancing through administrative and engineering controls, such as spacing chairs in waiting areas and minimizing the numbers of patients
• Continuing to follow all CDC guidelines for infection control and the use of PPE and supplies

Look for more coverage on how to safely reopen your hospital after a prolonged closure of areas during a national emergency in upcoming issues of Inside Accreditation and Quality  and Healthcare Safety Leader.