Coronavirus (COVID-19) Recommendations
Updated Patient Screening and Cancellation Criteria
When scheduling in-person appointments for routine medical care, instruct patients to call ahead and discuss the need to reschedule their in-person appointment if they develop symptoms of a respiratory infection (e.g., cough, sore throat, fever within 10 days prior to the day they are scheduled to be seen.
All patients will all get a text/call reminder 24-48 hours before their visits. ****Ask all patients about exposure to person with known COVID-19, or Persons under investigation for COVID-19. Ask patients if they have a mask, they are using to bring it to the office with them.
Travel outside of the state of Pennsylvania
Individual screening on arrival at the facility is required for each patient. Ask the patient if they have had:
- Diagnosis of COVID-19 in the prior 10 days
- Testing for COVID-19 in the prior 10 days and awaiting results
- Direct exposure/close contact with someone with a diagnosis of COVID-19 in the prior 14 days.
Close contact, defined as anyone who has been within 6 feet of a person infected with the virus for a cumulative period of 15 minutes without PPE, those who have had direct contact with an infected persons' secretions, you provided care at home to someone who is sick with COVID-19, you had direct physical contact with someone with COVID-19 (hugged or kissed them), you shared eating or drinking utensils with someone with COVID-19 or someone with COVID-19 sneezed or coughed on you.
- 100.0 or greater
- Subjective fever
- Other symptoms
- Shortness of Breath
- Repeated shaking with chills
- Fatigue/Muscle pain/Body aches
- Sore throat
- New loss of taste or smell
- Congestion/Runny Nose
FOR EMPLOYEES: WHAT TO DO WHILE YOU ARE WAITING FOR TEST RESULTS
After you get tested
Stay home and away from others if:
- You have symptoms
- Someone in your home has COVID-19
- You've been in close contact with someone with COVID-19 in a non-healthcare setting
If you don't have symptoms and HAVE NOT been in close contact with someone in the community setting with COVID-19, you do not need to stay home while you wait for testing results.
If you don't have symptoms and HAVE been in close contact with someone in the healthcare setting with COVID-19, you do not need to stay home while you wait for testing results.
You MUST adjust waiting rooms to have 6 feet of separation between waiting patients. Mark chairs that you do not want to be used. Place markings on the floor 6 feet apart in any area where patients might wait in line ie: check-in or check out.
Make sure hand sanitizer is available in waiting areas and at all workstations.
Visitors (those accompanying patients to their appointment and drivers for procedures) MUST wait in their car or outside of our waiting area. Drivers for procedure patients should be texted to come inside to accompany their patients' home.
No children will be permitted into the offices or ASC.
Infusion patients should use a direct entrance when possible or taken directly to the infusion suite.
Infusion suites should have door kept closed whenever possible
All patients MUST always wear masks. Encourage patients to bring their own masks if they have one available. Patients who are not able to wear a mask should be rescheduled for telehealth. Face shields are not a substitute for masks.
Lunchroom clean up duty MUST include cleaning all tables with appropriate EPA cleaning products. Maintain a social distance of 6 feet while sitting in the break room. Employees should face forward and not across from one another when using the break room. Staff should not sit within 6 feet of one another in the lunchroom.
Visitor/Sales Rep - Virtual lunches are permitted if social distancing can be maintained. Pharmaceutical Reps may resume dropping off samples to offices.
Patients should not come in to pick preps or prep packets up until 1 week before their scheduled appointment. Send prep instructions via portal or mail immediately upon scheduling
Take the temperature of all patients and staff entering the facility. Document staff temperatures at the start of each shift. Staff taking patient temperatures must use PPE including isolation gown, gloves, eye protection, and face shield. Staff should have temperatures taken twice daily. You will need to track your own temperature on non-workdays. It should be under 100.0. Staff will complete an assessment for symptoms twice each day according to the procedures described in the COVID 19 employee screening policy and procedure. This includes temperature and written screening questions. Misrepresenting symptoms or masking fever with the use of fever reducers is subject to staff disciplinary action.
When entering the building, all patients are asked about the presence of symptoms of a respiratory infection and history of travel to areas experiencing transmission of COVID-19 or contact with possible COVID-19 patients. Patients should be instructed to put on a cloth face covering or mask. Patients who have traveled to a state listed on the quarantine list must wear a medical mask.
All staff MUST always wear a cloth face covering or medical mask at all times while they are in the workplace, including in breakrooms or other spaces where they might encounter co-workers. All staff in healthcare facilities (locations where we see patients) MUST wear a facemask, instead of a cloth face-covering because it provides both source control and protection from exposure to splashes and sprays of infectious material from others. You will use 1 mask per week and store them in a paper bag. Endoscopy centers staff should wear full PPE and all staff in procedure rooms should use N95 or similar filtration masks according to instructions provided in the Endoscopy PPE attachment. When leaving work, staff should remove their workplace mask and place a cloth face covering. Workplace masks should not be worn in public. Hand washing is required after the exchange of masks.
In the current state of substantial community transmission, all patient-facing staff must wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth are all protected from splashes and sprays of infectious material from others. HCP should continue to use eye protection whenever they are involved in patient care as part of the standard or transmission-based precautions. Protective eyewear with gaps between glasses and the face are unlikely to protect the eyes from splashes and sprays. Goggles or a face shield that covers the front and sides of the face is recommended.
FAQ: "Given the potential for asymptomatic transmission of SARS-CoV-2, what PPE should be worn by HCP providing care to patients who are not suspected to have COVID-19"
Vital signs including weight should be taken according to office protocol on office patients provided social distancing between patients can be achieved and proper cleaning of equipment is conducted. Staff should use appropriate PPE while conducting these activities. Vital signs of infusion patients will only be taken at the start and finish of infusion unless using an automatic programmable machine.
How to Protect Yourself and Patients
All staff MUST wear a mask at all times. Visitors and patients should be encouraged to wear cloth face coverings. If a patient or visitor arrives without a facemask offer them a cloth face covering or surgical mask.
Patient facing staff must wear eye protection.
Site managers are responsible for the evaluation of all cleaning products for effectiveness against Coronavirus.
Diligent cleaning between patients and on regular schedules. The staff is responsible to ensure that effective cleaning is conducted. Make sure to clean all the surfaces in your work area.
- Wear disposable gloves when cleaning and Discard gloves after each use. Clean hands immediately after gloves are removed.
- Wear eye protection when there is potential for splash or splatter to the face
- Disinfectants must be stored in labeled closed containers in a secure location
- Clean surfaces and objects that are visibly soiled with soap and water prior to disinfection.
- Cleaning should progress from the least soiled (cleanest) to most soiled (dirtiest) areas and from higher to lower levels.
- Use an EPA registered disinfectant approved for use against novel coronavirus according to manufacturer instructions. Pay special attention to concentrations and contact time.
- Use fresh clothes at the start of each cleaning session and discard clothes no longer saturated with solution.
- All high touch surfaces in patient care areas should be cleaned after each patient visit and at least once daily. Low touch surfaces, bathrooms, clerical counters, public desk spaces, railings, and equipment used by patients should be cleaned at least twice daily. https://www.who.int/publications/i/item/cleaning-and-disinfection-of-environmental-surfaces-i nthe-context-of-covid-19
Wash hands with soap and warm water for 20 seconds or use a Hand Sanitizer containing at least 60% alcohol between patients.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Employees MUST stay home if you are sick- DO NOT REPORT TO WORK TO TELL US YOU ARE SICK!! This increases exposure to patients and coworkers.
Employees must stay home if they have had testing and are awaiting results or have had close contact with someone who has had testing and is awaiting results (see definition of close contact).
Employees who have traveled anywhere outside of the state should discuss individually with their supervisor. Contractors and other visitors may be subject to additional limitations. Use PPE when appropriate but only when appropriate- if a patient gets in the door, the provider who examines the patient should use a cover gown, mask, gloves, and eye protection. In order to manage supplies please keep masks behind the check-in desk.
Please be diligent about ordering supplies as needed. Be sure that you continuously order PPE in order to keep a sufficient supply.
In locations where no-touch infrared thermometers are available use these in place of oral thermometers.
Health Department Contact Information
PA Department of Health
PA DOH 1-877-724-3258
County Health Departments
Berks County 1-610-378-4352
Bucks County 1-215-345-3318
Chester County 1-610-344-6225
Delaware County 1-610-447-3250
Lancaster County 1-717-299-7597
Montgomery County 1-610-278-5117
Philadelphia County 1-215-685-6748