COVID-19 LESSONS LEARNED – JPT Healthcare Architects

As the novel Coronavirus has tightened it's grip around the globe and we continue to experience hardships with this outbreak in the US, the JPT team has enhanced our commitment and responsibility to provide value for our clients. Additionally, the health and welfare of our internal team, their families and our communities is of the upmost importance. JPT wants to show the healthcare design world how we are responding and maneuvering through these uncertain times.

Note: JPT Architect's COVID-19 webpage is an ever-evolving resource that will be updated and revised as new information is obtained and materials are created.

COVID KNOWLEDGE BASE

Keeping it Positive for COVID-19 Patients in the OR

Coronavirus 2019 VS. Medical Oxygen

Emergency/Auxiliary Fuel Maintenance in a Time of Crisis and Beyond

TRACKERS & MAPS

DOMO - Coronavirus Tracker

Johns Hopkins - COVID-19 Map

Microsoft - Bing - COVID-19 Tracker

INSIGHTS

When dealing with public health emergencies, such as Emerging Infectious Diseases (EIDs) or Pandemics, Healthcare Facility Leaders should consider risk assessments to include the needs of the patient population they serve in relation to a communicable or emerging infectious disease outbreak.

A plan of action should include a system to study the facility's needs based on the defining characteristics of an EID that includes:

Increased need for Personal Protective Equipment (PPE)
Options for screening staff, patients and other hospital guests; which may also include testing options for infectious diseases
Transfers or discharges of patients
Settings in home-based Healthcare
Changes in physical environment such as distancing, isolation and capacity/surge

Source: All information was found from the Pennsylvania Department of Health

What are the steps that the CDC is recommending all healthcare facilities do to protect their workforce from COVID – 19 at this time?

Screen patient and visitors for stmptoms of acute respiratory illness (e.g. fever, cough, difficult breathing) before entering your healthcare facility. Keep up to date on the recommendations for preventing the spread of COVID-19.
Ensure propser use of personal protection equipment (PPE). Healthcare personnel who come in close contact with confirmed or possible patients with COVID-19 should wear the appropriate personal protective equipment.
Conduct an inventory of available PPE. Consider conducting an inventory of available PPE supplied. Explore strategies to optimize PPE supplies.
Encourage sick employees to stay home. Personnel who develop respiratory symptoms (e.g., cough, shortness of breath) should be instructed not to report to work. Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.

Source: All information obtained from the Centers for Disease Control and Prevention website on 3/29/20. Please click to view current status.

Healthcare facilities and clinicians should prioritize urgent and emergency visits and procedures now during the COVID-19 pandemic.

These actions can preserve staff personal protective equipment (PPE) and patient care supplies; ensure staff and patient safety; and expand available hospital capacity.

Delay all elective ambulatory provider visits
Reschedule elective and non-urgent admissions
Delay inpatient and outpatient elective surgical and procedural cases
Postpone routine dental and eyecare visits

Source: All information obtained from the Centers for Disease Control and Prevention website under "Preserve Supplies" on 4/20/20. Please click to view current website status.

Interim additional guidance for infection prevention and control for patients with suspected or confirmed COVID-19 in nursing homes.

Updated guidance to recommend that nursing homes:

Act now to implement all COVID-19 preparedness recommendations, even before cases are identified in their community
Address asymptomatic and pre-symptomatic transmission, implement source control for everyone entering a healthcare facility (e.g., healthcare personnel, patients, visitors), regardless of symptoms.
- Cloth face coverings are not considered personal protective equipment (ppe) because their capability to protect healthcare personnel (HCP) is unknown. Facemasks, if available, should be reserved for HCP.
- For visitors and residents, a cloth face covering may be appropriate. If a visitor or resident arrives to the facility without a cloth face covering, a facemask may be used for source control if supplies are available.
Dedicate an area of the facility to care for residents with suspected or confirmed COVID-19; consider creating a staffing plan for that specific location

In May of 2020, Centers for Medicare and Medicaid (CMS) has added three components, stemming from COVID-19, to the 1135 Waiver for the Physical Environment.

The new and revised COVID-19 blanket waivers below were either added and/or modified.

Alcohol-Based Hand Rub (ABHR) Dispensers: "CMS is waiving the prescriptive requirements for the placement of alcohol-based hand rub (ABHR) dispensers for use by staff and others due to the need for the increased use of ABHR in infection control. However, ABHRs contain ethyl alcohol, which is considered a flammable liquid, and there are restrictions on the storage and location of the containers. This includes restricting access by certain patient/resident populations to prevent accidental ingestion. Due to the increased fire risk for bulk containers (over five gallons) those will still need to be stored in a protected hazardous materials area. Refer to: 2012 LSC, sections 18/19.3.2.6. In addition, facilities should continue to protect ABHR dispensers against inappropriate use as required by 42 CFR @482.41(b)(7) for hospitals; @485.623(c)(5) for CAHs; @418.110(d)(4) for inpatient hospice; @483.470(j)(5)(ii) for ICF/IIDs and @483.90(a)(4) for SNF/NFs."
Fire Drills: "Due to the inadvisability of quarterly fire drills that move and mass staff together, CMS will instead permit a documented orientation training program related to the current fire plan, which considers current facility conditions. The training will instruct employees, including existing, new or temporary employees, on their current duties, life safety procedures and the fire protection devices in their assigned area. Refer to: 2012 LSC, sections 18/19.7.1.6."
Temporary Construction: "CMS is waiving requirements that would otherwise not permit temporary walls and barriers between patients. Refer to: 2012 LSC, sections 18/19.3.3.2."

Please click here to read and/or download CMS's "COVID-19 Emergency Declaration Blanket Waivers for Healthcare Providers".

What are the steps that the CDC is recommending all healthcare facilities implement to prepare for Coronavirus Disease 2019 (COVID – 19) at this time?

Stay informed about the local COVID – 19 situation. Know where to turn for reliable, up-to-date information in your community. Monitor the CDC COVID – 19 website and your state and local health department websites for the latest information.
Develop, or review your facility’s emergency plan. A COVID – 19 outbreak in your communication could lead to staff absenteeism. Prepare alternative staffing plans to ensure as many of your facility’s staff are available as possible.
Establish relationships with key healthcare and public health partners in your community. Make sure you know about healthcare and public health emergency planning and responsive activities in your community. Learn about plans to manage patients, accept transfers, and share supplies. Review any memoranda of understanding (MOUs) with affiliates, your healthcare coalitions, and other partners to provide support or assistance during emergencies.
Create an emergency contact list. Develop and continuously update emergency contact lists for key partners and ensure the lists are accessible in key locations in your facility. For example, know how to reach your local or state health department in an emergency.

Source: All information obtained from the Centers for Disease Control and Prevention website on 3/13/20. Please click to view current status.

For more Healthcare Design and Maintenance quick tips, check out JPT's website Insights page by clicking here.