COVID-19: 11 Practical Steps to Reopening Your Practice

1. Comply with governmental guidance

For federal guidelines refer to Guidelines for Opening Up America Again. AMA provides a chart & fact sheet that details state-specific conditions and resumption of elective or non-urgent procedures.

2. Make a preopening plan.

Chart a course to expected reopening day; include a "soft reopening" period for incremental change. Assess personal protective equipment (PPE) needs, alternatives - what's in stock, what you'll need. Order now.

3. Open incrementally.

Consider reopening in a stepped fashion to allow time to identify & address any practical challenges encountered.

3. Open incrementally, in phases, communicate plans clearly.

Consider bringing employees back in phases, or having them work on alternate days or different parts of the day to help reduce contact.

4. Institute safety measures for patients.

Create a modified schedule to avoid high volume, spearate "well" and "sick" patients, and consider a flexible schedule with more time between visits.

5. Ensure workplace safety for clinicians & staff.

Communicate personal health requirements clearly to clinicians and staff and keep records of employee screening results in a confidential employment file.

5. More on workplace safety.

Consider rearranging open work areas to increase distance between employees and assigning work stations & exam rooms to minimize equipment sharing.

6. Teletriage & previsit screening.

Use a teletraige program to ensure in-person appointment is needed and contact patients 24h before a visit to review logistics of office protocol and screen for COVID-19 symptoms.

7. Coordinate testing with local hospitals & clinics.

Identify COVID-19 testing sites in your catchment area and provide patients with clear, current information on where they can be tested and how the process works.

8. Limit nonpatient visitors.

Clearly post office policy for individuals who are not patients or employees to enter the practice and use phone, teleconference to engage with them. When necessary, designate a time outside office hours to minimize interactions with patients, clinicians, staff.

9. Contact your medical malpractice insurance carrier.

Congress has put in place protection, in certain instances, from liability for front line clinicians treating COVID-19 patients—however new risks may arise upon reopening that do not fall under those protections.

(AMA is also advocating to governors that physicians be shielded from liability for both COVID treatment and delayed medical services due to the pandemic.)

10. Establish confidentiality, privacy.

Institute or update confidentiality, privacy and data security protocols. Keep results of any employee screenings in employment records, separate from personnel file.

(While certain HIPAA requirements related to telemedicine are not being enforced during the COVID-19 public health emergency, generally, HIPAA privacy, security and breach notification requirements must continue to be followed.)

11. Consider legal implications.

Consider employment obligations that may not have been required of your practice (eg, paid sick leave) because of furlough, etc. You may need to make decisions about opting out of these or putting in place and communicating to employees about procedures for requesting same.