Angie Franks
Five ways health systems can optimize care and minimize risk during COVID-19
July 06, 2020
By Angie Franks
Health systems, hospitals and clinics across the country have deployed multifaceted strategies for coping with the COVID-19 pandemic. Many of these measures are highly visible, from the placement of tents and blockades outside emergency departments (EDs), to the conversion of off-campus buildings into dedicated COVID-19 treatment centers.
Less conspicuous, but just as crucial, is the role of the health system access center that manages transfers to the health system and orchestrates care for patients across the network. In fact, a properly staffed, well-run access center plays a vital role in responding effectively to the challenges of COVID-19. For example, access centers can intelligently stratify patient risk, prevent inappropriate ED use, safely arrange transportation and initially manage infected patients, optimize capacity utilization, and ensure that COVID-19 patients receive prompt, targeted care while minimizing risk to other patients, clinicians, and staff.
The following are five ways your access center can help optimize care and minimize risk during the COVID-19 crisis, whether you are in the midst of your first wave of cases or preparing for your second:
1. Robust screening process
Triage is a core component of preventing facility overcrowding, along with guiding providers and patients to the appropriate resources. In the access center, a screening workflow, based on CDC guidelines, will stratify each patient’s exposure risk. Given the rapidly emerging new information, these workflows and screening questions must be quickly alterable as new recommendations are released.
Screening must occur with every potential patient transfer into your network, not selectively or intermittently. This will prevent overlooking medium- and high-risk cases, or even patients with a documented COVID-19 diagnosis, which can occur if clinicians are focused on other reasons for transfer, such as traumatic injury or stroke. The assumption should be that a patient is COVID-19 positive, unless ruled out.
Through an effective screening process, coupled with downstream notifications, your access center can ensure patients are safely managed at every step of the transfer process. At the same time, by extending the reach and influence of your access center as an information hub, you will more readily guide patients and their providers to the appropriate levels of care and treatment venues to avoid overwhelming ED and inpatient resources.
2. Intelligently aligning care and resources
Guided by data from the screening process, your access center agents will determine the appropriate placement or location for each known or potential COVID-19 patient.
This determination addresses decisions regarding the level of care, which could include a telehealth visit with an advanced practice provider or admission to the intensive care unit (ICU), a dedicated facility where COVID-19 patients are cohorted, or another temporary setting. The key is to transfer patients directly to the most appropriate endpoint of care, which can avoid improper use of high-acuity resources or unnecessarily routing patients through the ED, which creates bottlenecks and risks additional staff and patient virus exposure.
As surge conditions make resource allocation decisions even more difficult, the access center will, in certain instances, readily facilitate alternative methods to assist referring providers with their patients such as telehealth consultation, remote monitoring, visiting nurses, or other means.
By avoiding unnecessary admissions and transfers in this way, it keeps beds available for patients who require acute and intensive care at designated locations. We saw these considerations become crucial in early U.S. COVID-19 hotspots, such as New York, Washington, and many locations internationally where case volumes rapidly increased. Load balancing is critical to prevent overwhelming providers and ensuring patients receive optimal care, so access center agents should have a real-time bed vacancy perspective for each facility.
3. Alerting relevant stakeholders
All personnel involved in a transfer of a patient with COVID-19, or if there is a medium-to-high risk of infection, should have advance notification so they can appropriately prepare for and transport the patient. This includes donning appropriate personal protective equipment (PPE), readying isolation rooms, and having relevant staff available. Automatic push notifications to desktop and mobile devices ensure that this essential information reaches each stakeholder consistently.
When setting up notifications, make certain that all stakeholders are included. For example, a fire department may transport a patient with a traumatic head injury who, based on the access center’s screening, may also be at high risk for COVID-19. With advance notification, they can protect themselves with the appropriate PPE, which is a preventive step that may be overlooked during a traumatic injury rescue and transport.
4. Serving as a consumer hub
Transfer and access centers are generally focused on service to referring providers. However, many organizations are extending their focus to interact directly with patients. During this pandemic, residents of communities have been seeking answers about their symptoms, as well as concerns about information accuracy, testing and potential exposure. Consequently, they may overwhelm clinic or hospital phone lines with inquiries, or they may even visit an urgent care center or ED for non-emergent reasons. All of this diverts valuable resources needed in other areas and risks exposing healthy patients to the virus.
Your access center can alleviate this pressure and mitigate risks by serving as a community information hub. In many cases, access centers are implementing and publicizing a designated phone number for consumers to call. Non-clinical personnel can be temporarily assigned to field these calls and respond to initial consumer concerns and connect them with clinical personnel as needed. This reduces phone-line congestion, builds stronger goodwill with the community and allows people who should self-isolate and shelter-in-place to do so safely and confidently.
5. Data to support planning and response
The data captured from patient care orchestration activities, as well as from calls to the COVID-19 information line, are valuable as your organization tracks activity across the community and assesses changes in the infection curve over time. Additionally, infection clusters can be readily identified based on referring or home locations. Outcomes data for admitted, transferred and telehealth patients can also be tracked to optimize future treatment protocols, such as when a likely second wave of COVID-19 cases arrives later this year.
Accurate, real-time answers to these and other questions, when presented in at-a-glance dashboards and easy-to-understand reports, enable decision-makers to more proactively and effectively respond to the pandemic. In addition, data generated by your access center can benefit the business side of your organization, particularly as you strive to judiciously allocate finite resources.
Combined, your access center can be your health system’s secret weapon to combat the spread and harm caused by COVID-19 to your patients, providers and your community.
About the Author: Angie Franks is the CEO of Central Logic, an industry innovator in enterprise visibility and tools to accelerate access to care.
Health systems, hospitals and clinics across the country have deployed multifaceted strategies for coping with the COVID-19 pandemic. Many of these measures are highly visible, from the placement of tents and blockades outside emergency departments (EDs), to the conversion of off-campus buildings into dedicated COVID-19 treatment centers.
Less conspicuous, but just as crucial, is the role of the health system access center that manages transfers to the health system and orchestrates care for patients across the network. In fact, a properly staffed, well-run access center plays a vital role in responding effectively to the challenges of COVID-19. For example, access centers can intelligently stratify patient risk, prevent inappropriate ED use, safely arrange transportation and initially manage infected patients, optimize capacity utilization, and ensure that COVID-19 patients receive prompt, targeted care while minimizing risk to other patients, clinicians, and staff.
The following are five ways your access center can help optimize care and minimize risk during the COVID-19 crisis, whether you are in the midst of your first wave of cases or preparing for your second:
1. Robust screening process
Triage is a core component of preventing facility overcrowding, along with guiding providers and patients to the appropriate resources. In the access center, a screening workflow, based on CDC guidelines, will stratify each patient’s exposure risk. Given the rapidly emerging new information, these workflows and screening questions must be quickly alterable as new recommendations are released.
Screening must occur with every potential patient transfer into your network, not selectively or intermittently. This will prevent overlooking medium- and high-risk cases, or even patients with a documented COVID-19 diagnosis, which can occur if clinicians are focused on other reasons for transfer, such as traumatic injury or stroke. The assumption should be that a patient is COVID-19 positive, unless ruled out.
Through an effective screening process, coupled with downstream notifications, your access center can ensure patients are safely managed at every step of the transfer process. At the same time, by extending the reach and influence of your access center as an information hub, you will more readily guide patients and their providers to the appropriate levels of care and treatment venues to avoid overwhelming ED and inpatient resources.
2. Intelligently aligning care and resources
Guided by data from the screening process, your access center agents will determine the appropriate placement or location for each known or potential COVID-19 patient.
This determination addresses decisions regarding the level of care, which could include a telehealth visit with an advanced practice provider or admission to the intensive care unit (ICU), a dedicated facility where COVID-19 patients are cohorted, or another temporary setting. The key is to transfer patients directly to the most appropriate endpoint of care, which can avoid improper use of high-acuity resources or unnecessarily routing patients through the ED, which creates bottlenecks and risks additional staff and patient virus exposure.
As surge conditions make resource allocation decisions even more difficult, the access center will, in certain instances, readily facilitate alternative methods to assist referring providers with their patients such as telehealth consultation, remote monitoring, visiting nurses, or other means.
By avoiding unnecessary admissions and transfers in this way, it keeps beds available for patients who require acute and intensive care at designated locations. We saw these considerations become crucial in early U.S. COVID-19 hotspots, such as New York, Washington, and many locations internationally where case volumes rapidly increased. Load balancing is critical to prevent overwhelming providers and ensuring patients receive optimal care, so access center agents should have a real-time bed vacancy perspective for each facility.
3. Alerting relevant stakeholders
All personnel involved in a transfer of a patient with COVID-19, or if there is a medium-to-high risk of infection, should have advance notification so they can appropriately prepare for and transport the patient. This includes donning appropriate personal protective equipment (PPE), readying isolation rooms, and having relevant staff available. Automatic push notifications to desktop and mobile devices ensure that this essential information reaches each stakeholder consistently.
When setting up notifications, make certain that all stakeholders are included. For example, a fire department may transport a patient with a traumatic head injury who, based on the access center’s screening, may also be at high risk for COVID-19. With advance notification, they can protect themselves with the appropriate PPE, which is a preventive step that may be overlooked during a traumatic injury rescue and transport.
4. Serving as a consumer hub
Transfer and access centers are generally focused on service to referring providers. However, many organizations are extending their focus to interact directly with patients. During this pandemic, residents of communities have been seeking answers about their symptoms, as well as concerns about information accuracy, testing and potential exposure. Consequently, they may overwhelm clinic or hospital phone lines with inquiries, or they may even visit an urgent care center or ED for non-emergent reasons. All of this diverts valuable resources needed in other areas and risks exposing healthy patients to the virus.
Your access center can alleviate this pressure and mitigate risks by serving as a community information hub. In many cases, access centers are implementing and publicizing a designated phone number for consumers to call. Non-clinical personnel can be temporarily assigned to field these calls and respond to initial consumer concerns and connect them with clinical personnel as needed. This reduces phone-line congestion, builds stronger goodwill with the community and allows people who should self-isolate and shelter-in-place to do so safely and confidently.
5. Data to support planning and response
The data captured from patient care orchestration activities, as well as from calls to the COVID-19 information line, are valuable as your organization tracks activity across the community and assesses changes in the infection curve over time. Additionally, infection clusters can be readily identified based on referring or home locations. Outcomes data for admitted, transferred and telehealth patients can also be tracked to optimize future treatment protocols, such as when a likely second wave of COVID-19 cases arrives later this year.
Accurate, real-time answers to these and other questions, when presented in at-a-glance dashboards and easy-to-understand reports, enable decision-makers to more proactively and effectively respond to the pandemic. In addition, data generated by your access center can benefit the business side of your organization, particularly as you strive to judiciously allocate finite resources.
Combined, your access center can be your health system’s secret weapon to combat the spread and harm caused by COVID-19 to your patients, providers and your community.
About the Author: Angie Franks is the CEO of Central Logic, an industry innovator in enterprise visibility and tools to accelerate access to care.