Learn how emergency medicine groups are evolving their protocols to protect staff, patients, and revenue during the coronavirus (COVID-19) crisis and beyond in this guide.
How prepared was your emergency medicine group to handle the current coronavirus (COVID-19) crisis?
With healthcare providers on the front lines, hospitals and emergency departments are facing shortages in personal protective equipment (PPE), medical supplies, staff, and more.
Before the pandemic, a 2011 study published in the American Journal of Disaster Medicine revealed that[*]:
- Just 42% of healthcare workers felt that their ED was prepared for a pandemic disease outbreak.
- Only 68% of EDs actually have a plan for pandemic influenza response and other infectious disease threats.
- 63% said their ED had a plan for the distribution of vaccines and antivirals, but only a scant 32% had a plan for the allocation of ventilators.
Though we expect these stats to change dramatically as a result of the COVID-19 learning curve, they don’t inspire much confidence as they currently stand.
So learning from these impacts may be the best way to create a plan to combat them in the future.
What Can Independent Emergency Departments Learn from the COVID-19 Crisis?
Preparing your emergency department for the next pandemic isn’t just about freeing up bed capacity and creating a separate entrance for patients with the virus.
You also need to plan for your financial health.
As we saw, stock prices for major hospital systems fell significantly with each coronavirus-related market crash. So independent emergency medicine groups may be feeling the financial strain more than ever.
Shortages in medical supplies as a result of this pandemic, and the surge in prices, may be the most frustrating and unanticipated part for healthcare providers. Yet even this may be preventable in the future.
It will take a lot more time and data retrieval to fully understand the global implications of COVID-19.
But for now, emergency departments are being advised to begin preparations using a model that’s been studied extensively for decades (and that seems similar to coronaviruses): pandemic influenza.
How to Prepare Your Emergency Department for the Next Pandemic
With already-limited resources as a result of COVID-19, you may not even be thinking about how to prepare your emergency department for the next pandemic.
But decision-makers at all levels should be actively drafting protocols to handle the most common issues faced during these times, such as:
- Preventing your ED from becoming a disease amplifier
- Protecting your healthy staff and non-infected patients
- Testing and treating infected patients safely
- Minimizing potential financial losses
So follow these eight tips to help your emergency department plan for the future:
1. Create a Dedicated Pandemic Task Force
It’s imperative to set up a group of administrators and healthcare staff dedicated solely to pandemic preparedness and response.
This group of decision-makers will develop processes and procedures to oversee a broad range of potential impacts to the ED and anticipate resource needs.
Specifically, consider designating a/an:
- Emergency Manager in each ED. They’ll be responsible for communicating and spreading the committee’s decisions to the staff at their local emergency departments.
- Infection Prevention Practitioner to educate, train, and perform exercise drills with the staff and teach them the best safety practices for wearing PPE.
- Administration Rep to discuss the financials during these meetings.
This team should be comfortable creating policies and using predictive modeling tools to help them make decisions.
2. Take Advantage of CDC Pandemic Modeling Tools
The CDC’s pandemic influenza preparedness efforts include ongoing surveillance of human and animal influenza A viruses, risk assessments of influenza A viruses with pandemic potential, and the development and improvement of preparedness tools that can aid health practitioners in the event of an influenza-like pandemic.
Emergency departments using modeling tools like these should have a better grasp on the potential impacts a pandemic worse than COVID-19 may bring. Once your team understands these projections, they can better prepare for the unexpected.
Below are a list of helpful resources:
- CDC pandemic influenza plan report (updated in 2017)
- CDC Community Flu 2.0
- CDC FluAid 2.0
- CDC FluSurge 2.0
- CDC FluLabSurge 1.0
- CDC FluWorkLoss 1.0
- PanVax Tool for Pandemic Vaccination Planning
Your team will also be able to save money by making informed decisions regarding resources ahead of time instead of at the last minute.
3. Implement a Regular Stockpile of PPE and Other Necessary Supplies
COVID-19 created a surprising shortage of medical masks, soap, antibacterial hand sanitizer, and more in a very brief timespan.
So while your ED may not have been stockpiling these in the past, you’ll want to start regularly ordering a bit more to fill up your reserves for next time.
This includes buying extra:
- Surgical masks for everyone entering your emergency department.
- N95 respirators for healthcare workers in direct contact with potentially-infected patients.
- Powered Air-purifying Respirators (PAPRs)
- Gloves and gowns
- Disinfectants and sterilizers
- Medical supplies
Try to stock up at least three weeks’ worth of supplies in case re-supplying becomes difficult during the pandemic (as it did during COVID-19). Ideally, you should have enough to get your ED through an outbreak lasting several months.
Purchase a bit more than you need in each order, and you may even save money over the long-haul as prices soar later in a limited supply/high demand market.
These stockpiles may also give your physicians and staff more confidence to continue working.
4. Take Care of Your Staff
Your healthcare workforce is essential yet may be significantly reduced during a pandemic.
Depending on the severity of the virus, your staff may not want to risk coming in contact with infected patients and bringing it home to their relatives. They may also need to take care of sick family members or stay home with kids when schools are closed.
So have your team come up with ways to offer your staff daycare for healthy children or medical care for their sick relatives (with screened caretakers).
These incentives may help your ED maintain or even stretch your workforce to handle the potential influx of patients.
From an administrator POV, you may also want to:
- Schedule longer/overtime shifts to limit the amount of staff needed and prevent exposure to the majority.
- Cohorting, or keeping dedicated staff in specific pandemic units to limit the number of those who are exposed. Staff outside this area will take care of non-infected patients in the rest of your ED.
- Track staff symptoms. You don’t want infected staff spreading the virus to healthy patients. Yet staff who are immune or recovered make the best choice for treating infected cases. So watch for symptoms, keep testing employees, and log confirmed cases.
Certain employees may be better off working from home — just like some of your patients are better off using telemedicine instead of the emergency room.
5. Establish Protocols for Employees to Work Remotely
As social distancing becomes more natural, businesses are learning that switching to a remote workforce actually saves them money and boosts productivity while protecting their staff.
Your physicians may not be able to work from home, but your revenue cycle employees certainly can. All coders, transcriptionists, etc. need is a secure computer and a stable internet connection to get their work done.
So rather than this critical segment either risking exposure or taking time off, your ED will continue to generate income while they work remotely.
Create a remote work policy for these telecommuting employees which will include protocols for:
- Daily check-ins with supervisors
- Messaging procedures (such as being available via phone, email, Slack, or Skype)
- Employee workloads, work times, and productivity goals
6. Turn to Telemedicine
Your patients should also consider a virtual option if they can avoid your emergency department.
During a pandemic, telemedicine gives patients a safer route when they have questions or need advice. Set up your telehealth options, and you’ll reduce non-urgent emergency room visits, decrease patient volume, and lower potential spreading.
In the wake of COVID-19, President Trump enacted an $8.3 billion emergency funding measure which lifted restrictions on telehealth services for Medicare beneficiaries[*].
Now physicians can get reimbursed for video visits with patients, thus driving revenue which may be slipping during the pandemic.
Read next: Emergency Medicine Trends in Telemedicine
7. Partner with the Right Emergency Medicine Revenue Cycle Management Specialists
No one can predict whether your ED will be the only place patients will need to go during a pandemic, or one to be avoided (like it is with COVID-19). This uncertainty and lack of emergency department use may cause a sudden dip in your revenue.
That’s why it’s so important to partner with an experienced revenue cycle management team. Optimizing your collections will help your ED stay open so you can keep treating patients (and continue to bring in revenue). You can then allocate this money for your future pandemic preparations.
Plus, expert billing partners will keep your emergency medicine group in compliance with all the changing billing and coding practices that arise during a health crisis.
The Centers for Medicare & Medicaid Services (CMS) just released new billing and coding rules for COVID-19 testing and treatment[*]. These cover everything from virtual visits with a physician to isolated or quarantined private rooms if infected beneficiaries need to stay.
The last thing your team needs during a pandemic is new rules to follow. So it may be wise to outsource this task to those who specialize in it.
Collect Every Last Cent with DuvaSawko, and Prepare for Uncertain Futures with Less Stress
It’s challenging to prepare for a pandemic when the current COVID-19 crisis may be draining your resources. But many of these tips require substantial time to implement, which means your emergency department should begin preparing for them now.
So don’t leave any more money on the table.
Check out the DuvaSawko Medical Billing Calculator, and find out where you may be losing valuable reimbursement dollars. All you have to do is plug in some information about your emergency medicine practice and your payer mix.
With these extra funds, you’ll be able to prepare your emergency department to better handle dips in revenue, supply shortages, and everything else a global pandemic brings.
Talk to the team at DuvaSawko today and schedule your complimentary practice analysis.