This playbook provides guidelines for health care organizations in Greater Des Moines (DSM), such as hospitals, clinics, dentists, eye doctors and more.
Sample: Nurse Practitioner Risk Profile
The sample risk profile is relative risk to the professional carrying out their role as a nurse practitioner in DSM. The profile shows frequency, or how many people in a day; duration, or length of typical interaction; and variety, or the number of different people.*
The coronavirus outbreak has had direct and lasting impacts on health care organizations in the form of financial, operational and supply chain challenges. Hospitals and clinics saw sharp drops in regular doctor visits, emergency room arrivals and elective, non-essential surgeries that are vital to most organizations' bottom lines. It's not just the large, urban hospital systems that are struggling. Doctors with their own independent practices in small to mid-size towns are suffering these same severe revenue cuts. Safety-net clinics, who serve the nation's poorest residents, have also been hard hit. Perhaps the most dramatic impact has been on rural health care. As the crisis drags on, health care organizations will be presented with tough choices and potential furloughs. Amid the uncertainty, initial shortages of personal protective equipment (PPE) have put health care workers at risk of infection.
Telehealth Visits Surge
The rise of telehealth has brought about increased access to health care across the country, especially in rural areas. Telehealth will continue to be expected by some consumers, even in a post-pandemic environment. However, addressing cybersecurity concerns will be paramount in the future. Hospitals, health care systems, providers and payors will all have to accelerate digital transformation plans. These plans will likely be contingent on a resolution to the payment issue of telemedicine and telehealth.
Elective procedures resumed in all Iowa counties in the late spring as long as hospitals had bed space and enough PPE for the procedure. This has helped reduce the financial stress hospitals are facing during the pandemic.
Mental Health Effects
Demand for mental health services will increase substantially due to the pandemic, including the health care workforce and the general population. Hospitals and other organizations must prioritize the mental health of their employees, ensuring they have the proper resources and support to continue their work effectively and safely.
Leverage Culture to Build Resilience
An organization’s ability to thrive during COVID-19 is directly related to organizational culture. COVID-19 has threatened to introduce negative elements into the organizational culture across healthcare organizations due to strains on employee physical and psychological safety and its medium- to long-term financial impacts. Leaders must leverage culture to overcome COVID-19 impacts by understanding the unique needs of groups across the organization and adapting leadership styles where required.
Health & Sanitation
- Implement a pre-appointment phone screening process for patients.
- Take temperature of patients, staff and visitors on-site.
- Require patients and visitors to wear a cloth face covering when possible.
- Take every effort to conserve PPE.
- Ensure there is an established plan for thorough cleaning and disinfection of spaces used for care.
- Regularly screen staff for COVID-19 when adequate testing capability is established.
- Encourage employees who feel sick to stay home. Employees who have had close contact with someone with COVID-19 should take precautions, including self-quarantine, in accordance with CDC guidance.
- Provide masks and gloves for all staff.
- Provide accommodations for vulnerable populations.
- Maintain a strict visitor policy.
Process & Space Modification
- Establish COVID Care zones and screen all patients, visitors and staff for symptoms of COVID-19.
- Divide workforce into COVID-19 care and non-COVID-19 care groups to conserve PPE.
- Designate separate floors, buildings, or entrances to non-COVID-19 patients and treatment.
- Minimize time in waiting areas and ensure social distancing by spacing chairs at least six feet apart or asking patients to wait in their vehicle instead of a lobby area prior to an appointment.
- Maintain low patient volumes in waiting rooms.
- Visitors should be prohibited unless they are necessary for an aspect of patient care.
- Prepare to cease non-essential procedures in case of another surge in COVID-19 cases.
- Waive last-minute cancellation policies due to illness.
- Use touchless payment methods if possible.
- Provide hand sanitizer throughout the building for use.
- Encourage telehealth where possible.
- Consider installing plexiglass guards for registration areas and entrance screening locations.
- Consider establishing COVID-19 urgent care clinics along with primary care clinics for preventative wellness and chronic care management.
- Establish an employee resource center to address the needs of staff, including mental health support, meals, care essentials, onsite sleeping arrangements or additional assistance of any kind.
- Encourage use of 2-1-1.
- Post signage throughout the building clearly identifying COVID-19 care zones and non-COVID-19 care zones.
- Post relevant information throughout the building in multiple languages.
- Provide relevant instructions on a website for procedures inside the health care facility.
- Provide patients with communication devices to reach family members not allowed in due to visitor policy.
- Request patients report coronavirus symptoms to your facility within the next 14 days.
- Physicians should consider verbalizing actions by scripting when delivering care.
- Consider using telehealth for virtual patient visits and hospital rounds.
- Conduct regular staff communications to ensure the organization is apprised of procedural updates and pertinent information during the COVID-19 outbreak. Provide staff with outlets to voice questions or concerns about protocols and procedures and suggest innovative ideas.
DSM has come together to provide support for the health care community. Organizations and groups such as St. Francis of Assisi, ChildServe and KinderCare are offering child care services to families of essential workers; hotels such as Country Inn of Ankeny and TownePlace Suites by Marriott are offering discounts to medical professionals; and Christian Brothers Automotive is offering free courtesy inspections and oil changes to help other essential workers
Mental Health Support
The effects of states of emergency and operating in crisis mode induce stress, burnout and emotional burden — the effects of which are felt by medical professionals. MercyOne is offering free support groups for nurses, providers and other staff. Telehealth company ThriveTalk is also offering free mental health services for essential workers during COVID-19.
Additionally, UnityPoint Health has recently opened a behavioral health urgent care center in collaboration with Eyerly Ball and Orchard Place open daily 10 a.m. – 8 p.m. located at 1250 East 9th Street in Des Moines.
In early May, Delta Dental of Iowa Foundation announced $360,000 in grants to community health centers. To support Iowa dentists directly during the COVID-19 situation, Delta also introduced the Advance Claims Payment Program (ACPP). This program will allow dentists to receive up to 50% of their average weekly claims payment in an interest-free advance for four weeks with repayment beginning in July.
MercyOne and Corteva Agriscience™ announced have joined forces to fill the urgent need for processing COVID-19 samples. MercyOne health care providers will collect the samples and deliver them to Corteva, where a small team of trained Corteva employees will assess them using the company’s sophisticated genetic screening capabilities.
Vulnerable & Minority Populations
Broadlawns Medical Center has developed outreach programming to ensure vulnerable and minority populations receive proper information and guidance. Broadlawns also recently partnered with the United Way of Central Iowa to expand this outreach programming for the current pandemic and are in ongoing communication with Central Iowa Shelter and Services and Food Bank of Iowa to provide reciprocity for the individuals they serve.
Equipment & Supplies to Those in Need
Running low in their supply of hand sanitizer and PPE equipment, Broadlawns Medical Center was seeking ways to replenish their inventory. Fareway Grocery Stores offered Broadlawns their hand sanitizer shipment while the Des Moines Quilters Guild provided thousands of handmade masks for non-clinical staff and patients to use. Broadlawns has also supported other community organizations, recently delivering an inventory of surgical masks and faces shields to Easterseals of Iowa so they could serve their patients.
The business function playbooks include takeaways that are specific to professional functions that could be present in any business, regardless of industry.
*We note that these assessments are qualitative and based on expert-led judgment (Johns Hopkins, 2020). Currently, there are not enough detailed data available to enable quantitative risk stratification. Businesses will need to make decisions about re-initiating business activities before there are validated data to know the precise levels of risk.
The Greater Des Moines Partnership's DSM Forward playbook is not intended to constitute legal advice or provide specific direction
. The preparation of a business continuity or preparations plan should be undertaken with the advice and direction of appropriate specialists and personnel, in consideration of the unique circumstances impacting each business. Third-party websites or material linked to or referenced in DSM Forward are for informational purposes only and do not constitute a recommendation of The Partnership of that material or its authors.
Last updated: 8/20/2020