Rassetti Gynecology Policy/Procedure Manual -COVID-19

Edwin Ramirez, MD March 17, 2020

1801 Solar Drive, Suite 251 Version 1

Phone 805-278-0190

Fax 805-278-6291

Our offices will remain open and fully-operational, We are closely monitoring the rapidly changing news surrounding COVID-19 and its effect on our community. As we move forward, our actions will be based on guidance and recommendations set forth by the CDC and Ventura County Public Health officials, as well as with the safety of our patients and employees at the forefront of our operations.

Staff Precautions:

We will be checking our employees temperatures to ensure no one is working with a fever or a cough. Anyone identified with an elevated temperature or illness will be sent home.

Vendors, family members, and other visitors have been suspended from visiting our offices.

More aggressive cleaning protocols, including regularly disinfecting all high-touch areas, have already been implemented in our facilities and will occur frequently throughout the day

Patient Precautions:

All patients and visitors will be screened and examined for symptoms of illness prior to entering the office.

If anyone has symptoms of illness, they will be asked to go home and inform their primary care doctor. If anyone is experiencing difficulty breathing, they will be sent to the ER. We will waive any last-minute cancellation fees associated with rescheduling the appointment at that time.

We ask that you postpone your scheduled appointment if you or anyone in your household may have been exposed to COVID-19 through travel or attendance at large gatherings less than two weeks ago.

In order to reduce the number of people in the office, no visitors are allowed except for one parent for one or more minors or one visitor for patients requiring assistance for a disability. We recognize that there will be a number of exceptions to this rule and will work with you to accommodate your needs. Please call us ahead of time if you have a need to bring more than one visitor.

If the appropriate minimum 6 feet of distancing is not maintainable in our waiting area we ask that you wait in the privacy of your car until your exam room is open.

We are reducing the number of patients we schedule in one day, to give adequate time to sanitize exam rooms and common areas between patients. Please understand if we must change your appointment time/day to meet this guideline of reducing patient interaction.

Our highest priority is to continue providing excellent care in a safe environment for our patients and staff. We have created and implemented a strategic plan using best available practices plus proactive ideas to minimize the risk of person-to-person COVID-19 exposure in our practice.

INSTRUCTIONS FOR EMPLOYEES

1. Check your own temperature upon coming to work. Notify the office manager and or MD immediately if you have a temperature of 100.4 or greater. Or if you are experiencing a cough or feeling unwell.
2. Reschedule annual exams for June 2020.
3. Limit scheduled patients to 15 per day.
4. When calling patients to confirm appointments, triage by phone with following questions: Have you had contact with a known COVID-19 patient within 14 days. Have you traveled outside of the country or via a cruise ship in the last 14 days. Are you experiencing fever and/or signs of respiratory illness (e.g. cough, difficulty breathing). If any of these questions are answered yes, please reschedule the patient for a later visit at least 2 weeks in the future. Also remind the patients they may not bring children or visitors with them unless they are a minor or need physical assistance.
5. Wipe all touchable surfaces between patient interactions, scale, door knobs, exam table, counter, faucet, chair.
6. Clean all touchable surfaces in the bathroom on the hour, every hour.
7. Require patients to maintain 6 foot separation, social distancing guideline. We are trying for a no-patient in the waiting room goal. Encourage patients to wait in their car and call their cell phone when the exam room is ready, if they cannot be immediately roomed.
8. Employees should also maintain 6 foot separation from patients unless actively examining them.
9. Maintain proper handwashing technique of sanitizing hands before and after patient contact.

IN THE EVENT YOU SUSPECT A PATIENT MAY HAVE COVID-19 OR YOU VISUALIZE SYMPTOMS CONSISTANT WITH CURRENT COVID-19 INFECTION, PLEASE DO THE FOLLOWING:

1. Immediately place a face mask on the counter of the exam room. Ask the patient to put the mask on themselves and you leave the exam room quickly and maintain the greatest distance from the patient as possible. Keep the exam room door closed at all times while the patient is in the room.

2. Go straight to handwashing station and wash your hands with soap and warm water for at least 20 seconds.

3. Before re-entering exam room for any reason, you must don personal protective equipment designed to reduce risk of contamination to employee via droplet or airborne pathogen.

N95 Respirator or facemask while supply shortage is encountered in US.

Gown

Gloves

Eye protection via faceshield

If the patient is in any distress with vital signs or showing symptoms of respiratory distress call 911 and notify the operator of the patient’s situation.If the patient is stable, ask the patient to go home, while wearing the face mask, and contact their primary care physician via phone or contact the Ventura County Covid-19 hotline at 805-465-6650.

IF CONTACT WITH A COVID-19 POSITIVE PATIENT HAS OCCURRED

We are following the CDC Interim US Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (Covid-19).Exposure Risk Category in determining level of employee work restriction required.

Please see table for guidance for work restrictions via CDC.gov.

IF you fall within Low exposure risk and are asymptomatic you may continue to work as normal with no restrictions.If you fall within Medium exposure risk and are asymptomatic you will be excluded from work for 14 days after last exposure.

If you acquire Covid-19 you must be restricted from work until cleared by your PCP.