Daily CEO Update
I want to begin this update by sharing my heartfelt appreciation.
These are extraordinary times. You are lifting each other up.
Our goal is to protect patients and caregivers while fulfilling our mission.
Our patients, families and communities need the very best from us, and we are answering the call.
I mentioned last week that containing COVID-19 is our highest priority. We are taking further action.
Patients with routine appointments are being rescheduled for virtual visits when appropriate. We are moving non-essential visits. We continue to provide care in person when it is necessary.
Yesterday, we updated our visitation policy.
The policy limits patients to one visitor at a time with reduced hours. We also require visitors to wear identification and wash their hands.
We are reminding caregivers to wear their badges at all times. Thank you for your compliance with this long-standing policy.
Cleveland Clinic brought drive-through testing into the community. We’ve already tested nearly 1,400 patients since Saturday. Overall, less than 3% are testing positive for COVID-19 at Cleveland Clinic.
The vast majority of patients who present with fever and cough are diagnosed with flu or the common cold.
Testing is located in the garage of the Walker Building in University Circle. Patients remain in their cars while samples are collected.
This is a superb example of teamwork between our caregivers and University Hospitals.
Going forward, Cleveland Clinic will manage the Walker testing site. Our colleagues from UH will manage a new testing site at Landerbrook in Mayfield Heights. Both sites will serve patients with a doctor’s order from either health system.
Our caregivers in Florida are responding tremendously.
Martin North Hospital recently began drive-through testing. More test sites are opening in Weston, Coral Springs, Wellington and at Indian River.
All Florida locations have implemented similar policies on visitation.
The Centers for Disease Control and Prevention released new guidelines on healthcare worker exposure.
Caregivers exposed to COVID-19 without wearing personal protective equipment may return to work if they do not have symptoms.
We require these caregivers to wear a mask as a precaution. Occupational Health will check in daily to monitor for any symptoms.
Please remember to follow our guidelines for wearing protective equipment.
We are taking additional steps to reduce the spread of COVID-19 in our facilities.
Vendors and other non-employees are not permitted onsite unless their work is mission critical and cannot be done virtually.
Self-serve food items are now grab-and-go. Seating in our cafeterias is limited, and has been spread out to maintain 6 feet of distance.
To further limit exposure, we suspended caregiver access to our fitness centers.
These actions will protect our patients, caregivers and communities.
We are all experiencing change and discomfort during this pandemic. It is happening at home, with our families and at work.
Throughout our history, our founders and caregivers responded to immense challenges.
The idea of Cleveland Clinic began on the battlefields of wartime medicine.
Shortly after our founding, we survived a historic fire that captured attention around the world.
For nearly a century, we’ve met every challenge and continued to thrive. We have been able to do so as a team.
I am inspired by your teamwork and desire to do what is right.
As this situation evolves, we will continue to implement new measures and keep you informed with timely communication.
You are doing a wonderful job caring for others. Thank you for all that you do.
Tom Mihaljevic, MD
CEO and President
Update on COVID-19 Testing
Following overwhelming demand for testing we have made the decision to reserve COVID-19 testing for patients who are at the highest risk. We currently have a supply of testing swabs on hand, however, we did not fully anticipate the impact of the crisis in Italy which is where the swabs are manufactured. We hope to continue to receive additional supplies, which will be a key part of our decision-making.
In the first four days of activating our public testing sites, we tested more than 2,200 patients with a small number of test results positive for COVID-19. We currently have 2,100 more patients waiting to be tested.
Beginning Wednesday, March 18, we are revising which patients will be tested moving forward at the W.O. Walker testing facility located at 10524 Euclid Ave. in Cleveland.
- We are prioritizing high risk patients, which includes those who are currently hospitalized and those who are age 61 and older. These patients will continue to be tested at the W.O. Walker testing facility with a Cleveland Clinic physician’s order.
- For patients 60 and under who already have a Cleveland Clinic physician’s order, we are re-evaluating our ability to provide COVID-19 testing and are asking they not report to the W.O. Walker testing facility until they are contacted by Cleveland Clinic with further instructions. We are advising patients with a fever higher than 100.4 degrees and/or cough to please isolate yourself from others. If your medical condition worsens, please contact your primary care provider or go to the emergency department.
In addition to changes related to testing, patients with a Cleveland Clinic physician’s order will no longer be tested at the Landerbrook location.
We are adapting to this unprecedented and rapidly evolving situation as quickly as possible while continuing to stay true to our mission of caring for our community.
Update on Ohio Guidelines to Postpone Elective, Nonessential Cases
Our goal in responding to COVID-19 is to protect our patients and caregivers while fulfilling our mission.
Today, the Ohio governor’s office, in collaboration with the Ohio Hospital Association, released new guidelines on postponing nonessential procedures for adult and pediatric patients. This change supports statewide efforts to conserve hospital beds, equipment and supplies while protecting healthcare workers in preparation for a potential surge of patients with COVID-19.
Surgical procedures that do not meet any of these Ohio Department of Health guidelines will be postponed:
- threat to patient’s life if surgery is not performed;
- threat of permanent dysfunction of an extremity or organ system;
- risk of metastasis or progression of staging; or
- risk of rapidly worsening to severe symptoms which are time sensitive.
Effective immediately, we will work to suspend nonessential cases scheduled between Thursday, March 19, and Friday, March 27, in Ohio only. Cases will be postponed based on the guidance outlined below. We will reassess these recommendations on a daily basis.
We will proceed with surgical cases such as urgent or emergent surgery, cancer surgery or cancer evaluation, infected joints, or concern for worsening symptoms over a 4-week period, or other indications consistent with the department of health guidelines above.
Surgical cases suitable for postponement may include cases like deferrable bronchoscopy, deferrable upper and lower endoscopies, routine dental procedures, symptomatic problems which are stable, management of benign conditions, cosmetics, primary and revision joint therapy (non-infected), bariatric and elective hernia surgery, and urogynecology.
Physician chairs and institute leaders will work with their teams to implement these changes over the next 24 hours. This will allow for an organized decrease in the number of patients we serve.
We have also asked clinical leaders to identify caregivers who will be available for other duties to help meet these new demands. We may be reaching out to you with new assignments for an interim period.
This is an extraordinary situation that requires the very best teamwork. We are calling on everyone to do what is in the best interest of our patients, fellow caregivers and communities.
You are providing exceptional patient care. Thank you for everything that you do.
Tom Mihaljevic, MD
CEO and President
Keeping Our Facilities Clean and Safe
Keeping Our Facilities Clean and Safe Is One Way We Can Help Prevent the Spread of COVID-19
Across the enterprise, our Environmental Services (EVS) teams are working around the clock to keep our patient and common spaces clean, including:
- Adding extra wipe downs of surfaces — including door handles, tables and chairs — in waiting and common spaces. This includes elevators, check-in desks, restrooms, conference rooms and other high-touch surfaces and spaces.
- Continued emphasis on cleanliness of patient rooms.
- Installing portable hand sanitizer stations at entry/exit points.
- Extra attention to ensuring foam and gel soap dispensers, hand sanitizer dispensers and paper products are filled at all times.
- Daily review of cleaning needs and frequency at daily EVS huddles.
Caregivers are encouraged to take the following steps to help keep their workspaces clean:
- Wipe down workspaces, common spaces and break rooms using household cleansers and wipes on a regular basis (1-2 times per shift).
- In non-clinical spaces, this includes counters, refrigerators, keyboards, door handles, keypads, and other high-touch surfaces.
- In clinical spaces, this includes workstations on wheels (WOWs), nursing station surfaces, counters and other high touch surfaces.
- Wash your hands often with soap and water for at least 15-20 seconds. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
- Report any cleaning concerns to your facility’s EVS team.
Together, we can help keep our fellow caregivers and patients safe.
We’re Waiving Co-Pays for Express Care Online Visits
We’re Waiving Co-Pays and Prepayment for Express Care Online Visits
As part of our efforts to contain the 2019 coronavirus disease (COVID-19), we are asking patients to use virtual visits to receive care whenever possible.
Our primary care providers are also asking patients to reschedule using virtual visits, which should limit in-person appointments to only those where a physical exam is necessary.
Cleveland Clinic is waiving copays and prepayment for on demand and scheduled virtual visits through Cleveland Clinic Express Care® Online for all patients — regardless of health coverage — including caregivers.
By following these guidelines, we will also ensure physicians can order COVID-19 testing when it’s appropriate.
How do virtual visits help with COVID-19 testing?
A doctor’s order is required for COVID-19 testing. Here’s how it works:
- First, patients are screened by their primary care provider, or during a virtual visit.
- Because of the presence of community spread of COVID-19, patients with flu-like illness will be tested for influenza, RSV and COVID-19.
If you believe you have been exposed to COVID-19, call Occupational Health at 216.445.8246. Occupational Health will collect information and determine if quarantine is needed.
If you believe you have symptoms of COVID-19, use Express Care Online for a virtual visit, or call your primary care provider. These clinicians will determine if testing is needed.
How to use Express Care Online
Download the free Express Care Online app. For caregivers with Cleveland Clinic iPhones, Express Care Online is already downloaded for your convenience.