COVID-19 Testing Reminders for Surgeries and Procedures in Ohio
While we continue to expand daily testing capabilities and sites in Ohio, we need to ensure that our current capacity allows for testing of appropriate surgical and procedural patients. We want to clarify a few points regarding COVID-19 testing for surgical and procedural reactivation.
As a reminder, we highly encourage everyone to refer to the COVID-19 Surgical Services Workflow Documents (available in the Reactivation Toolkit on the intranet) which answer the majority of questions and is regularly updated.
- Testing remains mandatory and should occur 2-3 days (72 hours) prior to any surgery or procedure performed in all operating rooms (ORs) and ambulatory surgery centers (ASCs) in Ohio.
- Unknown COVID-19 test results: When encountering patients with tests that are expired, pending or unknown on the day of surgery, please refer to the patient workflow. Ordering additional testing creates challenges and should generally not occur.
- Test ordering: Tests are ordered in Epic by providers. COVID-19 tests are not ordered by the hotline.
- Test ordering for independent providers/regional practices: Independent providers and certain regional practices in Ohio may have different processes for test ordering. In these instances, providers should adhere to their local workflow.
- Testing of patients for procedures outside an OR/ASC: Non-OR/ASC patients who do not meet current testing requirements should not undergo testing at this time. The appropriate level of PPE should still be utilized. As testing capacity increases, additional non-OR/ASC procedures will be phased in for COVID-19 testing. Timelines and information will follow as it becomes available.
- Rapid testing update: At present, the capacity for rapid COVID-19 testing is limited. Please refer to the patient workflow in the COVID-19 toolkit for current indications.
- Testing of asymptomatic patients: Asymptomatic patients undergoing outpatient Urgent/Emergent cases do not require COVID-19 testing and should proceed with the appropriate level of PPE.
- Testing of symptomatic patients: Symptomatic patients requiring Outpatient Urgent/Emergent surgery/procedure should get admitted and undergo rapid COVID-19 testing.
- Testing of inpatients: Inpatients undergoing Urgent/Emergent surgery/procedure should undergo rapid COVID-19 testing.
We continue to actively triage issues surrounding COVID-19 testing appropriateness and ability to increase testing volumes. We anticipate additional testing capacity in the near future.
Please refer to the most recent workflow in the Reactivation Toolkit available on the intranet.
Specific questions can be directed to [email protected].
Lifestyles to Reopen for Caregivers on May 26
Cleveland Clinic Akron General is reopening our three LifeStyles centers today, May 26, for caregivers who are members:
- Bath Health & Wellness Center
- Green Health & Wellness Center
- Stow Health & Wellness Center
Facilities will reopen to all LifeStyles members on June 1. All facilities will follow guidelines provided by Ohio Gov. Mike DeWine. The LifeStyles Express location at Akron General is not reopening at this time.
The safety of our members is our top priority. Changes at the facilities include:
- Member-only access for the time being. No guest passes or “pay to use” service.
- Screening/thermal scan – We will ask COVID-19 screening questions and check temperatures of everyone who enters.
- No keypad access. LifeStyles staff will assist with check-in and check-out.
- Only credit or debit cards will be accepted for purchases. No cash accepted.
- Masks – Caregivers are required to wear a cloth mask when on duty. People who are exercising will not be required to wear a mask.
- Limited access – Each area is labeled with a maximum occupancy level allowing for one member per 120 square feet.
- Hand sanitizer stations – Additional stations have been added.
- Safety monitors – Caregivers in red vests will wipe down equipment regularly and make sure members are social distancing.
- Equipment – Use of equipment will be limited to every other machine in order to follow social distancing guidelines.
- Towels will be available at the front desk only. They will not be available in the locker rooms. Also, some lockers will be blocked off to avoid people being too close to one another.
- Group exercise class size – Class participation will be limited in order to follow social distancing guidelines.
- Pools – Only one lap swimmer per lane.
- Areas to remain CLOSED – Opening date to be determined.
- Babysitting and KidStyles
- Swim lessons
- Steam room and sauna
- Gymnasium: no team activities
- Center lane of the indoor track
Ohio Fitness Centers Managed by Employee Wellness
We are evaluating processes for fitness centers in Ohio managed by Employee Wellness to ensure everyone’s safety and well-being; caregivers are not yet able to participate at these fitness centers. We will provide updates as they become available.
Collaborating to Keep Patients Connected With Loved Ones
To protect our patients, caregivers and communities from the potential spread of COVID-19, we restricted guests from visiting loved ones in our facilities in March. Recognizing that patients and their families are an essential part of the care team and the healing process, several teams immediately collaborated to develop an innovative way for patients to see and speak with loved ones.
Caregivers from our Information Technology Division, Nursing and the Office of Patient Experience formed our “Enterprise Virtual Visit” team, which worked quickly to initiate online family visitation connections for admitted patients in Ohio and Florida.
“With remarkable speed and agility, this mighty team worked out the technical and operational logistics to connect patients with loved ones,” says Enterprise Virtual Visit team leader Nelita Iuppa, DNP, RN, Associate Chief Nursing Officer for Nursing Informatics. “Swift decision making, collaboration and deployment of virtual visit technology was the goal. The result; however, was far more impactful than we could have envisioned.”
The Enterprise Virtual Visit team first created a plan for patients to use their own personal smart phones, tablets and mobile applications (apps) to communicate with family members. Team members analyzed potential challenges and obstacles that could occur, such as the security of virtual meeting apps; patients’ ability to download and use the apps independently; the guest wireless network’s capacity for increased mobile app usage; and the safety of charging and storing patient devices at the bedside.
The team was able to successfully address all potential scenarios within five days.
Another priority for the Enterprise Virtual Visit team was to ensure that patients without personal devices had the opportunity to connect with their loved ones. Less than two weeks after our visitation restrictions were put in place, the team deployed more than 500 shared iPad devices to 363 nursing units across 20 locations in Northeast Ohio and Florida. Units received up to four devices depending on unit size and number of inpatient beds.
“We worked with Microsoft, the Office of Patient Experience and Nursing to allow caregivers to use our corporate tools on the iPads to securely connect patients and their families using an application that they are familiar with,” says Sonja Struna, Manager of Enterprise Messaging in Information Technology (IT). “The appreciation from patients and families was heartwarming and made us proud to represent a small part of IT in this crisis. Everyone can make a difference in the life of a patient.”
Helping Patients Make the Virtual Connection
In addition to encouraging patients to use personal devices and mobile apps to connect with loved ones when possible, nurses are working with the Office of Patient Experience to schedule virtual visits between patients and their families on the shared iPads.
“The virtual visitation program offers an amazing connection between patients and loved ones — whether it’s simply to check in and chat, give family members the chance to see each other for the first time in weeks or provide closure before a loved one passes,” says Grétchen Hebert, Program Coordinator in the Office of Patient Experience. “Loved ones, patients and nurses have all been touched by this process and such good has come from the program.”
Iuppa agrees. “Nursing caregivers have benefited from these encounters as they feel good about the small role they are playing in keeping families whole,” she says. “This is a great example of how nurses not only care for the physical well-being of their patients but also the emotional well-being.”
Serena Wiseman, Patient Experience Manager for the Office of Patient Experience, adds, “On a few occasions, families have expressed that virtual visits have actually given the patient a will to live. At times, the visits also give families a chance to say goodbye to their loved ones, allowing them closure."
Hospital Visitation in the Future
Iuppa believes using technology to connect admitted patients with their loved ones will continue well into the future — for any circumstances where visitors cannot physically come to the hospital.
“Using innovation and compassion as our tools, COVID-19 has taught us to address healthcare opportunities and the services we provide,” Iuppa says.
“Video visits between patients and loved ones have permanently enhanced our outreach and capacity for caring,” she says. “These visits provide comfort, personal connection and assurance during a time of uncertainty and unrest. They reduce feelings of separation and loneliness, while aiding in the healing process.”
Read more about our efforts to support patients who wish to virtually visit with loved ones in this article on Consult QD.
Join #FitfortheFrontLine National Fitness Challenge and Celebrate Each Other
Exercise is a great way to decompress and stay fit. Whether it’s a daily walk, a game of hopscotch with your kids, a training ride for Virtual VeloSano or a stair climbing challenge, you can dedicate your physical activity to fellow caregivers and other frontline workers by joining in the #FitfortheFrontLine national fitness challenge. The campaign — lead by New York’s Mount Sinai Health System — kicks off today, May 26, and runs through June 14.
Share a healthy fitness activity you’re doing and post it to your social channels with #FitfortheFrontLine to celebrate frontline healthcare workers.
To get involved and view live updates, follow #FitfortheFrontLine on Facebook, Twitter or Instagram.
Internal Online Service Requests Moving to MyServiceNow
As part of our organization’s strategic digital transformation goals, we are investing in the next generation service management platform called MyServiceNow. This new enterprise service management system will be rolled out in phases, replacing some of the systems that caregivers currently use for their service requests, to a centralized system that is built for a more modern, service-oriented work environment.
The new portal makes it easier for caregivers to submit and fulfill non-urgent service requests from one centralized location.
What to expect and when
- June 15: Clinical Engineering and Facilities will transition their current service request systems to the MyServiceNow service portal. The Facilities Fix It administrative desktop icon will be replaced with the new MyServiceNow desktop icon.
On this date, Clinical Engineering will go live at all Ohio locations, Martin Health, Union Hospital and Weston, while Facilities will go live at all Ohio locations, Las Vegas, Union Hospital and Weston.
- July 9: The HEAT (4Help) and Information Technology (IT) project request system will transition to the MyServiceNow service portal, and the 4Help administrative and clinical workstation desktop icon will be replaced with the new MyServiceNow desktop icon.
- This applies for all Ohio locations, Canada, Las Vegas, London, Union Hospital and Weston.
- July 9: A mobile app called Now Mobile will be pushed to Cleveland Clinic-issued iPhones, and will also be available for download from the Google Play Store, Apple App Store or the Cleveland Clinic Corporate Catalog that is located on your Cleveland Clinic-issued phone.
- An interactive experience offering two-way communication between the caregiver requesting service and the service support representative to ensure process transparency from the start of the request through to the resolution.
- The ability to attach files (e.g. screenshots, photos, etc...) that can help the service support representative in their efforts to provide appropriate service assistance to caregivers.
- Upon first login to the new MyServiceNow site, caregivers requesting service will receive a pop-up box with the option to take a tour of how the new site works. They can accept or decline. If declined, they can opt to take the tour at another time via the Tours link at the top of the page.
- A Quick Reference Guide (QRG) will also be available for caregivers requesting service.
Requests requiring immediate assistance
- For urgent Facilities requests, caregivers should continue to call their designated facility support phone number for assistance. Location phone numbers are listed within the Buildings & Properties Service Catalog in MyServiceNow.
- For urgent Clinical Engineering requests, caregivers should continue to call either main campus Service Express at 216.444.Ask4 or the appropriate regional hospital operator and ask them to page Clinical Engineering. This information is listed within the Medical Equipment Service Catalog in MyServiceNow.