Daily CEO Update
One of our aims in responding to COVID-19 is to present facts with appropriate context. Our approach is positive and evidence-based. We strive to ease the emotional impact that change has on patients, caregivers and community members.
We are all touched by a message from a patient who recovered from COVID-19. The patient stayed in our medical ICU. Our compassionate caregivers communicated with him daily by writing messages on the glass door of his isolation room. Upon his recovery, he left this thank-you note.
This message reminds us there should be no stigma associated with a diagnosis. Patients are eager to beat the virus and return home to their families. Thank you for treating them with kindness and respect.
Our caregivers are doing a wonderful job giving back.We’re partnering on additional blood drives with the American Red Cross in Northeast Ohio. A new community-facing drive takes place from 9 a.m.–3 p.m. this Friday, March 27, at the Rocket Mortgage Fieldhouse in downtown Cleveland. Read more and make an appointment if you would like to give.
We are humbled by the support from our community. Cleveland Whiskey is working with us to formulate, blend and bottle hand sanitizer for our caregivers. Nearly 1,000 bottles were already distributed.
A few updates on recent changes made:
- On Tuesday, we updated our personal protective equipment guidelines. The most current guidelines are on the intranet homepage. Please follow our guidelines as they are updated — they will keep you safe and conserve supplies. Talk to your manager if you have questions.
- In addition to our Ohio locations, all Cleveland Clinic Florida locations will be conducting thermal temperature checks at patient care locations by the end of this week. That includes all five hospitals and 30 ambulatory locations.
- HIMSS, our partner on the Patient Experience Summit, announced today that the summit is canceled. Summit registrations will be fully refunded within 30 days.
Social distancing remains essential. The Ohio Department of Health reinforced yesterday how state orders to encourage people staying at home will reduce the spread of COVID-19 and its impact on the healthcare system. After postponing nonessential procedures in Ohio, hospitals in the state are at 60% capacity. There is a push to open up new intensive care beds in preparation for a surge of patients.
I am maintaining close communications with leaders in the State of the Ohio. Cleveland Clinic will continue to collaborate with public health partners and help guide policy decisions with our patients-first perspective.
Thank you for being driven by a strong sense of purpose throughout our response.
Tom Mihaljevic, MD
CEO and President
An Important Message Regarding Personal Protective Equipment
Thank you for your dedication to our patients during this challenging time. Your service is invaluable and your efforts are making a difference.
Your continued safety is top priority and continues to guide our approach to managing this evolving situation. We’ve taken a number of recent measures, such as restricting visitor access into our facilities and screening caregivers for fever prior to their shifts, to ensure you continue to work in a safe environment.
We understand you may have concerns about personal protective equipment (PPE) and your own health. We are monitoring our supplies daily.
Caregivers who provide care for patients with COVID-19 or suspected COVID-19 patients will continue to receive appropriate protection. To clarify, there is no evidence that face masks provide protection outside of high risk areas. There is little evidence that COVID-19 can be transferred in the absence of symptoms.
Our current PPE recommendations exist to protect you, our caregivers, and part of that involves ensuring we have enough PPE as the volume of COVID-19 patients increases. It is every caregiver’s responsibility to follow these recommendations, which align with guidelines from the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Please use our valuable PPE resources appropriately to help us conserve supplies for a potential surge of patients.
We have created a “PPE Resources” section on our intranet homepage so you may easily access our current PPE recommendations.
Proper N-95 respirator mask use
Before wearing an N95 respirator mask, caregivers are required to:
- be fit tested. Please see updated fit testing guidelines below.
- shave their facial hair (e.g. beard). Caregivers must be clean shaven to properly wear an N95 respirator mask and maximize protection.
- Read more information about proper N95 respirator mask use.
Fit testing updates
OSHA has approved healthcare systems to temporarily waive annual fit testing for N-95 respirator masks. Effective immediately, we have revised the criteria for fit testing in order to preserve and prioritize our supply of N-95 respirator masks.
Fit testing is currently waived if you have been fit tested within the past two years.
Proceed with fit testing if it has been greater than two years since your last fit test, or you have the following has changed:
- Weight loss/gain (+/- 10%)
- Growth/loss of facial hair
- Dental/facial surgery
- Serious health issue
Call your local Occupational Health contact to be fit tested.
Thank you for your dedicated service during this challenging situation.
Confidentiality of Protected Health Information and COVID-19
As Cleveland Clinic prepares for the effects of the COVID-19 pandemic, we must remind ourselves that the rules of maintaining patient confidentiality and privacy continue to apply. Caregivers must protect PHI by implementing reasonable safeguards against impermissible uses and disclosures. The following reminders are for all caregivers:
- You are only to access Protected Health Information (PHI) to perform your job at Cleveland Clinic. This means that access is appropriate when you are actively involved in treating a patient; providing services related to payment, such as billing and coding; or conducting activities related to hospital operations, such as quality assurance reviews.
- Access only what you need to perform your job duties. You should not browse a patient’s medical record out of curiosity.
- If you are approached by the media seeking information on patients that are being tested or treated at Cleveland Clinic with COVID-19, kindly tell them to contact Media Relations at 216.444.0141. Learn more about Cleveland Clinic’s Media Policy.
- Do not disclose patient information without the patient’s written authorization unless the disclosure is permitted by HIPAA. If you aren’t sure, review HIPAA policies or call the Compliance Office at 216.444.1709 for guidance.
- Securely dispose of paper PHI in designated Iron Mountain bins.
- Position computer screens so that they are not visible to the public.
- Never discuss patient information where you can be overheard by others and never ever post patient information on social media.
- Remember, inappropriate access to a patient’s record (snooping) is a violation of federal law and exposes you to serious ramifications.
If you have questions or need any guidance, contact your manager or the Office of Corporate Compliance at 216.444.1709.
Chloroquine and Hydroxychloroquine Prescriptions to Require Diagnosis
Beginning March 24, 2020, in concordance with Ohio Board of Pharmacy emergency, all prescription orders for chloroquine and hydroxychloroquine will require an associated diagnosis. The Associate Diagnoses screen will present to the ordering provider when signing one of these medications.
Ordering instructions will also be added to all chloroquine and hydroxychloroquine medication records outlining Ohio COVID-19 prescribing requirements. Click here to view screen shots.
The full ordering instructions read as follows:
Ohio COVID-19 Prescribing Guidelines
If this order is being written for a COVID-19 diagnosis please ensure the prescription follows the Ohio Board of Pharmacy guidelines:
- The prescription is limited to no more than a fourteen-day supply;
- and no refills may be permitted unless a new prescription is furnished
Prescriptions for either presumptive positive patients or prophylactic use of chloroquine or hydroxychloroquine related to COVID-19 is strictly prohibited unless otherwise approved by Ohio Board of Pharmacy's executive director in consultation with the board president, at which time a resolution shall issue.
If you have questions or need assistance, please contact the physician specialist COA for your area or contact the Help Desk for your location:
- Akron General: call 330.344.6604 or contact Agemail@example.com
- Akron PPG: call 4EPIC (4-3742)
- Florida: call 5.5555, option 1
- Main campus and all other regions: call 216.444.HELP