Had a meeting at lunch and immediately after lunch signs are up on the doors instructing patients to STOP. Call xxx-xxxx and notify front desk staff you are here. Then wait in your car until someone comes for you. Front desk staff writes down color of car patient is in once they arrive them. Once arrived staff goes out the side (employee) entrance to patients car. No matter what they are there for from 6 feet away or more I ask them if they have had a fever, cough or shortness of breath in the last 30 days (we're looking for 2 of 3). Pretty sure the other nurses do too. Anyone calling wanting to be seen for a sick visit is pre-screened asking about fever, cough or shortness of breath. If so appropriate precautions are taken. Only one person may come in with any patient. Once they are seen they check out up front and go out through the way they came in. It prevents people from sitting in the lobby. Everyone waits in their car until someone comes for them. Schedules are made months in advance but we are also scheduling routine visits (and non-respiratory things like a rolled ankle, UTI, etc) in the morning and sick visits after lunch. Still will have a mix though as again schedules are made months in advance for some. We are calling our elderly to see if they want to postpone their appointments or, if there is an opening, if they want to come in that morning. Same for routine visits. We're a small clinic but it's a start. During the meeting we were informed that the medical director stated that 43% of cases do not have a fever. Some facilities are doing temp checks before letting anyone in. If 43% are afebrile going screening for the other two symptoms will be very important. Our Providers feel we have already seen it in the community. We, along with most everyone else weeks ago, just didn't know it. Patients coming in with temps and cough but negative for Flu and strep. Dry coughs that last days or weeks (I had one for nearly two weeks as well as one of my sons about 6 weeks ago. Just couldn't shake it). Emails daily (if not more often) from the mother ship on updates as the situation is fluid and changes frequently. We also only had a handful of test kits. Now we (and our sister entities) were informed today we can use flu swabs to check for CV. However the usual suspects must be screened for first (Flu, RSV, strep) and then, if negative, the Provider can choose to screen for CV. This gives a little more flexibility in testing if a Provider chooses to do so as we have more flu swabs but like other things that are needed (mask, etc) there will be a backorder shortly on the swabs if testing is ramped up. For med refill request for routine meds (bp, diabetes, etc.) We're changing them from 30 day supply to 90 days so patients won't have to go to the pharmacy as much.
