The first article in our three-part series covered workplace safety policies, changes to your office space, and workflow processes. Next, we will discuss the many aspects of human resource management and address patient scheduling in this new environment.
Human Resources Policies for Your Staff
It is important to first gauge what your workload and volume needs will be when re-establishing your staffing plans. There will be fluctuating volume in the coming months, so do your best to prepare your employees for this.
Stay in touch with furloughed or laid off workers. Establish an HR contact that will provide them with resources and keep employees updated weekly about any changes that are occurring in the practice. Ensure your HR team is well educated on any documentation that needs to be completed for rehires. When finalizing your plan, ensure you are maintaining compliance with the CARES Act reporting requirements.
Make sure you have set a firm policy so that employees understand their options for paid time off (PTO) or family and medical leave (FMLA) if a long-term absence for sick time or the care of a family member is necessary, especially with regard to the newly enacted Emergency Sick Leave and Emergency FMLA provisions of the Families First Coronavirus Response Act (FFCRA). Such a policy must be consistent across the organization. Give your employees visibility to their available PTO balance so they can make their own preparations for an extended time out of office. This transparency will ensure that your staff stays home and does not come into the office for fear of retribution or loss of wages.
Employees who are coming back to work may have been required to use vacation time during this period, so new expectations will need to be set about future time off and work hour requirements to make sure everyone is on the same page. Update your employee leave policies to address your state’s unique requirements. Have a plan in place for how you will address leave requests.
Address your employees’ concerns about safety when returning to the workplace. Have a plan in place for addressing employee pushback on job requirements and determine how far you want to go as an employer in balancing your rights with your employees’ requests. Many employees will see a shift in role requirements. Make sure they are prepared to be flexible and step up to handle tasks they might not have done in the past. Repurposing will be critical to ensuring you’re able to capture all possible volume. Make sure all employees are well informed about safety protocols around testing and cleaning, so they feel safe and comfortable resuming work.
Employers must be cautious in determining which staff members to bring back to the workplace to mitigate risk of potential discrimination claims. Employers will need to have a legitimate, non-discriminatory reason for choosing which employees to rehire or return to work and have a process in place for doing so.
Employees will need to be screened on a daily basis. Consider taking temperatures upon entry to your facilities. Identify an individual who will be responsible for this task and for tracking that information. As an alternative, you may decide to have employees take their own temperatures twice a day and create a repository for reporting this data. Be aware that such data should be maintained in a confidential file and destroyed when it is no longer relevant.
Have a policy in place for sending employees home if they present with a fever and connect them with your human resources staff to discuss appropriate steps for quarantining and return-to work-dates. Help them connect with the proper health entities to self-report any illness. Consider sending a daily text message questionnaire to employees to allow them to self-report any changes in their health status so entering the facility is avoided.
Physician Staffing and Management Considerations
As you begin planning to bring radiologists back to work, develop a revenue benchmark that you feel is a feasible goal. If you are aligned with a revenue cycle partner, they should be very involved in this process. They will assess volume and revenue projections in the coming months and help you gauge what percentage of lost revenue may be recoverable.
Notify radiologists who are temporarily not working or on vacation that you may need them to be on call to handle the potential increased workload during this post-COVID rebound. They may have family or other obligations that prevent working expanded hours and this may be a determinant of whom you bring back and when.
Consider a short-term succession strategy if members in key leadership or management positions fall ill or are exposed to a positive patient. It is important to plan a secondary chain of command or have an alternate workplan in place to make sure key business functions are occurring and performance is stable. Be aware of options for alternative workflows, such as a revenue cycle partner or new software platforms, in the event staff losses or budget concerns have created gaps.
Establish Scheduling Parameters
To help adjust for a potential surge of patients, institutions are planning extended operating hours. Stay in touch with your patients so they are ready to reschedule once restrictions are lifted. Share a consistent and concise message regarding how you have prepared for their safety while confirming appointments. The scheduling team must be conscious of the language used when rescheduling appointments. Consider offering two to three alternative dates for appointments, with the flexibility to change pending stay-at-home orders or other circumstances.
Prioritize procedural care and preventive services that are “highly necessary” when re-opening. Hopefully, there will be many patients eager to have delayed screening exams taken care of as soon as restrictions are lifted. However, a marketing push to bring everyone back right away could backfire if patients are unable to get an appointment slot, creating frustration. Some of our clients’ facilities are reporting patients eager to return and “beating down the door” for appointments, while others are seeing high no-show rates on rescheduled services.
Over the past few months, many procedures have been classified as “elective” even though the patient’s issues were quite debilitating. Imaging is always an important part of the pre-operative process, so those patients who have been in the “non emergent” category will be anxious to move forward with their previously scheduled surgery. Making sure that you have priority slots for those patients will be an important part of ramping elective procedures to a pre-pandemic state.
Patient scheduling should consider how to triage patients based on two main factors: (1) their general COVID-19 risk, and (2) their current or prior COVID-19 infection status. To date, the treatment of non-hospitalized COVID-19 patients has been a “hands off” approach. We now have the opportunity to treat known or suspected positive patients with a more hands-on, physician-led approach. Imaging can play a vital role in the management of these sick patients. Regardless of the number of outpatient and inpatient imaging locations your organization supports, you will need to deploy a strategy to manage the imaging for high-risk patients as well as ongoing management of COVID-positive patients. This can be done through designated hours or days, locations (separate building), rooms or floors with separate entrances to ensure minimal crossover with non-COVID areas.
Any pre-exam questionnaires that have been altered should be communicated to the patient along with information about the process that has been put in place to assess their health prior to arrival. You will also need an escalation plan in the event that a patient arrives and is flagged as a health risk and therefore not able to continue with the appointment. Determine how many patients and employees can be on site at one time and still ensure social distancing in common areas like waiting rooms. Communicate the existence of dedicated entrances and traffic patterns for immunocompromised patients, including patients undergoing chemotherapy, who return to hospitals and treatment centers for clinic appointments and imaging studies.
At Healthcare Administrative Partners, our goal is to be a valued resource to your community. We hope we have provided valuable content as you look to transition your practice into the recovery phase. Subscribe to this blog for the final installment of our series on reentering the radiology market, and other information that will help your practice maximize its potential.
You can view the references for this article series here.