The Morning Journal (Lorain, OH)
READY FOR CARE
Minimizing exposure: Avon Hospital makes changes Adapting to new normal: Protocols in place for safety
It’s time to start going to the doctor again — and not just for novel coronavirus.
On May 4, the Cleveland Clinic Avon Hospital resumed outpatient services that went on hold as the medical staff prepared to deal with a surge of patients with COVID-19.
The health care leaders there said people should know the hospital has taken precautions to minimize exposure to the disease if patients need to go there.
“So many people are afraid, but there’s no need to be afraid,” said Dr. Rebecca Starck, hospital president. “We are definitely adapting as a community to what the new normal looks like.”
On May 7, Starck discussed the hospital conditions with Dr. Elizabeth Streby, head of the emergency department, and Dr. Joseph Knapp, an internal medicine specialist there.
“I think one of the positive pieces of this experience was that there was a rapid development and deployment of virtual health care.” — Dr. Elizabeth Streby
Starck also thanked area residents for strong community support including posted signs of thanks, meals, gift cards and other tokens of appreciation for the health care workers.
Staying busy
The Avon Hospital at Richard E. Jacobs Campus is located at 33300 Cleveland Clinic Blvd. in Avon.
With an outpatient clinic, emergency department, surgical center and testing lab, the health campus was the busiest family health center in the Cleveland Clinic system before COVID-19.
The facilities remained open during Ohio’s shutdown period.
But daily visits dropped dramatically because people stayed at home and feared being exposed to COVID-19 while visiting the medical facilities.
In the last four to five weeks, the Cleveland Clinic has had stable inpatient volumes, which is part of the reason why the Clinic leaders agree with Ohio Gov. Mike DeWine’s plans to allow businesses and gathering places to reopen, Starck said.
The new normal will be managing COVID-19 and non COVID patients, likely for the next several months, so as a society and health care system, people must learn to care for both, Starck said.
“I’m very confident that we are able to do that at Cleveland Clinic, certainly at Avon Hospital,” she said.
Precautions in place
Upon entering the clinic, everyone must go through a health screening with a forehead temperature reading and questions about possible exposure to the disease and symptoms of it.
Visitors wear wristbands to show they were screened and not showing signs of infection.
“We have hand sanitizer all over the place,” Starck said.
The environmental services team cleans constantly, the doctors said.
The furniture in waiting areas is spaced out to keep people at least six feet apart.
All patients and visitors are asked to wear masks.
If patients do not have a mask, they will receive one.
Starck acknowledged wearing a mask constantly seemed “a little strange” at first.
“Now, when I go out without a mask, it feels funny, it feels like I’m missing something now,” she said. “So, you do get used to it.”
Visitor restrictions remain in place, with no visitors permitted except in extreme circumstances, or if patients, such as children or those with developmental disabilities, need a guardian present.
“We wanted to really reduce the potential exposure to individuals,” Starck said.
The outpatient lab is the busiest in the Cleveland Clinic system and will expand hours, 6 a.m. to 6 p.m., starting next week.
The hospital will maintain three main public entrances; workers enter through a separate door and also are screened daily for their health symptoms.
Emergency room
The emergency department was divided in half, with one zone reserved for COVID-19 treatment and the other used for patients with other ailments.
“When patients come in and we ask them why they’re here right at this front door,” Streby said about walk-in patients. “If they’re here because they’re showing infectious symptoms, then we separate them from the general population of people who may be coming for another claim, like a fall or chest pain or a laceration or something like that.
“We want to try as best we can to separate that out.”
The hospital emergency department also provides screening services for local first responders including medics, police officers and firefighters.
Virtual visits
Before the pandemic, about 8 percent to 9 percent of visits were virtual.
That has rocketed up to about 75 percent of visits, Starck said.
“We very quickly rolled out virtual health, which has been, I think, a really great benefit, and some of that will stay with us for the future,” she said.
For COVID-19 patients recovering at home, outreach staff check in with them every day to ensure their conditions are not getting worse, Starck said.
If they need to return to the hospital, the emergency staff are notified.
Patients also use a smart phone app to do a symptom assessment every day to upload to their electronic health records, Starck said.
“I think one of the positive pieces of this experience was that there was a rapid development and deployment of virtual health care,” Streby said. “And I think we’ve always needed some of that, but now, the necessity really presented itself.”
Knapp, an internal medicine specialist for 21 years, said the outpatient clinic averaged up to 1,700 patients a day, but he never had a virtual visit in his career.
“And literally within a day, that completely switched to all virtual care and all telephone visits to try to, again, limit foot traffic through here,” Knapp said. “That transition to virtual visits has been astonishing; it really has been amazing.”
“So many people are afraid, but there’s no need to be afraid. We are definitely adapting as a community to what the new normal looks like.”
— Dr. Rebecca Starck, Cleveland Clinic Avon Hospital president