Practice Operations Guidance

Employee/Staff Policy

  • Establish and continually reinforce a policy that all of your office staff should stay home if they are sick, especially if they show signs of respiratory illness (cough, sore throat, difficulty breathing)

Practice Preparedness Checklist

  • Implement and reinforce staff sick policy
  • Insist all patients call by phone before visits
  • Screen patients for symptoms
    • Have them call 911 if emergent care needed
  • Reschedule patients to telephonic or televisits

Patient Screening and Triaging

Screen every patient over the phone before any in-person visit:

  • Do you have a fever, sore through, cough or difficulty breathing?
  • Have you had contact with anyone known or suspected to have coronavirus/COVID-19?
  • Do you live in a community with confirmed sustained community transmission of COVID-19?
  • In the last 14 days have your traveled domestically or internationally anywhere with confirmed sustained community transmission of COVID-19?

Testing and Prioritization

Incubation Period: 2-14 days

The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days.

Sending Referrals

Tiers /
Description
DefinitionLocationsExamplesAction
Tier 1aLow acuity surgery/healthy patient
Outpatient surgery
Not life-threatening illness
HOPD ASC
Hospital with low/no COVID- 19 census
Carpal tunnel release
Penile prosthesis
EGD
Colonoscopy
Postpone surgery or perform at ASC
Tier 1bLow acuity surgery/unhealthy patientHOPD ASC
Hospital with low/no COVID-19 census
Postpone surgery or perform at ASC
Tier 2aIntermediate acuity surgery/
healthy patient
Not life threatening but potential for future morbidity and mortality.
Requires in hospital stay
HOPD ASC
Hospital with low/no COVID-19 census
Low risk cancer
Non urgent spine
Ureteral colic
Postpone surgery if possible or consider ASC
Tier 2bIntermediate acuity surgery/unhealthy patientHOPD ASC
Hospital with low/no COVID-19 census
Postpone surgery if possible or consider ASC
Tier 3aHigh acuity surgery/healthy patientHospitalMost cancers
Highly symptomatic patients
Do not postpone
Tier 3bHigh acuity surgery/healthy patientHospitalDo not postpone