Has anyone started to give thought about how they are going to schedule, see and perform testing on sick patients this fall/winter. We usually do rapid streps, throat cultures, rapid flus and are more than likely going to do covid testing. Wondering what others are thinking about how to get it all done efficiently and safely.
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Following! This is a great topic for discussion as PPE is still limited. We are discussing implementing COVID PCR testing as well and our options. Possibly swabbing in the patient’s car?
One of the issues that our practice has recently discussed is that in MN, come Fall, practically any patient presenting for a well check, if in daycare or school setting, typically has a runny nose. We currently have allocated one of our sites for well only visits and pre-screen for COVID symptoms, while our other site is just for sick. It’s going to be really tough to pre-screen for potential COVID symptoms at the well site if majority have congestion. Are we going to ask all of them to re-schedule?!
Wow… did not think of that. I’m a solo practice, so currently preparing back room with separate entrance as our sick room, PPE, screening tests, nebulizer machines, etc readily available. Schedule those sick visits in the pm, no contact with the staff; check-in and copays online prior to arriving. Once daycares, summer camps and eventually schools reopen, sick kids all over the place. Maybe create a pre-visit screening questionnaire that parents must provide within 24hrs of scheduled well visit? Then screen again at the door (MA can eye-ball kid prior to moving patient into exam room), flag doc if questionable signs or symptoms. Telemedicine has really helped us keep our space safe, but once kids go back to group settings, game over.
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We struggle because we feel that the sick children should be seen by us in the office because telehealth just doesn’t allow us to get a good feel on how the child really is, as well as the obvious things such as not being able to check ears, lungs, etc. Currently,we usually do the history portion by telehealth and then bring them in for an exam and testing if needed. But as volumes of sick kids picks up, this will not be possible because it is too time consuming. And if they need swabbing of any kind, not too keen on doing it in the exam room. Can go outside in the nicer weather, but we are in the northeast and when winter comes this may become more difficult. And thinking about swabbing - Strep, flu and COVID. It doesn’t seem practical to swab for strep and or flu, wait for the results and if negative swab again for COVID. If you do all 3 at the same time, you may be throwing away a lot of COVID swabs which are more difficult to get (the NP ones anyway).
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We are also trying to sort out how to do this in the fall… or at the rate things are going, this summer!
When will it be safe to do spirometry in the office?
How can we safely do nebulizers in the office?
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The health system that we are “affiliated” with, NOT owned by, has stated that there should be no use of nebulizers in the ambulatory setting. I guess we’ll have to send them home with one and hope for the best? Definitely not ideal but not having proper ventilation makes it difficult to do anything.