Protecting Our Patients With New Safety Measures

Baptist Health South Florida has always put patient safety first. But what does that mean in practical terms, as we reopen for routine medical care like in-person doctor appointments, imaging scans and elective surgeries?  What differences can patients expect to see, and what is taking place behind the scenes to ensure their safety and provide them with peace of mind? Host Jonathan Fialkow, M.D. welcomes the CEO of Baptist Outpatient Services, Nancy Batista-Rodriguez, to detail the steps being taken at all Baptist Health facilities to protect everyone who walks through our doors, on this episode of Baptist HealthTalk.

Learn more about enhanced safety measures in response to the coronavirus pandemic at BaptistHealth-coronavirus.com

Transcript

Announcer:

At Baptist Health South Florida, it's our mission to care for you when you're injured or sick and help you stay healthy and fit. Welcome to the Baptist Health Talk podcast, where our respected experts bring you timely, practical health and wellness information to improve your family's quality of life. 

Your next visit to the doctor will look very different from the days before COVID-19. From temperature screenings to stringent infection control procedures and more, we’ll explain what’s being done to keep patients and staff protected on this episode of Baptist HealthTalk.

Dr. Jonathan Fialkow:

Hello Baptist HealthTalk podcast listeners. This your host, Dr. Jonathan Fialkow, and I'd like to welcome you to another special edition of our show focused on the coronavirus. 

In this age of pandemic there's one universal truth, we're all being forced to make adjustments to the way we do things. That's true for individuals as well as for organizations.

As a healthcare provider, Baptist Health South Florida has always put patient safety first, but what does this mean in practical terms? As we reopen for routine medical care, like in person doctor appointments, imaging scans, elective surgeries, what differences can patients expect to see and what's going on behind the scenes to insure their safety?

Today I've invited my colleague, Nancy Batista-Rodriguez, to the podcast to talk about the many ways Baptist Health is enhancing safety measures to protect the health of everyone who comes through our doors. Ms. Batista-Rodriguez is CEO of Baptist Outpatient Services and her role in this process includes leading as a co-chair with me, although she's done the lion's share of the work, the Baptist Health System Recovery Playbook, which you'll hear more about.

Welcome to the podcast Nancy.

Nancy Batista-Rodriguez:

Thank you so much Jonathan, and thank you for having me. As you said, we've been working very closely together on our recovery initiative for Baptist Health South Florida, and I'm very happy to report that again we were very.. really started looking at recovery very early on. 

Dr. Jonathan Fialkow:

For the listeners' perspective, it was 70-80 people involved at the top levels, with lots of other people doing work behind the scenes, major components of this recovery playbook.

I think what's important to note, Nancy, is that this was being done from the very beginning, while we were still operating in terms of taking care of sick patients and emergency patients, so it wasn't as if everything shut down, let's work this. So great work for you and your team, and I think everyone listening will hear about that. What is in the playbook?

Nancy Batista-Rodriguez:

As you mentioned, we wanted to make sure that as leaders and caregivers were dealing with the pandemic, as soon as we started on our recovery efforts that they had real life tools.

When you look at the playbook, it's very comprehensive. We touch upon... From patient safety measures, annotation checklists, infection control protocols, assurances for our patients on safety, signage that we should universally have at all of our areas across Baptist Health.

We have scheduling guidelines for surgery, for imaging. Again, it is a very comprehensive document, and what we've... It's done in an electronic format, so regardless of where you are at Baptist Health you can go ahead and print a particular page or use a tool... We created a lot of checklists format, right?

So if you're a leader on a floor, again, and you're busy dealing with patients and your staff, we wanted just leaders to be able to print the checklist and go through it to insure that they have the information that they need.

It is electronic, because this document is going to be a living document, if you will. Every week we're adding new material to it. 

Dr. Jonathan Fialkow:

It really is a remarkable document. I think what we should state is that every meeting we've had always starts with the premise that it's all about safety and that is the pervasive component of all the decisions that are being made. Can you speak to that a little bit?

Nancy Batista-Rodriguez:

Right, we want to make sure that our patients feel comfortable, our physicians feel comfortable, and our staff feel comfortable.

So we really took that comprehensive approach in a very standardized fashion, which is very important, as you think that we have 23,000 employees across multiple counties, so that was very, very important as part of our approach, that we were standardized and comprehensive.

Dr. Jonathan Fialkow:

So Nancy, I've spoken in other podcasts and elsewhere about the patients or people being afraid over the last couple of weeks and months to get healthcare, which has placed certain people at a disadvantage, getting sick at home, quite frankly people even dying at home.

We do want to change that understanding of our population, that again these measures have been taking place not specifically for volume, but we want you to get the care you need so bad things don't happen by delaying care.

What can the patients see for example now if they're going to come into let's say a surgical center or a hospital? Let's start with screenings for example. What are we doing in terms of making sure people are not walking through the doors of our facilities with COVID symptoms?

Nancy Batista-Rodriguez:

Every patient and every staff member that walks into our facilities today receive a touchless temperature check. It's done with a thermometer that doesn't touch the patient. It's done at a distance. We also ask a series of screening questions related to potential exposure to the coronavirus, so very important, right at the front door we're taking these measures.

We've also limited visitors at this point in time through stage one and stage two, so that really walking through doors it's either staff or patients that are seeking care. So again, we've really started the process of safety at the front door.

Then when you move on, right, we've even looked at the way patients are registered at all of our locations, whether it's in the hospitals or our outpatient sites, where we've developed a contact list registration process and checkout where really we're trying to limit or do away with exchange of paperwork back and forth, pens for signatures.

We're doing a lot of things electronically, really to even make that front office process and registration very streamlined and smooth, and, again, we do see the ability or the chance of transmission of any type of a virus.

Dr. Jonathan Fialkow:

It really is noticeable, and I think it is a good level of screening, and it's also for the employees as well, as you mentioned. Even I have to walk into my clinical office, because I may have some work to do there, whether it be televisits or patient contacts, and I'm getting screened as well on a daily basis, and I think that's something we'll be dealing with for a long time.

I know there was a lot of work also done regarding spacing and social distancing within the waiting rooms and within the facilities. So, again, what can people see if they walk into a doctor's office or they go to get a mammogram? What can they see differently in terms of what's been done to align with the social distancing rules?

Nancy Batista-Rodriguez:

Great question. Our lobbies, as you walk through we have separate seating so that, again, patients are not one right next to the other. We're insuring that we meet the six feet social distancing in the lobby.

Another important component, any items that are high touch, like magazines and coffee stations, we're really... We moved all of those things from our lobbies. We've also implemented a feature that if a patient feels more comfortable waiting for their appointment in their car we're also being able... We're accommodating that as well. If they feel more comfortable, we will call you in your car when we're ready.

You will also see markings on the floor really separating folks from where they stand at six feet apart, and in some locations where either our front desk is smaller or it doesn't allow for that six feet, we've also put plexiglass as well.

So, again, as you walk into the lobby it is going to feel and look different, but it's all being done, of course, for the safety of our patients, our physicians, and our staff.

Dr. Jonathan Fialkow:

Again, I'm going to reiterate that we want people to get their necessary healthcare, we want them to feel comfortable that they can receive that healthcare through various aspects of the Baptist Health System facilities and practices, and they will notice significant safety measures in place when they seek that healthcare.

What about... A couple of other things, and I'm very much visional about this in the practice. We could put shields up, we can space people, but if we're not cleaning the surfaces and cleaning these touchpoints regularly, again it could all be for naught. So again, the work being done in that space, can we elaborate on that a little bit?

Nancy Batista-Rodriguez:

Sure. We have enhanced cleaning and infection control processes that we've implemented across the enterprise. We actually created a great video tool for all of our environmental staff across the health system to insure that we're very standardized.

All of the high touch areas within our clinical settings are being cleaned at a very regular basis, as well as enhanced cleaning and infection control processes in between stations, whether, as you mentioned, having a mammography, you're having a procedure. So, again, we've done that at a very standardized process, and all of these tools live within our recovery playbook.

Another very important component regarding safety is our PPE. We've made sure that every staff member, physician, or patient that walks into a Baptist Health facility receives a mask, a surgical mask. So you will see all of our staff and our doctors with masks on within our facilities, and we've asked that if patients come with their own masks that they remove them once they come to our facility and we give them for their safety one that the health system provides.

Again, whether it's PPE, sanitation or infection control, we've really left no stone unturned, just making sure that we are enhancing all of these protocols. And it goes without saying all of the training that's occurred for our staff from the very beginning of this pandemic through recovery, constant review of our training and of our expectations to our staff, a lot of leader rounding to insure that this is happening as we want it to happen, so it's really been a true team effort both with leaders, with physicians, and our staff.

Dr. Jonathan Fialkow:

I think... You know, you and I use the term PPE. We have it kind of embedded in our eyelids at this point, but it's... For listeners, it's personal protective equipment, and that's what Nancy is talking about with masks and gloves and all those pieces of equipment to help keep everyone safe. You will see that in the practices as well and in the imaging centers and the hospitals as well.

Maybe something for the hospital which is more significant as well, again regarding the fear of coming to the hospitals, which again is inappropriate, especially if you have a medical condition that warrants it, we're kind of keeping the COVID-19 suspected patients separate.

Can you speak a little bit about what's been done in terms of if someone is positive or suspected positive, how someone coming in for a non-COVID related symptom won't be necessarily exposed to people who might have the infection?

Nancy Batista-Rodriguez:

Sure. Within all of our facilities we have cohorting of patients that exists. So if you walk into the emergency room and you're screened and you have flu-like symptoms or COVID-like systems, you actually go through a very separate track than any other patient that could have a laceration or chest pain or anything else.

Immediately at the point of entry those two patient populations are separated, and even within our floors within a hospital you will have a separate COVID area that is kept apart from all other types of patients. Again, the premise is patient safety, so that at all times from the very beginning of that patient experience throughout those two patient populations are kept separate.

Dr. Jonathan Fialkow:

Again, great reassurance. Let's switch gears for a second. We've spoken about what is being done to create that physical safety in the patients who may be coming into our facilities, whether it be hospital, ambulatory, again urgent cares, imaging centers. What are the other options people have? We've seen the explosion in telemedicine and televisits.

Clearly the first goal even for a stay-at-home in medicine is to do as much as you can outside of people leaving their houses, which can only go so far. Speak a little bit about the evolution and the potential for our Care on Demand services and even in the medical practices, the televisits.

Nancy Batista-Rodriguez:

Sure. When you even look at the time of the pandemic, the role that telehealth played in our response to the pandemic was very important. Why? Because we made sure that patients that had any symptoms went to telehealth first. Why was that? It helped to protect the patient or staff and preserve personal protective equipment, as we know that that was a national initiative, right?

So it was a very important part of our response to the pandemic, and now as we look at recovery it still remains a very significant initiative. Why? Because if you look at the way we have to redo our patient schedules, we do have to space patients out. So it helps our physicians, it helps our patients, because if our doctors see three or four patients an hour potentially they could see two on telehealth and two in person.

There are visits that really are very conducive to telehealth, things like preop visits, times that physicians just have to review results with patients, just virtual check-ins in between appointments for higher risk patients.

So these are visits that are very conducive to telehealth. It really helps to keep especially vulnerable patients safe and at home. Again, it's not conducive for all types of patients. Clearly there's patients that may need diagnostic tests or more in depth physical exams, but for some of these other types of consultations it's definitely a great tool in the toolbox, if you will. And it is going to be, as we've seen, important not only as we dealt with the pandemic, but more importantly as we look at recovery.

Dr. Jonathan Fialkow:

And how can people access Care on Demand?

Nancy Batista-Rodriguez:

Care on Demand is an app that you can download through the app store, whether you have an Apple phone or any other device. There's a very quick process to download and also to register, and we always ask patients to go ahead and do that even before they need the service so that when you do need it it is definitely streamlined and available to you.

But it is quite convenient, and again you can basically see a caregiver in a very short period of time, whether it's on demand for urgent care or it's a scheduled visit with your particular provider. We do have practices for on demand urgent care as well as for the different specialties available throughout the health system.

Dr. Jonathan Fialkow:

It is a great resource, and also for the patients with real symptoms, can't breath, chest pain, of course we want them to call fire rescue and get taken to the hospital, where again you will be safe in terms of any risk of exposures for infections.

So, again, full spectrum of services for the people not feeling well who can be handled through a televisit with Care on Demand, maybe calling the medical practice if a little bit more significant, and then certainly still able to use our facilities for imaging, elective surgical procedures, and emergency procedures where necessary.

I think, Nancy, you took thousands of hours of manpower and womanpower at work and condensed it to a few minutes of summary. It really is an extraordinary achievement. Key components include the fact, as you said, it's a living document. What we published a week ago has already been changed and adapted and updated, as it will continue to be, but it really is a great source of truth, for safety for, as you said, the patients, the employees and the providers, and I think it's something that you and everyone can be very proud of.

Really thank you very much for taking time from your busy schedule and reviewing for our listeners all these impactful procedures and successes in terms of opening up in the phased approach. Any final comments? Anything that you want to bring up that we didn't touch on?

Nancy Batista-Rodriguez:

I've just one other thing to add. As we talked about, this was a very comprehensive approach, and we've also created a recovery playbook for our medical staff. We basically took all of the tools that pertain to our physicians, how we can help them make their medical practices safe as well if they're community doctors.

We wanted to make sure that they had the benefit of these tools. Some of them include patient educational materials and all of the other materials that we talked about. But, again, we felt very strongly that we wanted to insure that our doctors as well, our community doctors, have the benefit of these tools, so that whether you started your journey with them through one of our Baptist Health medical groups or Boca Care physicians, that our doctors have the same tools available in this very standardized process that we went through for recovery.

Again, it's really been a team effort from a Baptist Health perspective, and as we know, Baptist is known for quality, exceptional care, and providing compassionate healthcare, and this is what we're doing throughout the COVID-19 pandemic, and more importantly through recovery.

It's really been an honor and a pleasure to work with you, Jonathan, and all of the incredible professionals that have been part of the taskforce.

Dr. Jonathan Fialkow:

Thank you very much for that Nancy. I think it is well said that we want our patients and their families to have that peace of mind with any contact point within the Baptist Health System, which can include medical practices as well as facilities. Thanks again. Again, great work.

Dr. Jonathan Fialkow:

As usual, listeners, any thoughts, any ideas or future topic requests, please send an email to baptisthealthtalk@baptisthealth.net. Stay safe, and as much as you can stay home. Thank you.

Announcer:

Find additional valuable health and wellness information on our resource blog baptisthealth.net/news. And be sure to interact with us on our social media channels for live and upcoming events. This podcast is brought to you by Baptist Health, South Florida, healthcare that cares.

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