Eyeworld Supplements

2 | SUPPLEMENT TO EYEWORLD | AUGUST 2020 Turning the Lights Back On don't have to be a barrier to the patient experience; it can be a great opportunity to show your patient how much you care. Get rid of the coffee station (and snacks, if they were offered before), space chairs adequately in a waiting room and between patients and staff, and require that all patients and staff wear masks. A lot of our waiting room is now in our parking lot vs. our lobby. But we still want a great experience. We still use our form to know Mrs. Johnson in the brown coat is sitting in which chair, and we can walk right up to her. Even with social distancing and masks, we're still smiling, providing eye contact, addressing pa- tients by name. Often, the missing link keeping some practices from reaching their fullest poten- tial is the big E: the patient experience. With all the new consid- erations during this time, why work on increasing refractive cataract surgery at this time? You want to make patients happy. What follows patient satisfaction is an increase in the financial health of the practice. For example, a practice that does 5% premium cata- ract surgeries in 500 eyes (25 premium IOLs/year) could translate into a $50,000 net profit for the clinic. A prac- tice that performs premium cataract surgery in 40% of its patients (200 premium IOLs out of 500 patients, for exam- continued from page 1 ple) could see a net profit of $400,000. As with before the pandemic, we still have to educate our patients to the point of: What type of cataract surgery would they want if they had my knowledge and experience? That's the goal—to educate them to that extent. These patients need to learn that if they are going for a postoperative result as close to plano as possible, a Staff training and protocols in the clinic and OR D aniel Chambers, MBA, COE, and Regina Boore, MS, BSN, discussed considerations for reopening the clinic and ASC, respectively, during the Turning the Lights Back: Part 1 session. Both discussed the importance of staff communication and training for new policies and procedures. Mr. Chambers stressed a calm, firm, positive approach to communications. To address concerns of staff and patients, extra house- keeping measures should be implemented around the prac- tice, and patient flow and volume should be adjusted with tiered increases, he said. Mr. Chambers shared how patients and staff are screened and questioned before entering the practice, and patients wait in the parking lot until their ap- pointment time. The practice also established drive-thru IOP checks, offered telemedicine visits, and suggested hybrid, diagnostic-only visits with a remote telemedicine call with the doctor afterward. At ASCs, Mr. Chambers suggested avoiding overlapping surgeons in block scheduling. Essential guidance sources for ASCs, Ms. Boore said, include the federal government, CMS, CDC, OSHA, state departments of health, accrediting organizations, and other professional societies. PPE and disinfection have always been a staple in operating rooms but to a greater extent now amid the pandemic. "Universal masking is the standard of care in this COVID period," Ms. Boore said, adding that the N95 res- pirator masks are only required during general anesthesia and aerosol generating medical procedures (AGMP), such as bronchoscopy, upper endoscopy, etc. She also mentioned that disinfectants need to be EPA-approved against SARS-CoV-2. Policies and procedures that should be addressed, at a minimum, Ms. Boore said, include those involving: • visitors • surgery scheduling • universal masking • appropriate use of PPE • disinfection of non-patient care environment in the ASC • patient COVID-19 screening • a post-exposure plan • social distancing • a respiratory protection program if performing general anesthesia or AGMP ASC staff need to be trained in all new and revised pol- icies and procedures (which should be updated in response to current COVID-19 trends). "Any time you launch new policies and procedures, you have a need for new staff training and in service," Ms. Boore said. She added that some training elements should include infection control at the facility, PPE management, schedul- ing procedures, social distancing measures between staff members as well as between staff and patients, and updates to the employee handbook. Ms. Boore also said ASCs should conduct an updated hazard vulnerability analysis, a new infection control risk assessment, and consider new cleaning products, scheduling changes, and staffing changes. Editors' note: Mr. Chambers is the executive director at Key-Whitman Eye Center in Dallas/Fort-Worth, Texas. Ms. Boore is a principal and senior vice president at BSM Consulting and is based in San Diego, California. continued on page 3

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