Ten Ways Healthcare Systems Can Operate Effectively during the COVID-19 Pandemic
Purpose of this Guidance
CDC is listening to and learning from the experiences of healthcare systems as they respond to COVID-19. This document provides practical approaches that can be used to protect healthcare personnel (HCP), patients, and communities.
Healthcare system and healthcare facility decision makers
Worker Safety and Support
- Understand and execute current infection prevention and control (IPC) practices for COVID-19.
- Ensure HCP are well-trained on the use of personal protective equipment (PPE).
- Implement strategies to optimize personal protective equipment (PPE), including implementing extended and limited reuse of N95 respirators, reserving N95 respirators for aerosol-generating procedures, creating extended use PPE units where only patients with COVID-19 are provided care, and implementing a walk-up testing boothexternal icon that allows HCP to stand behind solid but transparent (e.g., polycarbonate) panels to collect samples for COVID-19.
- Institute universal source control for all HCP, patients, and visitors.
- Consider tracking PPE supplies available using the PPE burn rate calculator.
- Develop protocols for HCP to monitor themselves for fever and symptoms of COVID-19, restrict them from work when sick or post exposure, and to safely allow return to work after an exposure and/or suspected or confirmed COVID-19 infection.
- Establish a plan for providing additional support for HCPexternal icon, considering aspects such as mental health, parentingexternal icon, meals,external icon and non-punitive sick policies.
Patient Service Delivery
- Help your HCP become well-versed in evidence-based care of patients with COVID-19, including guidance provided by CDC, National Institutes of Health,external icon the Infectious Diseases Society of Americaexternal icon, the World Health Organizationexternal icon, and the Surviving Sepsis Campaign.external icon
- Understand the guidance for discharging a patient with suspected or confirmed COVID-19 from the hospital to home or to a long-term care facility.
- Use telehealthexternal icon strategies when feasible to provide high-quality patient care and reduce the risk of COVID-19 transmission in the healthcare setting. Consider implementing a phone advice line to triage patients and to address questions and concerns from possible COVID-19 patients.
Data Streams for Situational Awareness
- Maintain awareness of the COVID-19 situation in the state, city, and facility. Provide access to evidence-based guidance for caring for patients with COVID-19.
- Report hospital capacity data to HHS Protect using one of the approved mechanisms described in the HHS COVID-19 Guidance for Hospital Reporting and FAQs.
- Strengthen your facility’s response mechanisms by becoming familiar with pandemic, COVID-19 specific, and crisis standards of care
- Consider using a hospital preparedness checklistexternal icon and the COVID-19Surge spreadsheet to estimate and respond to the surge in demand for hospital-based services.
- Put in place or activate plans for cohorting patients with COVID-19 and assigning dedicated staff.
- Create plans to reduce staffing shortages and assess the need for alternative care sites, such as emergency field hospitalsexternal icon.
- Consider setting up an Emergency Operations Center (EOC) for your hospital if not already in place and ensure the EOC has enough staff for an extended response.
- Work towards resuming/maintaining essential healthcare services using a risk/benefit analysis for in-person care visits while optimizing telehealth.
- Develop and maintain a communication planexternal icon for your HCP, patients, and the community. Consider including virtual town halls, daily huddles with local leadership, calls with partners, emails and phone conferences for staff, media briefs, and others.
- NYC Health’s Strategies for Reuse and Extended Use of Personal Protective Equipment (PPE) During COVID-19 Outbreakexternal icon
- Institute of Medicine, Crisis Standards of Care, Summary of a Workshop Seriesexternal icon
- University of Washington COVID-19 Resource Siteexternal icon
- California Department of Public Health statement on resuming deferred and preventive health careexternal icon
- Transforming ORs into ICUsexternal icon. Peters et al. NEJM Correspondence.
- Universal Masking in Hospitals in the COVID-19 Eraexternal icon. Klompas et al. NEJM Perspective.
- Fangcang shelter hospitals: a novel concept for responding to public health emergenciesexternal icon. Chen et al. Lancet.