An AMA checklist designed to help physicians manage the safe reopening of their practices emphasizes new precautions that must be taken to protect patients, clinicians and staff from COVID-19 as in-person care resumes or becomes more routine. A key tool for a safe reopening is prescreening patients before their arrival.
The new AMA resource is designed to balance immediate care needed for COVID-19 while addressing patients’ other backlogged needs that have been postponed to support the physical distancing that is necessary to curb community spread of COVID-19.
Effective teletriage of patients can keep practice staff and visitors safe while putting patients on the appropriate care path as some who seek an in-person visit may be better accommodated through a telehealth virtual visit or, in more urgent cases, need to be directed to a hospital or COVID-19 testing site.
In addition to informing care decisions, the information collected from a well-designed pre-visit screening questionnaire can be part of an effort to reduce community spread of COVID-19.
Also, reaching out to patients to explain safety procedures in advance of their visit can help to alleviate patient anxiety by assuring them that the practice has protocols in place.
The AMA has developed the template for a pre-appointment patient screening script that practices can modify or use to assess patients’ potential COVID-19 symptoms or exposure ahead of entry to the office or clinic.
Patients should be told their responses will be kept confidential and will be reviewed by a practice clinician who will provide guidance regarding any adjustments to the patient’s scheduled appointment.
If patients answer “yes” to any of the questions, guidance is included on what actions to take. Here are some of the screening questions included in the script:
- Have you or anyone in your household had any of the following symptoms in the last 21 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit?
- Have you or anyone in your household been tested for COVID-19?
- Have you or anyone in your household visited or received treatment in a hospital, nursing home, long-term care, or other health care facility in the past 30 days?
- Have you or anyone in your household traveled in the U.S. in the past 21 days?
- Have you or anyone in your household traveled on a cruise ship in the last 21 days?
- Are you or anyone in your household a health care provider or emergency responder?
- Have you or anyone in your household cared for an individual who is in quarantine or is a presumptive positive or has tested positive for COVID-19?
- Do you have any reason to believe you or anyone in your household has been exposed to or acquired COVID-19?
- To the best of your knowledge have you been in close proximity to any individual who tested positive for COVID-19?
If patient answers “yes” to any question, their responses should be reviewed by a designated medical leader to assess whether the patient can keep the scheduled appointment. Patients will be contacted again after decision-making.
“With some physicians beginning the process of reopening their practices, this essential resource supplies them with guidance to do so while keeping patients, staff and the general public as safe as possible from a COVID-19 resurgence,” said AMA President Patrice A. Harris, MD, MA. “The AMA remains focused on ensuring the viability of physicians’ practices that have been seriously impacted by this public health crisis and will continue providing support while aggressively advocating on physicians’ and patients’ behalf.”
Physicians should also consult the Centers for Medicare & Medicaid Services’ phase 1 guide for reopening facilities to provide nonemergent, non-COVID care.
Other tools and guidance can be found at the AMA's COVID-19 resource center, which offers a library of the materials from the JAMA Network™, the Centers for Disease Control and Prevention and the World Health Organization