Highland Family Medicine Redesigns Practice to Include COVID-19 Precautions and Treatment
Heidi Tompkins, RN, BSN, NE-BC
Highland Family Medicine is a medical practice where walk-ins are welcome. So when the area saw its first signs of COVID-19 they knew they had to take action to ensure patient and staff safety.
At 777 South Clinton they quickly closed off the front entrance and set up nurses and medical assistants as screeners at the back door. If a patient had COVID symptoms they were escorted to what they called the Respiratory Care Clinic in the closest suite to the entrance, Suite 200.
Initial screening questions were about travel, respiratory symptoms, cough, and fever. That progressed to adding other symptoms as they were determined to be signs of COVID, temperature taking, and mask and hand sanitizer distribution.
“We were one of the first practices to recognize gastrointestinal symptoms could also be a COVID indicator as well,” said Mathew Devine, DO, medical director, Highland Family Medicine.
They had to redesign their practice model while triaging and treating COVID patients. The question “how can we still meet and/or see patients who had acute and chronic needs while keeping everyone safe?” was at the heart of their planning according to Heidi Tompkins, RN, BSN, NE-BC, Clinical Manager, Highland Family Medicine.
Telemedicine by video or phone was quickly implemented to help give patients access to our clinicians. The clinical management team worked with the Maternal Child-Health team lead by Dr. Dawn Pruett to arrange in-person well child and OB clinics that were located in a separate part of the building at 757 South Clinton. “All of the processes that are now in place didn’t happen overnight, but we did everything as fast as we could and in step with how information was changing daily,” said Tompkins.
Dr. Devine and Dr. Rachel Bian put together a tutorial to educate staff on new procedures and work flow. Staff input was involved and was critical to getting these sessions to run smoothly. “This was truly a team effort,” said Dr. Devine. “The entire practice helped create our plans in comprehensive, efficient ways. Camaraderie and dedication were our secrets to successful implementation.”
“Heidi and our leadership team were like a dog looking for a bone as we tried to stay up to date on the constantly changing information we had about the virus,” said Dr. Devine. “We were on every command center call, ambulatory care calls, primary care calls, AHP calls, and all over the internet looking for research articles and papers and putting applicable measures into practice right away.”
As more awareness of COVID-19 increased, patient walk-ins dropped. After redesigning the facility, in-person visits have started to increase week after week. Staff from Highland’s Infection Prevention have done multiple site visits to Highland Family Medicine to provide input as the social distance guidelines were implemented.
“Using staff in expanded ways we also worked to improve the video visit platform,” said Tompkins. “Our medical assistants are now helping to get patients prepared for the televisits to help streamline the process,” said Tompkins. Now Highland Family Medicine is getting back to the same, if not more, volume prior to the first two weeks in March.
“I will always prefer to see patients in person,” said Dr. Devine. “The ability to be in a room with a person, getting to know them and see them is a special part of being a family medicine physician. And I look forward to doing that again. I am grateful that we can accommodate and accomplish this with phone and video, and I do foresee these types of visits continuing as well in the future. For now we are going week to week and trying to get a good and safe balance using all of the opportunities that we have.”
“We are currently in a better place with supplies and knowledge if we were to have a resurgence of COVID,” said Tompkins. “Our team will be ready to care for our patients and meet the challenges.”
“This is a long, long marathon,” said Dr. Devine. “But we continue to get more information and learn about the virus, testing, antibody testing, vaccine development, and more. Because the population is taking precautions we are seeing drops across the country in diagnoses like strep throat and RSV and the flu season ended early. This shows that people are doing the right things and need to continue to keep doing them. Social distancing, mask wearing and hand washing continue to be best practices.”