Editor's note: For more coverage of the 2020 AAP Virtual National Conference & Exhibition, visit http://bit.ly/AAPNationalConference2020. For the latest news on COVID-19, visit https://www.aappublications.org/news/2020/01/28/coronavirus.
You may be offering your opinion on how the country should be dealing with the COVID-19 public health emergency. But if you don’t have any insights into how you can help your own practice through the crisis, you should be asking yourself why, said Susan J. Kressly, M.D., FAAP, chair of the AAP Payer Advocacy Advisory Committee.
“Ultimately, you have a critical role in ensuring that your practice remains sustainable so you can continue to deliver great care,” Dr. Kressly said during the session “Crossroads in Crisis: Your Practice During COVID-19” at the AAP Virtual National Conference.
During the session, Dr. Kressly and Suzanne K. Berman, M.D., FAAP, reviewed how the pandemic has impacted pediatric practices and health systems, and they offered pointers on how to survive and thrive amid the ongoing challenges.
Crisis uncovers vulnerabilities
“When a practice experiences a crisis, it really exposes what your practice is made of for better or for worse,” said Dr. Berman, chair of the AAP Section on Administration and Practice Management Executive Committee.
Drs. Berman and Kressly described qualities of practices that have fared well during the crisis.
First, they have a collaborative culture where team members are valued, empowered and know others care about them. If this doesn’t describe your culture, fix it now, Dr. Kressly said.
In addition, practices that recalled patients for well and chronic care did better than those that waited for patients to show up, Dr. Berman said. And the key to being able to recall patients is to have accurate contact information.
Disagreements on issues such as cutting salaries, instituting furloughs and distributing workloads created significant stress, Dr. Kressly said. Leadership matters during a crisis. Instead of trying to do what is fair, practices must use an equity paradigm where everyone has what they need to survive and have the best future possible.
Practice innovations
With no end in sight to the crisis, practices must continue to find ways to care safely for ill and injured children instead of sending them to the emergency department, Dr. Kressly said. Otherwise, families may feel abandoned and won’t return to the medical home.
While many practices are focused on personal protective equipment (PPE), Dr. Kressly said it actually is the last line of defense, according to the Centers for Disease Control and Prevention. Practices can use many other strategies to protect their teams and patients such as not bringing patients into office if they can be cared for in other ways, using plexiglass barriers, eliminating waiting rooms, decreasing unnecessary contacts and using alternate locations such as parking lots or empty offices.
Dr. Berman also suggested practices seek out alternative sources for and types of PPE such as elastomeric respirators that are used by painters.
The overriding goal is to provide the right care in the right place at the right time, Dr. Kressly said. Options may include managing patients at home, conducting telehealth visits or having a nurse give advice on the phone or via a portal. But don’t assume you know what the family wants. Ask them: “How can I best connect you to care today?”
Dr. Kressly also advised getting the word out to patients in every way possible. “They want to hear from you. They need to hear from you.”
Create short videos on what a well visit or drive-through flu clinic will look like. Update your website weekly. Have live sessions on social media.
Daily team huddles to brainstorm ideas also are vital.
“I would say no idea is too crazy, and some of the best ideas come from your staff who has to deal with some of the bottlenecks in your workflow,” Dr. Kressly said.
As practices implement new procedures, they won’t be as efficient as they once were. To improve throughput times, Dr. Kressly suggested eliminating unnecessary handoffs, using technology appropriately and asking whether ordering a test will change management. If not, don’t tie up a room and keep a patient in the office longer than necessary.
Finally, it’s important to adjust your plans just like you do when a medication you prescribe doesn’t work, Dr. Berman said.
“Some of your changes will fail and make things worse,” Dr. Berman said. “And that’s OK.”
Registered attendees can view sessions through Jan. 31, 2021, at https://www.eventscribe.net/2020/AAPexperience/.
