Friday, April 17 Community Briefing

• Which visits can be seen virtually? – medication follow-ups, assessment of common problems (back pain, diarrhea, etc.)
• Which visits cannot be done virtually? – hands-on physical examination (well visits, well-child visits) as well as new prescriptions of controlled substances
• Patients 18+ years of age or older
• Patients log in using their patient portal account, nurse completes intake, and provider begins seeing patient
• Requirements for a visit
• Patients must have a patient portal account
• Quiet place
• Microphone and video enabled
• If using a smartphone or tablet, patients must use the MHealth app, otherwise they can use Chrome or Firefox browsers on their computer
• Ensure enough service connectivity and a high quality internet connection/speed
• How are patients scheduled for a virtual visit? – A virtual visit can be requested through the patient portal. Patients that do not currently have a patient portal, please contact Health Information Management at (620) 343-5941 to get set up with a portal account or access www.newmanrh.org/healthrecords
• Biggest challenge: patient’s internet connection which can decrease video quality

Steps the clinic is taking to ensure patient safety:

• screening questionnaire is completed by reception staff prior to appointments over the phone (usually 1 day prior)
• all medical staff wearing personal protective equipment including masks and goggles
• symptomatic patients will be asked to wear a mask when screened by the registration staff at the clinic – patients are asked to wear their own personal mask in for their appointments
• well visits scheduled in the AM with sick visits scheduled in the afternoon to cohort patients and help mitigate the spread of the disease

Patients calling in with symptoms similar to COVID-19 are being directed to the drive thru collection to be tested, or scheduled with the respiratory clinic – helps to cohort patients to mitigate the spread

10:20am: Ester Knobloch, Infection Preventionist

Infection prevention role: keep patients and staff safe from the spread of infectious disease; involved in each step where COVID-19 may play a part

Testing platforms – viruses can be tested in a multitude of ways:

• cell culture: most common; determines the growth of the virus; very long and laborious that does not work well to quickly identify
• DNA/PCR test – looking for RNA of the virus; faster test but requires instrumentation); PCR tests are the ones currently being done through the Kansas state laboratory and Quest lab in Lenexa
• Serology tests – looking for the immune systems response to the virus, also known as antibodies; the problem with this test is that it’s not specific to SARS-CoV-2

At the hospital, we have the PCR test capabilities but we do not have the reagents specific to the SARS-CoV2 virus.  We are actively looking at how we can get that in order to have a quicker turnaround time of test results for our community.

In order to get an effective sample, the swab has to go way back in to the nasal cavity.  There is a current shortage of those swabs.  Currently, the hospital has an adequate supply but we are actively searching for more and doing what we can in-house to maximize our current supplies.

Test categories:

• Confirmed positive – test confirmation
• Probable positive – clinically compatible with a link to a confirmed case

Cloth masks – highly effective because the virus is droplet transmitted; proven to keep secretions to the person wearing the mask

• When wearing a mask, people must be diligent to not touch it.
• Educate yourself on how to properly wear the mask.

Secondary household attack rate – a measure of how frequently a virus would spread within one household

• Airborne diseases = greater than 90%
• With SARS-CoV-2, when people practice good isolation protocol within the homes, the rate is around 10%. This rate is very consistent with other respiratory illnesses that spread through droplets.

Social distancing – great way to prevent the spread since we know it is droplet.

Currently, there remains a significant number of positive cases with consistent increase within our community proving community spread.  When those numbers become less extreme, we are then able to take a look at how to begin incorporating more normal living habits.

10:35am: Bob Wright, CEO

County EOC update

• Health department is approaching area businesses to ensure proper guidelines and employee screenings and help educate our local companies
• Continue social distancing
• Communication with phasing in the reopening of community businesses
• Lyon County has not seen their peak yet
• More susceptible with hot spots in our community due to the number of employers we have with large numbers of employees

# of inpatients currently in COVID unit – 3 (20% admission rate based on number of people tested)

Cumulative # of COVID admissions – 10 since April 3; Average daily census of 2-3; Highest daily census to date is 4

Respiratory Clinic # – Increase in volume this week to an average of 7 daily; decreased the number of providers back to one

Drive Thru # – Average of 6 daily

Tests administered to date – 205

Outpatient appointments – please wear a personal face mask, if you have one

Cloth masks to be distributed to patients as follows:

• All inpatients
• 100% of ER, Respiratory Clinic, and Express Care patients
• Outpatients that screen positive, or with symptoms

Screening at Entrance B (Newman Medical Plaza entrance) has been discontinued due to the gathering of multiple patients at the entrance while waiting to be screened; screening will take place at the entrance of each individual clinic