COVID-19 Daily: Hospital Hacks, Tips for Small Practices

What your doctor is reading on Medscape.com:

MARCH 23, 2020 -- Here are the latest coronavirus stories Medscape's editors around the globe think you need to know about today: 

Hospital Hacks

Clinicians are developing innovative workarounds to standard practice in the face of shortages of vital equipment such as personal protective equipment (PPE). To save PPE sets, one advanced practice nurse at a hospital in Washington state proposed moving intravenous pumps outside of COVID-19 patients' rooms after noticing she kept having to suit up to tend to the pumps. Elsewhere, alcohol distilleries are turning their talents to producing hand sanitizer. 

Keeping Your Practice Going

As the COVID-19 pandemic stresses the healthcare system from major medical centers to local primary care practitioners, many practices are having to adjust their operations. One large New Jersey practice is asking patients to wait in their cars instead of the waiting room. Practice management consultants and medical group executives share their advice for physicians running independent practices during the coronavirus pandemic. 

Can Retired Nurses Help? 

Illinois governor J.B. Pritzker’s Saturday plea for retired healthcare workers to come back to work as coronavirus cases swell was the latest of several similar appeals. But if retired nurses want to help, how do they go about getting their licenses reinstated? A healthcare attorney writes that the rules from state boards of nursing are changing daily as some governors are authorizing emergency provisions to cut red tape. 

Eased Reporting Requirements

The US Centers for Medicare & Medicaid Services (CMS) announced that it's moving back the deadline for reporting 2019 performance for the Quality Payment Program of the Merit-based Incentive Program. A total of 1.2 million clinicians participate in the program, which originally had its deadline at the end of March. 

Protecting Health Care Workers

In the early days of the coronavirus epidemic in the US, healthcare workers were told to self-quarantine for 14 days if they came into contact with an infected person. But at this point, "if we had to quarantine every health-care worker who might have come into contact with a covid-19 patient, we’d soon have no health-care workers left," physician Atul Gawande writes in the New Yorker. It also seems, from the emerging data, such aggressive measures are not necessary to protect workers from infection. 

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'The Toughest Triage'

Hard choices lie ahead for healthcare workers, some are predicting. "Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale," dean of Harvard Medical School George Q. Daley, MD, PhD, and colleagues write in a perspective the New England Journal of Medicine. What might that look like? Other experts have sketched out some recommendations

Postcard from France

Whereas some parts of France have been hit hard already, others are just starting to see an increasing flow of patients. Dominique Savary, an emergency medicine physician at Angers University Hospital in the Pays de la Loire region, tells Medscape’s French edition that 80% of patients coming into the emergency room have suspected cases of COVID-19, and an average of 5% of them test positive. While fewer overall patients are coming in as people follow instructions to avoid the emergency room, safety measures make the staff's workload much greater, he says. 

Ellie Kincaid is Medscape's associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine.

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