How Safe Are Health Care Facilities?

Rutgers University

A Rutgers expert discusses the safety measures being taken by doctors’ offices, emergency rooms and hospitals to reduce exposure to coronavirus

As the flu season approaches and COVID-19 cases tick up, many people will need to seek care from their doctors and at hospital emergency departments.

While it makes sense to avoid exposure to places where sick people gather and manage health care at home with the support of telemedicine, M. Douglas Baker, professor of pediatrics and vice chair for clinical development, department of pediatrics at Rutgers Robert Wood Johnson Medical School, discusses the safety practices put in place to protect patients who need to seek urgent care or hospitalization.

How are outpatient facilities keeping patients safe?

During the initial COVID-19 surge, many outpatient facilities, including urgent care centers, closed or significantly restricted their hours of operation. Upon reopening, scheduled visits were limited to a fraction of capacity and many other new safety precautions became commonplace.

All health care workers are screened daily, tested if symptomatic and quarantined if positive. Patients who use outpatient facilities now encounter different practice routines. Information sheets on doors and windows list infection signs and symptoms and the requirement for masks while on-site. The staff questions all visitors when they enter and measure temperatures using touch-free devices. Waiting areas have new limits on occupancy and have widely spaced seating. Plexiglas dividers, personal protective equipment [PPE], hand sanitizer auto-dispensers, single use equipment and disinfecting practices between patients help prevent contact with viral particles.

Procedures that risk aerosolization, such as measurement of lung function or administration of inhaled medications, are largely discontinued for the time being. Sick visits are typically clustered at the end of the day to avoid intermingling with well visits. Telemedicine is used whenever possible.

Is it safe to go to the emergency department?

Safety practices in emergency departments are similar to those in outpatient facilities, but many add an extra layer of protection by providing pre-screening by triage nurses or other trained personnel in a location outside the main entrance. Questioning and measurement of vital signs combined with remote consultation with on-site emergency medicine physicians allows safe and rapid discharge of some patients without the need of them entering the building.

How are hospitals managing safety?

Hospital-based inpatient units employ most of the same safety practices that are found in outpatient facilities and emergency departments. Patients and family members are asked questions about symptoms and have their temperatures taken again when they enter regular medical or surgical wards, maternity or birthing wards, and medical or surgical intensive care units.

Patients are placed in individual rooms when possible. Those who test positive for coronavirus are placed in dedicated units. Similarly, COVID 19-free units are restricted to patients who are test negative and otherwise free of suspicion of infection. To minimize physical exposure to patients with infectious illnesses, physicians and nurses communicate with hospitalized patients using teleconferencing during daily rounds. When safe, discharges are expedited, coordinating ongoing care with patients’ primary care physicians and specialist consultants.

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