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Now that we are likely past the anticipated surge, some hospitals are planning to reopen non-urgent procedures and return to some semblance of regular operations. The following is a list of questions for labor and management to review to ensure the hospital is reopening in the most safe and secure manner possible.

Timing and Criteria

  • What is the timing and plan for reopening non-urgent care?
  • What criteria are being used to determine when to reopen functions (e.g., Has the hospital seen a 14-day decrease in COVID-19 incidence)?
  • What criteria will be used to determine whether to keep these functions open if there is another COVID-19 spike?

Personal Protective Equipment

  • Is there a 30-day supply of PPE on hand — including N95 respirators, facemasks, isolation gowns, eye protection, face shields and gloves – on hand? If not, why are non-urgent procedures being opened without an adequate PPE supply?
  • Dramatic measures were taken due to the PPE shortage. What is the plan to return to best practices for PPE use (single use to avoid cross-contamination)?
  • What are the PPE policies for newly opening areas and procedures that will prevent them from COVID-19 exposure?

Safeguarding the Facility

  • What areas will be designated as COVID-19/PUI areas?
  • Has plexiglass been installed at all patient interactive windows? If not, why not?
  • Will all patients be required to wear masks in the facility?
  • How will patient screening at all entrances continue, and who will do it?
  • Will policies limiting visitors be maintained?
  • What are the cleaning/sterilization protocols for reopened areas
  • What are the social distancing protocols in reopened areas, including waiting rooms, huddles, offices, etc.?
  • Will temperature checks continue/be implemented?
  • Will any functions be handled remotely or via “drive-through”? How will they be staffed?

Testing

  • Will pre-operative patients be tested, and is there a policy regarding patient testing/quarantine?
  • Will patients with confirmed or suspected COVID-19 be eligible for non-urgent surgeries?
  • What is the plan to test and retest employees (frequency, criteria)?

Staffing

  • How will staffing change as reopening begins? Will cancellations/flexing decrease? Will per diems/on-calls be utilized regularly? (Review contract language around additional hours and the order to follow).
  • What staff training will be provided on how to safely work in newly opened areas?
  • Will employees currently working at home be able to continue to do so? If not, why not — and what is the timeline to return them to the workplace?
  • Will staff assigned to COVID-19 care be restricted to those areas to avoid cross-contamination?

Staff Support

  • How will the hospital continue to support employees with childcare challenges?
  • How will the hospital continue to accommodate employees who become COVID-19 positive or exhibit symptoms of COVID-19?
  • How will the hospital support the mental health needs of employees who have been working during these extremely stressful times?
  • How will the hospital accommodate employees who are over age 65 or immunocompromised?

Hospital Finances

  • When do you anticipate census numbers returning to pre-pandemic levels?
  • How much money did the hospital receive from the $175 billion CARES Act funds and how is it being utilized?