Rise Above Recognition: Staying connected and sustaining patient loads with a rotating staff

Staying connected during the COVID-19 crisis meant social distancing, but it didn’t stop Angela Kort, CMA, MHA, practice director, Genesis Medical Associates Koman and Kimmell Family Practice, Pittsburgh, Pa., from going where she needed to make sure everything was working.

With two teams rotating every 14 days for in-office work, that meant having one team — a physician and two care extenders, a front desk person and a medical assistant (MA) to room patients — on site while the other team (along with phone schedulers, triage staff and billers) worked from home.

“If one of our teams was exposed, we could easily and quickly flop the teams and keep everybody quarantined … We were able to keep our business going and our patients being seen and all of our staff moving,” Kort said.

Of course, not everyone on the team was ready for such a change. In one case, Kort traveled to an employee’s home to help set up ethernet cables to enable internet connectivity for regular Zoom calls and other functions of the job.

In less than one week toward the beginning of the crisis, the practice implemented telehealth services and was able to maintain 90% of pre-COVID-19 patient loads. For the team working in the clinic, Kort and the leadership bought iPads for those facilities, which helped them stay connected with patients with two-hour blocks of telehealth visits, either in the morning or afternoon, to avoid providers having to switch frequently between in-person visits and televisits.

For the staff working exclusively at home, they stayed busy with responding to patient portal messages, handling prescription refills, making appointment reminder calls and checking eligibility, among other tasks.

This streamlined workflow is “what saved us, patient encounter-wise,” Kort added, who noted that the practice only brought patients into the office who did not have the ability to be seen via telemedicine, such as those without access to a computer or smartphone. Limiting in-person visits to this reduced volume helped older patients “still come and see their doctor but not be exposed to other people,” Kort said.

Looking back, Kort noted that it likely would have been possible to bring more patients into the office for vaccines and testing, or activities as simple as a monthly B-12 injection. Erring on the side of caution likely was difficult on same patients who didn’t want to find someone else to do these things or have them done in a pharmacy setting, especially older patients who were used to coming to the clinic for it. Scheduling time early each morning for simple and routine activities such as this are one area Kort said she would revisit if given the opportunity.

What helped above all else through it all, Kort said, was the leadership support to patients and employees alike. Beyond the plan to split the office into two rotating teams, Kort said that communicating to providers and staff was crucial. “We were trying to keep them just as safe as they’re trying to keep our patients,” she said.

To reinforce the importance of communication, the team had Zoom calls each week to assess how everyone was doing, what worked well and what improvements could be made in the facility for the other team to come in seamlessly at rotation time.

RISE ABOVE RECOGNITION

We know great work is being done every day on the frontlines during the COVID-19 pandemic, and we want to help share these compelling stories and honor our nation's healthcare heroes. Rise Above Recognition highlights those who have solved difficult problems, conquered challenging situations, inspired others in times of uncertainty, contributed to your community and overcome the circumstances with innovation and excellence. 

Keep watching The Ascent blog for more stories of perseverance and practice excellence, and then please join us Oct. 19-21 for the Medical Practice Excellence Conference to hear more about these amazing stories and the best practices borne from unprecedented challenges.