Reopening Your Practice After COVID-19

While COVID-19 is still terrorizing our nation, and the world, the CDC guidelines and state guidelines are changing. Postponement of routine eyecare is no longer necessary, and many practices that have been closed for weeks are creating a plan to reopen. With that relief comes a great number of concerns. The threat of this virus is still very real, and when opening your doors up to the public, it must be taken seriously. Here are a few things to consider, while you move towards this “new normal.”

Many practices have furloughed much, if not all, of their staff. This includes support staff and doctors alike, and they have had to adjust to unemployment for weeks. Before opening your doors to patients, it is important to have a meeting with your team. Have a plan in place before calling them all in, but be open to ideas that they may offer. Remember, the receptionist sees things you don’t; an optician may have a great idea that you didn’t even consider.  Welcome their thoughts and concerns, and don’t forget to express your gratitude to them. This is a stressful time for all, even those not wrapped up in PPP applications and EIDL grants (learn more about those here). Be gentle with your team while you figure out a plan to move forward.

Before bringing patients in, consider the physical layout of your office. How many patients can you afford to see per hour without allowing them to come to close to one another? Many practices are planning to see one patient every 30-60 minutes, as opposed to an exam every 15-30 minutes. This will greatly reduce the number of people in the office, thus reducing risk. Take a look at your waiting area. Chances are, it is designed in a way to be aesthetically pleasing and maximize space. Unfortunately, that means you likely have too many chairs too close together; decide how your furniture needs to be arranged to allow for social distancing. When patients enter the office, have signage up, and remind them that you are adhering to social distancing guidelines. This also means that you may want to consider asking them to come to their exams alone. If they feel the need to have a driver, don’t hesitate to ask the driver to wait in the car. While inconvenient for some, it is your responsibility to create a safe environment for everyone in your office.

Besides physically keeping people from being too close together, it is important to make sure yourself and your staff are protected. This means getting your hands on all of the personal protective equipment, or PPE, that you need.  All those in your office should be required to wear a mask at all times; this includes doctors, staff, and patients. I recommend you provide your staff with the best masks you are able to; if they are wearing a mask all day, you want them to be as comfortable as possible. This also creates some good will throughout the practice. By making sure they are safe, you remind them that you appreciate them and want to look out for them.

You may need to also consider your daily appearance. Many doctors are considering trading business attire for scrubs, which may be easier to wash each day when you get home. Women should consider wearing their hair pulled back, which reduces the number of times they touch their face. Gloves must be available, although likely not required. When worn, be sure to change your gloves between every patient. The gloves may protect your skin, but it is a smooth surface that can very easily transfer germs from one surface to another. To remove them, be sure you are pulling them off carefully, turning them inside out as you do, and throwing them away immediately.

While a mask is necessary to reduce transfer of germs, you must still be very serious about sanitization. Creating an organization chart may be helpful to make sure your staff stays on the same page. The front desk staff should be responsible for maintaining the disinfecting schedule of the desk and reception area. This includes regularly sanitizing counter tops, door handles, and furniture. Our office has a white board hanging on a wall somewhat visible from the check-in counter. If a patient happens to see it, while it’s not aesthetically pleasing, it provides them with reassurance that we are doing all we can to keep them safe.

All staff may be held responsible for keeping the common areas clean. They may all be held responsible for disinfecting certain areas of the office, while each staff member should be responsible for cleaning anything they happen to work with. For technicians, this means cleaning the pretest or special testing equipment. For opticians, it means wiping down the pupilometer, and disinfecting frames after a patient tries them on. Doctors must be vigilant about cleaning all equipment in their exam room, including slit lamps, chairs, occluders, and anything else the patient came in contact with. It is recommended the cleaning be done in front of patients, to show what you are doing for their safety; my personal recommendation is to handle cleaning after using the equipment with the patient. This allows time for the alcohol or solution to dry, without creating an imposing smell or feeling on a patient if you immediately utilize that particular item right after cleaning.

This is a very unique problem we are having to deal with. As professionals, we must adapt to the changes, maintaining some sense of normalcy while still being cautious and safe. If you have been closed for the past several weeks, as most have, be sure that you have a plan in place to handle what may come about when you reopen your doors. Taking steps like the abovementioned may help improve the safety of your staff and patients. While we can’t stay shut down forever, we can begin our “new normal” in the most responsible, conscientious way possible. We will adapt, we will move forward, and we will overcome. Safely, and together.