Hospitals across Massachusetts are moving back toward normal operations. But doing so is a balancing act because they're still caring for more than 2,000 COVID- 19 patients, 560 of whom are in an ICU.
One of the people who is guiding the transition at the state’s largest hospital is Dr. Inga Lennes, senior vice president for ambulatory services at Massachusetts General Hospital. She spoke with All Things Considered host Lisa Mullins about the challenges hospitals are facing at this point in the pandemic.
The following Q&A is derived from that interview and includes portions that did not air during the program.
What changes will patients see in this new COVID-era of care?
All of our patients are screened before they arrive for outpatient care. If they have symptoms of COVID, they're referred for testing and for treatment. All patients who expect to be admitted are asked to get a diagnostic test a day or two in advance of arrival.
What if I arrive with a cough or runny nose, can I still come in?
Yes, patients who have symptoms will be routed to our special respiratory illness clinic for evaluation and testing for coronavirus. They're tested in one of our Hexapods, which is a plexiglass structure that allows the practitioners to access patients without having to use as much protective equipment.
For any patient who comes in, do they have to wear a mask?
Yes. All patients are given a mask, they all wear masks as do all employees. We also have alcohol-based hand hygiene areas at building entrances, at all elevators and in all clinics.
What if you have to take the elevator?
There are prompts on the floors to maintain a 6-foot distance between patients as they access the elevators. And we limit the number of people in the elevators as much as possible.
Do you have somebody actually monitoring how many people get on an elevator or monitoring the hallways to see how many people are crowded in there?
Yes, we've repurposed staff who are now working in our lobbies, giving out masks, offering hand hygiene and directing patients in a sort of escort or concierge role. We also, because of the no visitor policy, have employees that are helping patients navigate to their clinics.
So if I'm dropping off somebody who might need a wheelchair, for instance, that kind of visitor is still not allowed?
We still have a strict visitor policy. We have help to transport patients to their clinic appointment. We do make exceptions for patients who are very ill and can't navigate or communicate without a visitor. Our pediatric patients are allowed visitors or escorts to their appointments. But we still are trying to limit the total number of visitors in our facility to help to protect both our employees and the other patients.
What other policies have you implemented?
One of the biggest changes that patients will notice is that we have spread out the scheduling of patients in the ambulatory clinics so that we can decrease the density in waiting rooms. We're also adding hours on the weekends to spread out the number of patients that are moving through our clinic settings. We also have enhanced infection control. Patients will notice the medical assistants wiping down the solid surfaces like the seating in the waiting rooms.
We are continuing to also use telehealth to its fullest extent. There'll be a combination of both virtual care and in-person care for a provider. It might change their workday.
The state says you have to be ready for another wave of COVID-19 patients by keeping 25% of the capacity you had during the surge available. Does that mean keeping a quarter of your beds empty or have extra staff on hand just in case?
We do not, as we understand the guidelines, have to keep the beds empty to be ready for that surge, but we have to have the immediate staffing plans to be able to pivot to accommodate that volume. We definitely have that.
Do you expect another surge?
We are watching the data and the analysis that comes from our epidemiologic colleagues very carefully. I don't think that we know for sure what's going to happen in the future. I'm not sure anyone does yet, but we want to be ready for whatever eventuality comes our way. So we're planning for it as if it will be a reality. If it isn't, then we'll be happily surprised.
Many patients are worried about contracting the coronavirus, in some cases more worried than about some kind of stomach pain or swelling. What would you say to these patients?
The feedback that I've gotten from the patients who have accessed our institution during this time is that they feel very safe here, and that is very reassuring to me. The other thing that comforts me is looking at the rates of infection in our own staff. We don't see a difference compared to the rates across Massachusetts. And that's reassuring in that, you know, we don't have a disproportionate number of people who might be contracting coronavirus from being here and that our infection control measures are working to keep people safe.
This segment aired on May 26, 2020.