Impact of COVID-19 on Medical Staffs Jennifer A. Hansen, Ruby W. - - PowerPoint PPT Presentation

Practical Pointers For Addressing the Impact of COVID-19 on Medical Staffs

Jennifer A. Hansen, Ruby W. Wood, and Emily L. Brinkman

Hooper, Lundy & Bookman, PC www.health-law.com

Presenter Information

Co-Chair Medical Staff Practice Partner Jhansen@health-law.com (619) 744-7310 Senior Counsel Ebrinkman@health-law.com (415) 875-8482

Jennifer A. Hansen Ruby W. Wood Emily L. Brinkman

Co-Chair Medical Staff Practice Partner rwood@health-law.com (415) 875-8514

• Common Questions facing Medical

Staffs regarding impact of COVID-19

• Effective Use of Communications,

Policies, and Practices

• Responding to Practitioners
• Safety Complaints, Social Media,

and Collaboration

• Questions?

Overview

COVID-19 and Medical Staffs

COMMON QUESTIONS FACING MEDICAL STAFFS IN LIGHT OF COVID-19

Common Questions for Medical Staffs

• Elective v. Essential Procedures
• Credentialing and Privileging

(Disaster, Emergency, Temporary)

• Use of Tele-Technology
• Committee Meetings, Voting, Officer Terms
• Confidentiality and Peer Review Issues
• Pending Corrective Actions and Judicial Review

Committee Proceedings

• Allocation of Critical Care Resources

Elective vs. Essential

• Each hospital should make its own determinations:
• CMS recommends a tiered approach:

https://www.cms.gov/files/document/cms-non-emergent-elective-medical-recommendations.pdf

• Industry leaders urge against blanket bar of elective procedures:

https://www.aha.org/system/files/media/file/2020/03/aha-to-surgeon-general-elective-surgeries- and-covid-19-3-15-2020.pdf

• Ongoing patient consideration
• Weigh (and re-weigh) critical care resources

Does delaying treatment worsen a life-threatening or debilitating prognosis?

Credentialing and Privileging

Disaster Emergency Temporary Other?

KNOW YOUR OPTIONS CHECK YOUR BYLAWS TRACK GUIDANCE

Rules and Regs Policies Practices Blanket Waivers Federal State Boards

Reasonable?

Use of Tele-Technology

• Impact of COVID-19 on:
• Committee Meetings
• Annual Meetings
• Officer Terms
• Voting Issues
• Board Meetings / Approval
• Reappointments
• Peer Review

It's Not Business As Usual

But keep calm lm anyway! yway!

• Consider impact of COVID-19 measures on
• Standard Peer Review
• Provisional Proctoring Requirements
• FPPE
• "FPPE should continue per the defined

medical staff process" (TJC FAQs)

• Corrective Actions
• Reporting Requirements
• Pending JRC Proceedings

Impact on Peer Review Proceedings

• Federal Laws
• Health Care Quality Improvement Act ("HCQIA")
• Patient Safety Quality Improvement Act ("PSQIA")
• HIPAA
• State Laws (for example)
• CA Evidence Code section 1157
• MN Code sections 145.61-145.66
• TX Health and Safety Code sections 161.031-161.934
• WA Revised Code section 4.24.250(1)

Keep It Confidential

• Patient Care vs. Public Health
• Avoid inclusion of potentially discriminatory criteria
• Collaborate with Medical Staff Leaders and

Administration

• Look to Healthcare Community
• Federal and State Guidance?
• Must be flexible
• Evolving issue

Allocation of Critical Care Resources

• Connecticut: Emergency Order (March 10)
• Michigan: Executive Order 2020-30 (March 29)
• Illinois: Executive Order 2020-19 (April 1)
• New York: Emergency Disaster Treatment Protection Act (April 2)
• New Jersey: S.B. 2333 (April 13, retroactive to March 13)
• Massachusetts: S.2630 (passed Legislature April 17)
• Florida and Pennsylvania are in the midst
• f active discussions

COVID-19 Medical Immunity Protections

COVID-19 AND EFFECTIVE COMMUNICATION WITH MEDICAL STAFFS

• Set expectations and protocols
• Set up a notification system
• Review remote work policies and resources
• Call Coverage Agreements
• Behavior Policies and Procedures
• Think critically about how prior practices

have been impacted by COVID-19 pandemic

Identify Available Tools

• Goals:
• Provide Resources
• Identify Existing Policies
• Open Communication
• Safe Practice Pointers
• Set Expectations
• Think about including:
• Efforts to Address COVID-19
• Notes of Appreciation

COVID-19 Communications

• CDC Guidance
• Test-based
• Non-test based
• Symptoms and Screening

measures

• Quarantine Protocols
• Reporting Mechanisms

COVID-19 Specific Protocols

RESPONDING TO PRACTITIONERS

• COVID-19 adds to existing concerns

regarding Physician Burnout

• Respond to Heightened Stress Levels
• Pay attention to basic needs

(food, water, bathroom, sleep)

• Mental health support resources
• Compassion and empathy from leadership

https://www.ama-assn.org/delivering-care/public-health/6-ways-address-physician-stress- during-covid-19-pandemic

Ensuring a Culture of Wellness

Flu, Allergies or COVID-19?

CDC Human Infection with 2019 Novel Coronavirus Person Under Investigation Case Report Form

COVID-19 Exposure and Infections

• Develop protocols for reporting

*Think about your existing practices *Get input from your own Medical Staff

• Consistency
• Investigate reports

*Think about patient protections

• Be flexible: evolving expertise

regarding COVID-19

• Balance Rumors with Fact

Other Considerations

• Consistency (where possible) with existing

protocols

• Self-reporting compared to reporting by others
• Behavior issues
• Corrective Action options
• Patient Safety AND
• Fairness to Practitioner

SAFETY COMPLAINTS, SOCIAL MEDIA, AND COLLABORATION

In the News ...

Patient Safety Complaints

• Recognize high public

awareness regarding COVID-19

• Work collaboratively
• Reduce risks for claims of

retaliation

Track Ongoing Developments

HLB: https://www.hlbcovid19.com NAMSS: https://www.namss.org/COVID-19 TJC: https://www.jointcommission.org/covid-19

CMS: https://www.cms.gov

Questions?

Presenter Information

Co-Chair Medical Staff Practice Partner Jhansen@health-law.com (619) 744-7310 Senior Counsel Ebrinkman@health-law.com (415) 875-8482

Jennifer A. Hansen Ruby W. Wood Emily L. Brinkman

Co-Chair Medical Staff Practice Partner rwood@health-law.com (415) 875-8514

NAMSS:

• Phone: 202-367-1196 | E-mail: info@namss.org | education@namss.org

COVID-19 Resource Page COVID-19 Discussion forum

• Register for live webinars

NAMSS Facebook NAMSS Twitter NAMSS YouTube NAMSS Linkedin

NAMSS Resources

THANK YOU!