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COVID-19 Healthcare System Operations Resources
Topic Collection
September 13, 2021

Topic Collection: COVID-19 Healthcare System Operations Resources

This Topic Collection focuses on adaptations to usual healthcare system operations and strategies to maintain provision of patient care during the COVID-19 pandemic.  

Please refer to CDC’s Coronavirus Disease 2019 webpage for the most up-to-date clinical guidance on COVID-19 outbreak management.  

If you have COVID-19 best or promising practices, plans, tools, or templates to share with your peers, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant topic area. Resources specific to healthcare system operations can be placed under the COVID-19 Healthcare System Operations Resources Topic.

Administrative Preparedness


American College of Physicians. (2020). Private Payer Coverage During COVID-19. (Added 12/10/2020.)
This table compares coverage by private payers under the headings of COVID-19 Testing, COVID-19 Treatment, Telehealth/Telephone, Prescriptions, and Other Policy Announcements.
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American College of Physicians. (2021). COVID-19 Coding. (Added 1/11/2021.)
This updated page gives coding information under the categories of vaccines, ICD 10 codes, CPT and laboratory codes, modifiers, and coding scenarios.
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This guide offers steps for hospitals to quickly identify community partners and collaborate with them to address the challenges of COVID-19. The three-step guide also includes a link to the more in-depth document, A Playbook for Fostering Hospital-Community Partnerships.
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American Hospital Association. (2021). Chart Examining Sources of Federal Funds During COVID-19 Pandemic for Hospitals. (Added 1/11/2021.)
This page offers links to a chart of financial support available for healthcare providers through the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security Act, and other sources.
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American Medical Association. (2020). AMA Announces Vaccine-Specific CPT Codes for Coronavirus Immunizations. (Added 12/30/2020.)
This page is a reference for the Current Procedural Terminology code set for COVID-19 vaccine-specific codes.
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American Medical Association. (2020). COVID-19 CPT Coding and Guidance. (Added 12/10/2020.)
The AMA has compiled CPT coding and guidance related to COVID-19, including immunizations; Category I pathology/laboratory; coding advice and testing guides; and other important tools and resources.
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This document offers coding best practices for several different scenarios. For each scenario, information is provided based on who is performing the service, applicable CPT codes, COVID-19 focused ICD-10 CM codes, the place of service, and any additional notes.
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American Society for Health Care Engineering. (2020). COVID-19 Resources for Health Care Facilities. (Added 4/29/2020.)
This page includes articles, tools, videos, and guidance to assist healthcare facilities in modifying and maintaining critical operations including air quality, safety and security, and infection prevention during the COVID-19 pandemic.
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American Society of Health-System Pharmacists. (2020). ASHP COVID-19 Pandemic Assessment Tool for Health-System Pharmacy Departments.
This tool allows departments of pharmacy to assess their readiness for COVID-19 by reviewing integration with institutional planning, departmental leadership, public and professional education and training, medications and supplies, staffing, and internal and external public affairs and communications.
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America's Health Insurance Plans. (2020). Health Insurance Providers Respond to Coronavirus (COVID-19).
This resource page lists information on how various health insurance providers are adjusting cost-sharing, co-pays, prior authorization, provider reimbursement, and other policies and programs for the COVID-19 response.
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During a pandemic or other emergency, healthcare facilities face significant challenges to quickly onboard additional healthcare providers when hospital admissions and ICU occupancy increase rapidly. This onboarding checklist can ensure new employees are compliant with administrative requirements, familiar with the mission and culture of the hospital, and understand expectations.
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Healthcare leadership is essential in ensuring continuity of operations based on effective decision making. During the COVID-19 pandemic, leaders in healthcare innovated to address COVID-related challenges, safeguarding infrastructure, staff, and patients while maintaining their institutions’ mission and values. This ASPR TRACIE resource highlights some of the considerations and promising practices that healthcare executives may consider implementing in their systems during the pandemic and beyond.
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This issue brief identifies strategies for state and territorial health agency leadership to consider in support of their COVID-19 response and recovery efforts.
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Centers for Medicare and Medicaid Services. (2020). Medicare Payment for COVID-19 Viral Testing: Skilled Nursing Facility/Nursing Facility. U.S. Department of Health and Human Services.
This document contains an algorithm and supplementary pages about how testing for COVID-19 is paid for in US nursing facilities.
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COVID-19 Health Care Resilience Taskforce. (2020). Strategies for Managing a Surge in Healthcare Provider Demand.
This resource highlights strategies that local healthcare workforce decision-makers could adopt to optimize healthcare workforce assets, assess ongoing staffing needs, and identify resources to meet patient surge during the COVID-19 pandemic.
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Healthcare Financial Management Association. (2021). HFMA Recommended Coronavirus Resources. (Added 1/11/2021.)
This page links to information resources about health insurance plans through Medicare, state, and commercial sources with respect to coding, billing, coverage of services, and disaster preparedness financing during the COVID-19 national emergency.
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National Association of Community Health Centers. (2020). COVID-19: CHC Finance Toolkit.
This toolkit offers resources to assist community health centers manage their finances during the COVID-19 pandemic. Topics include proactive communication, cash flow planning, understanding relief options, tax provisions, cybersecurity considerations, and remote work best practices.
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U.S. Department of Health and Human Services. (2020). CARES Act Provider Relief: For Providers. (Added 8/25/2020.)
This page includes various resources to assist healthcare providers in understanding options available through the Provider Relief Fund under the CARES Act.
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* UW Medicine Information Technology Services. (2021). COVID-19 Response Actions and Recommendations. University of Washington .
To help other healthcare organizations prepare their information technology services for infectious disease emergencies, this updated, downloadable document shares lessons learned and actions taken at UW Medicine during the COVID-19 pandemic. The information is organized into these three areas: clinical response, technical support, and people management. The addenda include a list of 10 ways hospitals can prepare now, a list of metrics tracked at UW, screenshots of UW dashboards, and a screenshot of the Epic Order Set called SmartSet.
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Communications Tools and Strategies


American Hospital Association. (2020). COVID-19 Communications Resources. (Added 6/29/2020)
This page includes various communications resources for the COVID-19 pandemic. Included are: a preparedness and response communications checklist; a recovery communications toolkit; hospital examples for internal and external communications, media relations, social media, and hospital recovery and reopening communications; other AHA communications tools and resources; and links to additional resources.
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This field guide includes message maps for frequently asked COVID-19 questions. It also includes appendices with additional resources, including links to communications guides from the Centers for Disease Control and Prevention and the World Health Organization, a master COVID-19 questions list from the Department of Homeland Security, and myth busters.
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Centers for Disease Control and Prevention. (2021). Communication Resources. U.S. Department of Health and Human Services.
The CDC's communication resources related to the COVID-19 pandemic are available on this updated page in digital audio and video format, as still photos and as text in multiple languages. Social media toolkits, one stop shop toolkits for various audiences, and public service announcements are also available from this page.
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This playbook describes the Cleveland Clinic's rapid implementation of telemedicine in response to the COVID-19 pandemic. It includes an ambulatory playbook to convert to telehealth, clinician training on virtual visits, patient facing materials, tips for showing empathy in virtual visits, and types of telehealth visits.
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COVID-19 Health Literacy Project. (2021). COVID-19 Health Literacy Project. (Added 1/11/2021.)
In collaboration with Harvard Health Publishing, this project creates and translates fact sheets about COVID-19 into more than 35 languages. Fact sheets are composed for a general adult audience, for pregnant people, and for children of different age brackets, with age-appropriate messages and illustrations.
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This is a resource hub for COVID-19 public health-related information in over 500 different languages.
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Orleans Parish Communications District. (2020). COVID ECC Resources *.
This website presents promising practices implemented by the Orleans Parish Communication District in response of COVID-19 to innovate their triage practices and reduce the risk of exposure to first responders in the field. These practices include administrative adjustments, software innovations that enable screening algorithms and computer aided dispatch, collaboration, and training of call-takers and dispatchers. Changes to software, protocols, and operating procedures enable the transfer of non-acute calls for medical service to paramedics stationed at the center, who then place video calls to screen callers for referrals, and perform daily follow-up to track symptoms of callers who are advised to remain at home.
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Patient Provider Communication Forum. (2020). Supporting Communication with Patients Who Have COVID-19. (Added 7/9/2020.)
This page hosts various free resources that healthcare providers can use to support communications with COVID-19 patients, particularly those who are unable to speak due to intubation or other interventions. Resources include pictograms and tools in various languages.
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Sandman, P. and Lanard, J. (2020). COVID-19: The CIDRAP Viewpoint - Part 2: Effective COVID-19 Crisis Communication. Center for Infectious Disease Research and Policy, University of Minnesota.
This report reviews established crisis communications principles in the context of the COVID-19 pandemic.
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Schwarze, M., Zelenski, A., Baggett, N., et al.. (2020). Best Case/Worst Case: ICU, with Special Content for Patients with COVID-19. University of Wisconsin-Madison.
This framework is designed to help clinicians communicate with patients and their families to achieve treatment decisions that align with patient preferences. The toolkit contains step-by-step instructions for use, templates filled with hypothetical examples, a blank template, photos demonstrating use of the intervention, and an ICU pocket card.
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Switchboard. (2021). A Round-Up of Multilingual Resources on COVID-19. (Added 1/11/2021.)
This updated page compiles information about COVID-19 from federal, state, and local government agencies and from selected nonprofit organizations. The page lists important CDC resources first, followed by information from other sources categorized by type of product: fact sheets, posters, multimedia resources, live updates, and other resource compilations.
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The Communications Network. (2021). COVID-19 Crisis Comms Triage Kit. (Added 1/11/2021.)
This page provides steps for designing a communications plan during the COVID-19 pandemic and encourages crowdsourcing best practices, resources, and examples. It also includes links to related previous roundtable events.
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This playbook offers communications tips to help healthcare providers respond to questions from patients and their loved ones about COVID-19.
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Continuity of Operations (COOP)


* American Hospital Association and American Medical Association. (2020). Working from Home during COVID-19 Pandemic.
This document provides information to physicians on protecting their computers, mobile devices, home network, and medical devices from cyber threats while working from home.
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CISA developed, in collaboration with other agencies, an “Essential Critical Infrastructure Workforce” advisory list. This list is intended to help jurisdiction officials as they work to protect their communities, while ensuring continuity of functions critical to public health and safety.
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* Healthcare & Public Health Sector Coordinating Councils. (2020). Management Checklist for Teleworking Surge During the COVID-19 Response.
This checklist assists healthcare enterprise managers in implementing a telework strategy that enables an uninterrupted workflow, supports patient care and facility operations, and protects against cyberthreats.
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This resource packet guides health centers implementing telework or reduced staffing of non-clinical services and functions during the COVID-19 pandemic. It offers best practices, decision trees, checklists, and other sample resources.
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National Association of State EMS Officials. (2020). COOP - Planning Outline Guidance.
This template guides the development of a continuity of operations plan during COVID-19 for public safety access points or emergency medical services agencies. A Word version is also available for customization at https://nasemso.org/nasemso-document/coop-plan-outline-for-ems-and-psap/.
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The COVID Staffing Project. (2020). COVIDStaffingProject *.
The COVID Staffing Project unites collaborators from Vanderbilt University Medical Center, Michigan Medicine, the Department of Learning Health Sciences, and the Center for Healthcare Engineering and Patient Safety, and the Procedural Learning and Safety Collaborative. The tools developed support hospitals in projecting frontline workforce needs, redeploying clinical teams, and protecting the health and well-being of providers.
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Cybersecurity


* American Hospital Association and American Medical Association. (2020). Working from Home during COVID-19 Pandemic.
This document provides information to physicians on protecting their computers, mobile devices, home network, and medical devices from cyber threats while working from home.
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Cybersecurity & Infrastructure Security Agency. (2020). Risk Management for Novel Coronavirus (COVID-19). U.S. Department of Homeland Security.
This guide identifies actions to address infrastructure protection, supply chain, and cybersecurity issues during the COVID-19 pandemic.
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Cybersecurity and Infrastructure Security Agency. (2020). COVID-19 Recovery CISA Tabletop Exercise Package (CTEP).
This package of materials assists stakeholders in assessing their recovery and business continuity plans related to organizational recovery from the COVID-19 pandemic.
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Health Sector Cybersecurity Coordination Center. (2020). COVID-19 VTC Exploitation. U.S. Department of Health and Human Services.
This white paper offers mitigation and remediation recommendations to those using video-teleconferencing services during COVID-19, particularly as the use of telehealth increases.
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Healthcare & Public Health Sector Coordinating Councils. (2020). Health Industry Cybersecurity Tactical Crisis Response Guide (HIC-TCR).
This guide offers tactics for the healthcare system to address cyberthreats, focused on education and outreach, enhanced prevention techniques, enhanced detection and response, and taking care of the team.
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* Healthcare & Public Health Sector Coordinating Councils. (2020). Management Checklist for Teleworking Surge During the COVID-19 Response.
This checklist assists healthcare enterprise managers in implementing a telework strategy that enables an uninterrupted workflow, supports patient care and facility operations, and protects against cyberthreats.
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* UW Medicine Information Technology Services. (2021). COVID-19 Response Actions and Recommendations. University of Washington .
To help other healthcare organizations prepare their information technology services for infectious disease emergencies, this updated, downloadable document shares lessons learned and actions taken at UW Medicine during the COVID-19 pandemic. The information is organized into these three areas: clinical response, technical support, and people management. The addenda include a list of 10 ways hospitals can prepare now, a list of metrics tracked at UW, screenshots of UW dashboards, and a screenshot of the Epic Order Set called SmartSet.
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Ethics


This document identifies ethical challenges associated with care of COVID-19 patients, specifies three ethical duties of health care leaders, provides examples of policies and processes for review, and offers guidelines for institutional ethics services.
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Incident Management


This ASPR TRACIE tip sheet highlights several key observations about how healthcare incident command systems functioned during the COVID-19 pandemic and includes lessons learned collected from interviews, surveys, and literature reviews as of August 2021. While the intended audience of this document includes HCFs, EMs, executives, and leadership, additional stakeholders including regional HCFs, emergency response teams, HCC members, vendors, and staff involved in emergency response may also find this information useful.
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Institute for Healthcare Improvement. (2021). How to Address Equity as Part of COVID-19 Incident Command.
This blog post describes how Brigham and Women’s Hospital (part of Mass General Brigham) added an Equity Committee to their COVID-19 Incident Command Team to address inequities intensified by the pandemic. It includes a flowchart illustrating a structure for integration of equity into incident command teams and summarizes risks to equity and lessons learned.
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Operational Modifications: COVID-19


Agency for Healthcare Research and Quality. (2020). COVID-19 Guidance Collaborative. U.S. Department of Health and Human Services.
This resource page features COVID-19 guidance summary reports on operational and patient care topics of interest to frontline clinicians and leadership.
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American College of Emergency Physicians. (2020). ACEP COVID-19 Field Guide. (Added 4/15/2020.)
This frequently updated online guide compiles resources helpful to emergency physicians in the evaluation and treatment of COVID-19. Topics include personal safety, work safety, emergency medical services, triage, patient presentation, assessment, diagnosis, risk stratification, treatment, special populations, business, regulations and liability, personal well-being and resilience, and impact on education, licensure, and credentialing.
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This frequently updated web page collects resources to assist physicians in their response to COVID-19. It includes background information on coronaviruses; clinical response information (transmission, presentation, diagnosis, treatment, infection control); and links to additional resources, including clinical care resources, telehealth, patient education, coding, ethics, and physician well-being.
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This toolkit compiles ideas from a May 2020 virtual roundtable among pharmacy leaders. The discussion centered on business recovery issues related to the COVID-19 pandemic.
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This updated, illustrated guidance for healthcare settings provides background information on the COVID-19 pandemic; identifies life safety and other goals; and categorizes information by suggested engineering approaches, specific "how-to" and unique areas, surge areas, facilities/maintenance, and medical gas/vacuum systems.
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Speakers from some of the hardest hit hospitals across the U.S. discuss their COVID-19 experiences in this webinar.
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This toolkit can help hospital emergency managers and planners manage large numbers of patients during the COVID-19 pandemic.
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Centers for Disease Control and Prevention. (2020). 10 Ways Healthcare Systems Can Operate Effectively During the COVID-19 Pandemic. U.S. Department of Health and Human Services.
This fact sheet offers 10 steps related to worker safety and support, patient service delivery, data streams for situational awareness, facility practices, and communications for health systems to consider while responding to COVID-19.
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Centers for Disease Control and Prevention. (2020). Healthcare Facilities: Managing Operations During the COVID-19 Pandemic. U.S. Department of Health and Human Services.
This updated guidance is intended to assist healthcare facilities manage their operations during the COVID-19 pandemic.
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Infectious Diseases Society of America, HIV Medicine Association, and the Society for Healthcare Epidemiology of America. (2020). COVID-19 Initial Lessons Learned: Recommendations to Prepare for a Fall Surge of COVID-19 Cases. (Added 6/22/2020.)
This document offers recommendations on the following issues to prepare for additional waves of COVID-19: personal protective equipment and other medical supplies, testing capacity, physical distancing and wearing masks/face coverings, contact tracing, telehealth, workforce capacity, access to care and treatment, health disparities, antimicrobial resistance, increasing immunization rates, preparing for a COVID-19 vaccine, minimizing viral spread during large gatherings, safe elections, comprehensive data collection, protections for frontline workers, and global cooperation.
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These online guidelines systematically review the evidence related to eight COVID-19 infection prevention practices and grade recommendations as strong, conditional, or a knowledge gap. Related guidelines are available for treatment and management and diagnostics.
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Operational Modifications: Usual Care


This statement outlines the conditions under which ambulatory surgery centers should restart deferred healthcare services. It also identifies additional factors to consider related to geographic variations, patient prioritization, procedure types, and availability of COVID-19 testing.
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This statement identifies principles for adoption by health insurance providers, including resuming procedures authorized prior to the COVID-19 pandemic, resuming routine and preventive care, promoting telemedicine use, supporting enhanced health system capacity, advancing evidence-based care and patient safety for new treatments, and streamlining administrative processes.
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American Academy of Family Physicians. (2020). A Checklist for Reopening Your Practice for “Non-Essential” Face-to-Face Visits. (Added 8/31/2020.)
This document offers considerations to physicians determining when to resume nonessential, in-person primary care services in their practices.
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American Academy of Pediatrics. (2020). Guidance on Newborn Screening During COVID-19.
The document provides guidance on following newborn screening recommendations during the COVID-19 pandemic.
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American Academy of Pediatrics. (2020). Guidance on Providing Pediatric Well-Care During COVID-19.
This document provides guidance on the health care that should continue to be provided to children during the COVID-19 pandemic.
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This guidance document details a series of recommendations to assist communities in a phased resumption of certain prioritized activities based on the best available evidence.
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This statement offers recommendations for the safe reengagement of non-urgent radiology care. It also includes a supplementary checklist of questions to guide decision-making.
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American College of Surgeons. (2020). Local Resumption of Elective Surgery Guidance.
This guidance document offers principles for the local resumption of elective surgery. It may be used as a checklist to address 10 priority issues.
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American College of Surgeons. (2020). Post-COVID-19 Readiness Checklist for Resuming Surgery.
This checklist identifies core facility and surgery-specific items that surgeons should assess the presence of in their facilities. The checklist of policies, structures and processes, and outcomes reporting should be modified based on what is appropriate for an individual facility, local resources, prevalence of COVID-19 in the community, and other factors. Surgeons should also consider communicating some of the checklist items to their patients to provide assurance that care can be provided safely.
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American College of Surgeons, American Society of Anesthesiologists, Association of periOperative Registered Nurses, and American Hospital Association. (2020). Joint Statement: Roadmap to Maintaining Essential Surgery during COVID-19 Pandemic. (Added 8/18/2020.)
This joint statement from four professional organizations lists principles and considerations for maintaining essential surgery during the COVID-19 pandemic. Issues discussed include: regional cooperation, supply chain, COVID-19 testing, personal protective equipment, case prioritization and scheduling, the five phases of surgical care, data collection and management, and safety and risk mitigation
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American College of Surgeons, American Society of Anesthesiologists, Association of periOperative Registered Nurses, and American Hospital Association. (2020). Joint Statement: Roadmap to Resuming Elective Surgery after COVID-19 Pandemic.
This statement from four professional organizations identifies eight principles and considerations to guide the resumption of deferred care.
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American Hospital Association, Association of periOperative Registered Nurses, and Advanced Medical Technology Association. (2020). Re-entry Guidance for Health Care Facilities and Medical Device Representatives.
This guidance from three professional organizations offers considerations to inform access policies supporting the safe reentry of medical device representatives to healthcare facilities.
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American Industrial Hygiene Association. (2020). Recovering from COVID-19 Building Closures*.
This document gives building managers guidance on reopening buildings after the COVID-19 pandemic subsides to keep employees safe.
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American Medical Association. (2020). A physician guide to keeping your practice open during COVID-19. (Added 5/8/2020.)
This document outlines a list of steps physician practices should take before reopening during the COVID-19 pandemic. It also includes a pre-visit screening script template, frequently asked questions about privacy and confidentiality, and links other resources related to relaxation of stay at home restrictions.
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American Society for Health Care Engineering. (2020). COVID-19 Recovery. American Hospital Association.
This page offers detailed information for healthcare facilities to consider as they recover from COVID-19 and begin restoring usual care. It identifies specific facility management issues; pre-recovery planning activities; immediate, short-term, and long-term needs; and the new normal. It is accompanied by an Excel-based recovery checklist.
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American Society of Clinical Oncology. (2020). A Guide to Cancer Care Delivery During the COVID-19 Pandemic.
This guide offers steps that oncology practices can take to protect staff and patients while continuing to deliver care during the COVID-19 pandemic.
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This resource highlights interrelated issues for the healthcare system to consider as they address their current status, restore services that have been curbed, maintain readiness for potential future waves of COVID-19 patients over the next two years, and adapt to improve their operations based on lessons learned.
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This document provides a framework for the provision of non-COVID-19 health care by the potential for patient harm and degree of community transmission.
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Centers for Medicare & Medicaid Services. (2020). Re-opening Facilities to Provide Non-emergency Non-COVID-19 Healthcare: Phase II. U.S. Department of Health and Human Services.
This document provides recommendations for the provision of non-COVID-19 care in communities with low incidence of COVID-19 and no evidence of a rebound.
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This document provides recommendations for the provision of essential non-COVID-19 care in communities with low incidence of COVID-19.
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Medical Group Management Association. (2020). COVID-19 Medical Practice Reopening Checklist. (Added 5/15/2020.)
This checklist identifies financial, operational, staffing, and procedural issues for medical practices to consider as they prepare to resume operations during the COVID-19 pandemic. A webinar describing these issues is also linked.
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New York City Health + Hospitals. (2020). COVID-19 Resurgence Toolkit. (Added 9/14/2020.)
This toolkit contains various resources to support safe, continued operations during the COVID-19 pandemic. Materials include electronic device and eye protection cleaning and disinfection guidance, personal protective equipment ensemble posters, a log for staff entering COVID-19 patient rooms, and signage on visitor restrictions and infection prevention.
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Toner, E., Waldhorn, R., Veenema, T., et al. (2020). National Action Plan for Expanding and Adapting the Healthcare System for the Duration of the COVID Pandemic. Johns Hopkins Bloomberg School of Public Health Center for Health Security.
This report identifies 10 challenges for the healthcare system to address during the COVID-19 pandemic accompanied by several recommendations for each challenge.
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This framework guides the resumption of usual care for veterans in accordance with federal reopening guidance.
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