Below are changes to the guidance as of June 9, 2020
- Updated guidance to reflect the current understanding and ongoing response needs of healthcare systems and facilities. Previous guidance was preventative and meant to help healthcare facilities prepare for community transmission, while current guidance is for managing operations during the pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has changed how health care is delivered in the United States and has affected the operations of healthcare facilities. Effects may include increases in patients seeking care for respiratory illness that could be COVID-19, deferring and delaying non-COVID-19 care, disruptions in supply chains, fluctuations in facilities’ occupancy, absenteeism among staff because of illness or caregiving responsibilities, and increases in mental health concerns. Currently, no FDA-approved medications to treat COVID-19 or vaccines to prevent it are available.
Healthcare facilities need to provide care for all patients in the safest way possible for patients and healthcare personnel (HCP) and at the appropriate level, whether patients need home-based care, outpatient care, urgent care, emergency room care, inpatient care, or intensive care. This guidance outlines goals and strategies for U.S. healthcare facilities to operate effectively and safely during the COVID-19 pandemic and provides links to CDC guidance on providing care in different settings and situations.
This guidance offers recommendations for healthcare facilities to
- Operate effectively during the COVID-19 pandemic
- Adjust the way they deliver healthcare services to reduce the need to provide in-person care
- Follow infection prevention and control recommendations tailored to their setting
- Provide necessary in-person clinical services for conditions other than COVID-19 in the safest way possible, minimizing disease transmission to patients, HCP, and others
During the COVID-19 pandemic, healthcare systems should adjust their standard approaches of delivering healthcare services to reduce the need to provide in-person care to minimize risk to patients and HCP.
Using Telehealth Services
For helpful considerations and strategies to provide telehealth services, please visit “Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic”.
Optimize use of telehealth
Telehealth services should be optimized, when available and appropriate. The federal government has made telehealth services easier to implement and access (see: guidance for planning, preparing patients, and billing and reimbursementexternal icon for telehealth services). CDC considers that telehealth could be used to deliver the following services:
- Screen patients who may have symptoms of COVID-19 and refer as appropriate.
- Provide urgent care for non-COVID-19 conditions, identify higher acuity care needs, and refer patients as appropriate.
- Access primary care providers and specialists, including mental and behavioral health care providers, for chronic health conditions and medication management.
- Participate in physical therapy, occupational therapy, and other modalities as a hybrid approach to in-person care for optimal health
- Monitor clinical signs of certain medical conditions remotely (like blood pressure and blood glucose levels).
- Engage in case management for patients who have difficulty accessing care, including those who live in rural settings, older adults, or those with limited mobility.
- Follow-up with patients after they are discharged from the hospital.
- Deliver advance care planning and counseling to patients and caregivers to document preferences if a life-threatening event or medical crisis occurs.
- Provide non-emergent care to residents in long-term care facilities.
- Provide education and training for HCP through peer-to-peer professional medical consultations (inpatient or outpatient) that is not locally available, particularly in rural areas.
Tips for using telehealth services to screen and care for patients with suspected or confirmed COVID-19
- Instruct patients who think they may have COVID-19 to use available advice lines, patient portals, or on-line self-assessment tools or to call and speak to an office/clinic staff rather than coming in person.
- Identify staff to conduct telephonic and telehealth interactions with patients. Develop protocols for staff to triage and assess patients quickly.
- Determine algorithms to identify which patients can be managed by telephone and advised to stay home, and which patients will need to be sent for emergency care, come for in-person visits, or follow up with a lab for COVID-19 diagnostic testing (or other testing services).
- Instruct patients with symptoms of COVID-19 to call before they leave home so staff can be prepared to care for them when they arrive.
Manage mildly ill patients at home
When possible, manage mildly ill patients with COVID-19 at home.
- Assess the patient’s ability to safely self-isolate and monitor their symptoms at home and assess the risk of the virus spreading to others in the patient’s home environment.
- Provide clear instructions to caregivers and people who are sick regarding home care, including when and how to access the healthcare system for in-person care or urgent/emergent conditions.
- Identify staff to monitor patients at home with daily check-ins using telephone calls, texts, patient portals, or other means, if possible.
- Engage local public health resources, home health services, and community organizations to assist with support services (such as delivery of food, medication, and other goods) for patients isolating at home.