Daily Operations and Clinical Update: July 15, 2020
|% of BMC Census|
BMC Total Inpatients:
BMC Inpatients Requiring Intensive Care:
|BMC Inpatients Under Investigation (pending + negatives treated as positives)||30|
|Cumulative COVID+ Patient Discharges:||
|Cumulative Staff Who Have Tested Positive||318 (3 new since 7/13)|
*This updated lower number reflects a slight change in how cases are counted.
REMINDER: Updated PPE Guidelines for Ambulatory Areas and Non-COVID Inpatients
In accordance with new MA DPH guidelines released last week, BMC has revised our PPE guidance for ambulatory areas and non-COVID inpatients.
Hospital employees and providers caring for these patients should don a surgical mask, eye covering (goggles, safety glasses or face shield), and a single pair of gloves. Healthcare workers providing patient care for COVID+ patients or patients under investigation (PUI) should continue to wear an N95, face shield, gown, and two pairs of gloves.
Please only take an N95 mask if you are participating in aerosolizing procedures and/or caring for COVID+, PUI, or TB patients. For more information, see the inpatient and ambulatory N95 frequency of use summary guidance, as well as the updated table of PPE by location.
REMINDER: Alternate N95 Mask Use and Upcoming Fit Testing Sessions
Because of constantly changing national supply chain demands, we have had to use several different N95 masks over the past three months in order to maximize our supply of PPE.
OSHA regulations state that most respiratory manufacturers produce multiple models with the same basic head form for size/fit. This means that BMC is able to reassign individuals into interchangeable masks that are equivalent to the masks they were originally fit tested on.
As available supplies will continue to change for the foreseeable future, we will continue to re-fit test groups as needed. It’s important that we have a full list of all the N95 masks employees and providers are able to fit into so we can adjust quickly as supplies change.
Currently, we are reaching critical levels of Gerson 2130 mask supplies.
All individuals who have previously worn a 3M 1860 Regular and were fit-tested after October 2019 will be reassigned back to the 3M 1860. All other individuals wearing a Gerson 2130 need to report to the fit testing area as soon as possible to get fitted to a different mask.
Drop-in fit testing will be offered for any staff member who needs fit testing in the Menino 2B conference room on the following dates and times:
- Wednesday, July 15: 4:30 – 7:30 p.m.
- Friday, July 17: 6 – 9 a.m.
- Monday, July 20: 6 – 9 a.m. (Menino 2 Conference Room A)
- Thursday, July 23: 2 – 5 p.m.
- Wednesday, July 29: 4:30 – 7:30 p.m.
- Friday, July 31: 6 – 9 a.m.
UPDATED: Daily COVID-19 Symptom Screening Tool for All Employees Now in Use
The Commonwealth of Massachusetts mandates that all healthcare employees complete a symptom screening prior to coming on site each day. As of July 7, BMC employees and licensed independent practitioners scheduled for shifts on BMC’s main campus are required to use the COVID-19 symptom screening tool in Enterprise Health as part of the daily screening process prior to coming to work each shift. Click here for a tip sheet for completing the symptom screening tool.
Each employee will receive a daily reminder via email and SMS text message. These reminders will be sent seven days a week, between 5 a.m. and 6 a.m. If your next scheduled shift is 24 hours or more in the future, you can simply ignore and delete the daily reminders.
Please review this list of FAQs for questions regarding the symptom screening tool requirement.
UPDATED: Patient/Visitor Screening Process
As of Monday, July 13, patient and visitor lobby symptom screening will be expanded to include additional symptoms and COVID-19 exposure. This change is consistent with the practice at other medical centers in the area and has been approved by the BMC Infectious Disease department.
If a patient/visitor presents with symptoms, tested positive, or has had contact with anyone known to have COVID-19 within the past 14 days, the lobby screeners will take the person’s temperature and send them home, to the ILI Clinic, or to the Emergency Department.
REMINDER: Research Study - COVID-19 Antibody Testing in Healthcare Workers
Two studies – (PI: Yachana Kataria - H-40503) and (PI: Karen Jacobson - H-40223) – at BMC are seeking to learn more about COVID-19 infection among those in the healthcare worker population who worked on campus during the surge using survey data, measurement of COVID IgG (antibodies/serology), and DNA.
They will be recruiting from July 13 through July 26 (6 a.m.-6 p.m. at Shapiro 5C). The results of the SARS-CoV-2 IgG (serology test) will be available to study subjects upon completion of consent, a survey and blood draw. Click here to learn more on the Hub. You may also drop in to Shapiro 5C from 6 a.m. – 6 p.m. through July 26 to learn more/participate.
NEW: COVID-19 Testing in Ambulatory Clinics
To help meet the testing demand in Ambulatory clinics, a new COVID-19 patient testing workflow was put into effect July 10.
For patients who are already in an Ambulatory encounter and are determined by their provider to require testing, a traveling MA will be available by page to perform testing in clinics Monday through Friday, between noon and 4 p.m.
If a patient is in clinic and is determined to require testing before noon, they should be sent to ILI Crosstown as a walk-in patient. COVID-19 testing for patients in Ambulatory clinics is not available Monday through Friday after 4 p.m. or on weekends. An ILI visit should be scheduled for patients who are seen during this timeframe and require testing.
Please note that this workflow does not pertain to pre-procedure COVID testing. BMC 710 testing operations remain as is.
NEW: COVID-19 Antibody Testing for Ambulatory Patients
COVID-19 antibody testing is now available in Ambulatory areas as the SARS-CoV-2 IgG test. In order to better understand the role of antibody testing in COVID-19, we are limiting the patients for whom it can be ordered. We will monitor and expand on these guidelines in the future.
For Ambulatory SARS-CoV-2 IgG testing, patients must meet one of the following criteria:
- Individual with febrile illness or viral upper respiratory infection symptoms without improvement for more than 11 days, and with negative COVID-19 PCR testing
- Persons with prior history of COVID-19-like illness who present with potential late complications (ex. multisystem inflammatory system in children)
- Asymptomatic individuals with recent and unexplained illnesses potentially related to COVID-19, including thromboembolic events, such as myocarditis, stroke, pulmonary embolism or deep venous thrombosis
You can find the order in Epic by searching for COVID Antibody. You must select one of the above reasons for ordering the test within the Epic order.
Please note that the guidelines for antibody testing in inpatients differs from the above based on expected impact on treatment decisions.