For nearly two months, much of radiology’s imaging volume has been sitting on the sidelines, waiting for the green-light for imaging centers to re-open their doors for non-urgent scans. While there’s no exact date that will work for everyone to begin elective imaging again, the time is coming when facilities may feel comfortable doing so.
But, before you raise the curtain on the growing backlog of studies, there are many safety, workflow, and personnel considerations you must address. To help you along the way, the American College of Radiology (ACR) released guidance Wednesday, in the Journal of the American College of Radiology, that can guide you to safely resuming non-emergent imaging.
“Radiology practices largely followed World Health Organization, Centers for Diease Control and Prevention (CDC) and ACR guidance to postpone non-urgent care,” said Jacqueline A. Bello, M.D., FACR, ACR chair of the Radiology Commission on Quality and Safety. “While local conditions prevent a single prescriptive strategy to resume such care, general principles can apply in most settings.”
There are many things that must factor into your decision on whether to re-open. Review your local statistics on current levels of viral presence and infection, and monitor that data in case it begins to indicate the emergence of a second- or third-viral wave. Make sure you’re abiding by both governmental and institutional regulations, and be prepared to disengage all non-urgent imaging if more cases emerge.
“To safely resume routine care, practices must balance local risk from illness or death to workers and patients from healthcare-acquired COVID-19 with the patient-specific risk of illness of death from postponing an examination or procedure,” wrote the panel of experts, led by Michael Davenport, M.D., from Michigan Medicine, responsible for drafting the ACR statement.
If conditions are favorable for you to start scanning patients for elective or non-emergent procedures again, the ACR recommended you enact these five over-arching safety measures:
1. Screening: Screen every patient for COVID-19 symptoms during scheduling, and screen them again, as well as workers and visitors, when they enter your building. Have a plan in place for how to manage people who screen positive, and devise a system to identify and flag any patients who have been previously infected with the virus.
2. Personal Protective Equipment (PPE): Be sure you have enough PPE for both workers and patients to meet both current and future needs. Require every patient, visitor, and healthcare worker to wear a mask, and train staff and providers on correct PPE use and hand hygiene. Also, ensure that you have PPE, such as N95 masks and powered air-purifying respirators, for aerosolizing care. And, coordinate with your health systems for PPE use, being sure to concentrate on the highest-risk care, and concentrate your activity in specific sites if there’s not enough PPE for you to re-start activity everywhere.
3. Social Distancing: Provide for adequate spacing in waiting rooms, hallways, and work areas. This can include one-way corridors to minimize unnecessary contact, as well as having patients wait in their cars until their appointment time arrives.