May 13: DAILY COVID-19 UPDATE

May 14, 2020  //  FOUND IN: Updates & Resources

NEW TODAY: Here’s the latest information about Michigan Medicine’s management of the COVID-19 pandemic:

  • DAILY PATIENT STATS
  • DAILY TEAM MEMBER TESTING STATS
  • PERIOPERATIVE AND PERIPROCEDURAL COVID-19 TESTING AND PPE TOWN HALL
  • COVID-19 TESTING ORDERS IN MICHART
  • NON-CONTACT TEMPERATURE SCREENING NOT RECOMMENDE
  • NEW HOSPITAL UPDATE
  • TOWN HALL Q&A

DAILY PATIENT STATS

Today’s census for COVID-19 inpatients and those patients under investigation (PUI) are noted below: 

Discharges: 463 total COVID-19 discharges to date, 9 in the last 24 hours. These numbers include patients discharged to skilled nursing facilities but excludes deaths and discharges to hospice. 

DAILY TEAM MEMBER TESTING STATS*

* Data from 3/10 through 5/12. The testing stats reflect just Michigan Medicine employees, not all University of Michigan employees. It also reflects only those who sought testing at or were hospitalized at Michigan Medicine or reported their testing to Occupational Health Services. Some Michigan Medicine employees may have been tested outside our system. Please note, this data is accurate; Monday’s data incorrectly included a few non-UMHS employees.

LINK TO JOIN: PERIOPERATIVE AND PERIPROCEDURAL COVID-19 TESTING AND PERSONAL PROTECTIVE EQUIPMENT TOWN HALL

As operations begin to ramp up again in our surgical and procedural areas, ensuring the safety of patients and employees is our No. 1 priority. We recognize there are many questions around pre-surgical and pre-procedural COVID-19 testing of patients, as well as recommended personal protective equipment for faculty and staff.

A virtual Town Hall event will take place tomorrow morning to provide the latest information.

Zoom Webinar: Perioperative & Periprocedural COVID-19 Testing and PPE

When: Thursday, May 14, 2020, 7 a.m. – 8 a.m.

Please click the link below to join the webinar: 

https://umich-health.zoom.us/j/92395315865?pwd=SnlYK084Y0J0V2JKdVVPMFowZnZjUT09

Password: 403665

Or iPhone one-tap: 

US: +13126266799, 92395315865# 

Or Telephone:

Dial: +1 312 626 6799 

Webinar ID: 923 9531 5865

Password: 403665

COVID-19 TESTING ORDERS IN MICHART

In order to facilitate COVID-19 testing and de-escalation per Michigan Medicine guidelines, MiChart has created three COVID-19 testing order panels. Order panels can be found under “During Visit Procedures” by searching for COVID-19. The following information provides guidance on which panel to select when testing a patient and the appropriate specimen type.  

Symptomatic COVID-19 Testing (COVID-19, RPAN, SP-ISO)

·       Order when testing symptomatic patients 

·       Includes an order for COVID-19 PCR, RPAN and Special Pathogens Isolation

·       Specimen Type: NP Swab

Asymptomatic COVID-19 Lab Orders

·       Order when doing pre-admission or pre-procedural testing of asymptomatic patients

·       Select “High Risk Patient” when testing asymptomatic patients from a congregate living situation or asymptomatic patients with prolonged contact to someone with known COVID-19. This option includes an order for COVID-19 PCR and Special Pathogens Isolation.

·       Select “Low Risk Patient” for all other asymptomatic patients. This option includes an order for COVID-19 PCR only.

·       Specimen Type: NP Swab

COVID-19 Testing for Respiratory Sources (Aspirates and BAL)

·       Order as part of the de-escalation protocol for COVID-19 positive patients who are ventilated or s/p tracheostomy

·       Specimen Type: Tracheal Aspirate, Endotracheal Aspirate, or BAL

For ambulatory testing, providers should continue to use the hot-line process for evaluation, ordering and scheduling of COVID tests.

NON-CONTACT TEMPERATURE SCREENING NOT RECOMMENDED 

In the wake of the COVID-19 pandemic, some health systems are utilizing non-contact temperature screening for employees and visitors to their clinics. The Department of Infection Prevention & Epidemiology (IPE) does not recommend this practice within Michigan Medicine clinics for a number of reasons:

·       There is a lack of availability for non-contact thermometers, and the accuracy of these devices remain questionable. Additionally, the identification of a fever alone will not change PPE use and/or the care encounter.

·       Doing so would require staff to have unnecessarily close contact with people entering the facility and may cause lines to form at clinic entrances, causing unnecessary delays and crowding.

·       The number of fevers potentially identified through this method is small. Patients are screened for illness over the phone prior to visiting our clinics and Michigan Medicine reinforces its strict “no sick visitor” policy through its websites, social media, phone reminders and other patient-facing vehicles.

·       All patients and visitors are required to wear masks while in our buildings. Michigan Medicine’s mask policy provides precautionary measures for everyone entering our facilities, including employees.

Michigan Medicine is committed to the safety of our employees and patients. For more information on the use of personal protection equipment (PPE) within our facilities, please see the PPE matrix. Information on the institution’s steps to ensure safe and reliable care for our patients can be found here.

NEW HOSPITAL UPDATE
As the organization pauses the new hospital project, steps must be taken to preserve the site during the shutdown. Regrading of the site will be done to prevent soil erosion, and some materials already purchased will be placed on the site for storage. In addition, the university may decide to finish utility work that was critical to this project and other current buildings, so you may continue to see some construction on Catherine St. and the north end of the current construction site throughout the summer.  After this utility work is completed, the fence around the perimeter will be repositioned and the walk path from the Med Sci buildings to the CVC will be opened up.

TOWN HALL Q&A

Med School

Is there a reason there aren’t any faculty RIFs?

Tenure track faculty may not be laid off without invoking the Regents Bylaw 5.09 process. Clinical faculty are on fixed term appointments whose employment may only be terminated at the end of the term and in accordance with the SPG required notice provisions. Research track faculty are eligible for voluntary furlough/reduced appointment but not RIF.

General operations

Regarding the 12x7x365 ambulatory services model, will other services (interventional radiology for port placement and biopsies for example, as well as imaging) become more available as well? 

We are dedicated to matching our supportive services (radiology, therapies, etc.) to the reopening of ambulatory services, both in timing and in proximity to the reopened sites.

How will we be able to staff the 24/7 model for some of the smaller services if there is a hiring freeze? 

We expect that most of the staffing will come from individuals currently redeployed or through practice optimization and redesign.

What is the timeline for bringing those who are working remotely back into the clinics? 

We expect our sites to reopen over the summer and fall as the COVID crisis abates, assuming there is no second wave, and as demand for our services increases again.

Finance

Does peer institution benchmarking indicate in which areas our staffing or expenditures are on the highest percentiles, i.e. most over-staffed or higher-cost?

Benchmarking information is available at both institutional and lower levels. While benchmarking is important, we need to be mindful that it is only directional as each institution has its own structural nuances that make exact benchmarking difficult.  

Is there any discussion of using the university’s $12 billion endowment fund to help offset some of these losses?

The pandemic caused a significant decline in the value of the long-term investment portfolio (often referred to as the endowment), therefore making it inaccessible until such time that the investment values return to pre-pandemic levels. A current withdrawal of funds from the portfolio would serve to exacerbate the financial loss projections.

Still have questions?

We are also posting all daily bulletins and policies on Michigan Medicine Headlines at https://mmheadlines.org/covid-19-updates/.  Please bookmark that site and refer to it throughout the day for the most up-to-date information. An FAQ for staff is also posted and updated frequently.

If you still can’t find what you’re looking for on these web pages, please email coronavirus-info@med.umich.edu and your question will be answered as quickly as possible.  Do not use this email for sharing patient health information.

Jeffrey Desmond, M.D.
Chief Medical Officer

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