JUNE 5: DAILY COVID-19 UPDATE

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
• SOCIAL DISTANCING AND MASK USE ON UNIVERSITY BUSES
• UPDATED VISITOR POLICY
• TOWN HALL Q&As

DAILY PATIENT STATS

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

 Discharges: 578 total COVID-19 discharges to date, 6 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 6/05. 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.

SOCIAL DISTANCING AND MASK USE ON UNIVERSITY BUSES
For the safety of all employees, it is important to follow expectations for social distancing and mask-wearing on buses at all times. All employees should observe the protections in place on public transportation. When riding university buses, be sure to:

• Use a face covering
• Use the rear door to board and exit (front door only available for ADA access)
• Practice social distancing while boarding and riding the bus
• Only ride for essential trips
• Only approach driver for emergencies
• Avoid touching surfaces and carry hand sanitizer with you if possible 

UPDATED VISITOR POLICY
Recent changes in the governor’s statewide orders have resulted in changes to visitor restrictions at Michigan Medicine. The latest policy is posted on PolicyStat and can be accessed by clicking here.

Information for patients and families can be found on the Visitor Guidelines page of the Michigan Medicine website.

TOWN HALL Q&As

If you missed last week’s Town Hall, held on May 29, click here to watch the video. Here are some Q&As that came out of the discussion: 

General Operations 

Q: If we divide the extra clinical duties across every physician, that could be 5% extra clinical fte. What about people on training grants or with other research funding that requires specific protected effort? 
A: All funded research commitments will be meticulously respected as well as recognized educational activities and administrative roles. The same is true for effort at the VA hospital. 

Q: Is the 5% extra clinic work expected for 1 year, or will this be the new expectation for the foreseeable future? 
A: The expectation is that the extra clinical work will be needed until we adequately address the deferred clinical care demand and “catch up”. However, the possibility of future COVID surges is presently unknown as well as the time of an effective vaccine. How these aspects play out over time will remain to be determined.

Q: Will the UMMG subgroups be making recommendations for how to feasibly schedule optimally over the 12-hour day? Or should each division/department be developing their own schedule templates?  
A: The UMMG will provide team support in template construction.

Q: Hearing that we are expected to increase our clinical hours, is there general acknowledgement that we should plan to reduce our educational or research hours? 
A: No. We remain committed to all three missions – education, research and clinical care. All three must be cherished and preserved. 

Q: What about the APP? I hear everything about faculty working but nothing about APP’s.
A: Our APPs are a valuable resource as providers on the care team. As we continue to ramp clinics up, our APPs will also be part of the work force to assist with coverage as a provider in nontraditional hours as well as traditional hours. Their assistance to help meet the critical needs of our patients seeking care and reducing the back log, is pivotal to the success of timely access to care. For details regarding shift and weekend premiums, please refer to the applicable provisions of our policies and collective bargaining agreements.

Q: Will you be providing screeners at all open entry ways during these extended hours? 
A: Yes. Entry screeners will be utilized during all hours of clinic operations.

Q: We understand that there is a back log of patients.  What is not clear is are you expecting faculty to increase their current cFTE to work down the back log. Extending hours does not equate to extending cFTE unless this is what is being mandated as well.  Please clarify. 
A: Additional clinical work will be required to see the deferred patients. How this is provided will vary department by department and provider by provider. As one widespread opportunity, there will be no professional travel in the coming year, translating into an opportunity for more care absent any other changes. We are committed to accurate effort reporting on an annual basis across all mission areas, including clinical effort. Some faculty members were less busy clinically during the COVID-19 peak due to the pause on elective procedures and in-person clinic visits. For these faculty members, there is an opportunity to make up for the few months when there was less clinical effort by increasing clinical effort now. We are engaging departments to look at new work flows and optimization of faculty effort as an approach to help all faculty succeed in meeting their needs.

Q: Has this increase in hours to catch up on backlogged appointments been factored in to the projected losses for the year? Meaning would this catch-up in appointments change the need to make up fiscal losses or has it already been factored in before HR measures were taken?  
A: Yes, the catch up on backlogged cases were taken into account as the economic recovery plans were developed.

Q: There have been instances where physicians have insisted in having patients added to their schedule for in person visits when they are scheduled for video visits/telehealth, leading to waiting rooms with far more patients/family members than the guidelines allow. What is being done about this health safety issue?  
A: Social distancing and masking will be strictly adhered to at all ambulatory clinic sites. Patient and staff safety will always be our number one priority.

Q: Surgeries and all procedures is understandable. What about these 110,000 deferred cases  – have they been addressed by virtual visits?  
A: Video visits have been used extensively to manage patients in the time of deferral, and will have a big role going forward. Many patients that have been deferred will now also need in-person examination and care.

Infection Prevention & Epidemiology

Q: As we ramp up in-person care, do we have guidance from IPE or OCA on having “high risk” faculty and staff seeing patients? 

A: Currently, we restrict pregnant and immune compromised staff from caring for COVID patients/PUIs but have not put any restriction in place for other patients. Universal masking remains in place. Those with concerns should discuss with their primary care physician and supervisor to discuss the need for a possible accommodation if needed. 

Still have questions?

We are also posting all daily bulletins and policies on Michigan Medicine Headlines athttps://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