Creating a Safety Officer Program to Enhance Staff Safety During the Care of COVID-19 Patients.

Staff safety is paramount when managing an infectious disease event. However, early data from the COVID-19 pandemic suggested that staff compliance with personal protective equipment and other safety protocols was poor. In response to patient surges, many hospitals created dedicated "biomode" units to provide care for patients infected with SARS-CoV-2, the virus that causes COVID-19. To enhance staff safety on biomode units and during patient transports, our hospital created a safety officer/transport safety officer (SO/TSO) program. The first SOs/TSOs were nurses, clinical technicians, and other support staff who were redeployed from their home units when the units closed during the initial surge. During subsequent COVID-19 surges, dedicated SOs/TSOs were hired to maintain the program. SOs/TSOs provided just-in-time personal protective equipment training and helped staff safely enter and exit COVID-19 clinical units. SOs/TSOs participated in the transport of over 1,000 COVID-19 patients with no safety incidents reported. SOs/TSOs conducted safety audits throughout the hospital and observed 86% compliance with COVID-19 precautions across 32,500 activities. During contact tracing of frontline staff who became infected with SARS-CoV-2, potential deviations from COVID-19 precautions were identified in only 7.7% of cases. The SO/TSO program contributed to a culture of safety in the biomode units and helped to enhance infection prevention throughout the hospital. This program can serve as a model for other health systems during the response to the current pandemic and during future infectious disease threats.

A Critical Care Transport Program's Innovative Approach to Safety During the Coronavirus Disease 2019 Pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has resulted in the frequent transfer of critically ill patients, yet there is little information available to assist critical care transport programs in protecting their clinicians from disease exposure in this unique environment. The Lifeline Critical Care Transport Program has implemented several novel interventions to reduce the risk of staff exposure. METHODS: Several safety interventions were implemented at the beginning of the COVID-19 pandemic. These initiatives included the deployment of a transport safety officer, a receiving clean team for select interfacility transports, and modifications in personal protective equipment. RESULTS: From February 29, 2020, to August 29, 2020, there were 1,041 transports of persons under investigation, 660 (63.4%) of whom were ultimately found to be COVID-19 positive. Approximately one third were ground transports, 11 (1.1%) were by air, and the remainder were intrahospital transports. There were 0 documented staff exposures or illnesses during the study period. CONCLUSION: The adaptation of these safety measures resulted in 0 staff exposures or illnesses while maintaining a high-volume, high-acuity critical care transport program. These interventions are the first of their kind to be implemented during the COVID-19 pandemic and offer a framework for other organizations and future disease outbreaks.

Preparing for the brave new world, Part 4: "Minimum necessary" disclosures under HIPAA.

"Minimum information given with maximum politeness," Jacqueline Kennedy once directed a White House press secretary. Decades later, a pending federal health-privacy rule says nothing about courtesy but does explicitly require a "minimum necessary" standard for most disclosures of personally identifiable information. Physician practices that understand these two key words will have a head start in complying with the privacy regulations, which were published in December 2000 under authority of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This article, the final installment of a four-part series on how the HIPAA privacy rule will affect the day-to-day lives of physicians and their staffs, focuses on what the U.S. Department of Health and Human Services (DHHS) means by "minimum necessary."

Health care privacy: exceptions to the rule preparing for the brave new world, Part III.

As physicians prepare for implementation of HIPAA, there will be times when they are asked to and may be required to release individual health information without patient consent and authorization. This third article in a four-part series highlights the situations in which a doctor may release health information without a patient's knowledge.