The Ins

and Outs of Community Entry

As the pandemic continues, therapy and acute health service providers find the safest ways to connect with residents


he look and feel of the entrances to many senior living communi- ties has changed drastically since February 2020.

In addition to a huge reduction in the

number of people going in and out—visita- tion restrictions and quarantines, those who do come in may face a number of safety measures including screening questions and remote temperature sensing. At the beginning of the pandemic, it was

in some places difficult to get even mail delivery. Essential service providers such as physical therapists quickly got down to researching, planning, and implementing the ground rules to ensure the greatest safety. They had to work out how to prevent risks of illness while guarding against residents losing ground in their recoveries or losing flexibility and muscle—which can lead to injuries. “When the pandemic first emerged in

February of 2020 it was a chaotic time for the nation,” wrote Travis King, PT, DPT, GCS, chief quality officer at FOX Rehabilitation, in an email response. “We knew that we needed to create organization and systems to manage the moving parts of the pandemic. We first established an internal task force

made up of executive leadership from each functional department of the practice.” FOX then brought in consultant Phenelle

Segal, from Infection Control Consulting Services, to help make informed decisions about what was needed in personal protec- tive equipment (PPE), infection prevention and control (IPC), and employee and patient safety. “The structure of a dedicated task force

and the experience of a seasoned infection control expert facilitated systematic and precise decision making that could be deployed to the practice using our existing communication strategies,” King writes.

Consistent care matters While keeping residents from having to visit the emergency room or the hospital whenever possible is a well-established goal in senior living. With COVID-19, clinics, physicians’ offices, and urgent care centers also became places to strenuously avoid. The paradox is that regular preventive

services, therapy, and mobile acute care services are some of the best ways to avoid ER visits and other health risks. Yet this means staff from these services must enter


communities—which can carry COVID-19 infection risk. The solution from service pro- viders was to triple up on safety practices, to get that risk as low as possible. “Adopting very strong infection prevention

strategies has obviously been top of mind for us," says Dr. Stefen Ammon, MD, emergency physician, medical director, and contributing member of the COVID-19 task force at Dis- patchHealth, a mobile acute medical service that brings same-day complex health care to residences to help avoid unnecessary emer- gency room visits or ambulance transports. “One of the challenges with this illness is

that even when you're seeing somebody for a laceration, given the rate of pre-symptomatic and asymptomatic shedding, you have to treat everyone as if theyʼre potentially a car- rier. Thatʼs something weʼve really worked on with our providers—and itʼs something to keep in mind at each community.”

Special practices required As with FOX, establishing a task force was also the first step for DispatchHealth. The issue is two-fold, Ammon points out: Preventing COVID-19 from entering the community, and identifying individu-

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