A strong COVID-19 response starts at the top — 4 tips from The Joint Commission

While largely isolated from initial and subsequent COVID-19 responses, ASCs have to ensure they have a comprehensive infection prevention plan to reduce the risk of viral transmission and continue elective procedures.

Implementing infection prevention and control practices in the age of COVID-19 was the subject of a Oct. 2 session during Becker's ASC Review Virtual Event hosted by Becker's ASC Review and sponsored by The Joint Commission.

Sylvia Garcia-Houchins, RN, director of infection control at The Joint Commission, led the presentation and offered insights into infection prevention best practices.

Here are four tips from the webinar:

1. Understand regulatory requirements. State and federal requirements differ. Surgery centers need to understand what regulatory requirements apply to them, and what requirements are more guidance-based. Federal agencies, like the Occupational Safety and Health Administration, have numerous infection control resources, including several guidelines around personal protective equipment use. Centers that ignore OSHA requirements could be liable if employees filed complaints with the department. On the other hand, CMS has deferred to state and local health departments for ASCs. "What [these agencies] are saying is, you need to have a plan," Ms. Garcia-Houchins said. "You need to be prepared and follow the requirements of your state, territorial or local health departments. That's really who is guiding what is happening in ASCs."

2. Adjust to the new normal. "COVID-19 has created a new normal for all us," Ms. Garcia-Houchins said. "We have to really think clearly and systematically about what each of our organizational responses should be and will be." ASCs must research infection control processes, decide which ones they'll implement and ensure staff members and patients, alike, are trained on following these policies. Centers must address the physical challenges to a virus response and keep an open dialogue with staff members to hear their concerns. Ms. Garcia-Houchins recommended running through new protocols with staff members to watch if they're conducted the way leadership expects. For instance, centers must decide where they stand on universal masking and how they'll handle a patient who doesn't wear a mask.

3. Be the leader your center needs. While these policies can be used to address the virus, ASC leadership needs to lead the roll-out, and needs to be present to enforce the process and requirements. "We are seeing this happen left and right, people have put these policies and procedures [in place] … They say they're going to use face coverings, they're going to do social distancing, yet they haven't really implemented them," Ms. Garcia-Houchins said. If a center implements universal face masking and social distancing, but then staff members go and congregate in break rooms, don't wear masks and are huddled together, it's reinforcing that it's okay to ignore the new infection control requirements. Leadership must question itself and its practices to keep staff and patients abreast of the process. "How do you support your staff? How do you let them know that you need to enforce your process and your requirements?" She said. "Because it's about their safety, your patient's safety and your business."

4. Identify weaknesses. An infection response is only as strong as its weakest link. "The culture of your organization makes a difference," she said. "Where you are located and what your employees know and agree to and think is very important to the bottom line." Centers should ask staff members if they know how COVID-19 is transmitted, and if they know how to prevent the spread. Taking a minute at a staff meeting to review current research or best practices helps eliminate uneasiness and ensures staff members have the information they need.

"COVID is just the newest, greatest thing," Ms. Garcia-Houchins said. "As a country, we've been through multiple outbreaks of organisms. … We need to think about this structure as something long-term. How are we going to protect our staff? … Because if we implement something now, we're going to protect them forever."

Learn more about The Joint Commission here.

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