Gone are the days where clinicians and administrative team members feel free to easily help one another out during routine office rounds. Instead, we're expected to "don" and "doff" personal protective equipment, completely sanitize ourselves between patients, and limit all movement as much as possible.

Many offices already have systems in place to manage communications between team members, but for those that only relied on simple patient handoffs in the past, much more complex orchestration is now needed to be sure that infection protocols are being followed, by everyone, every single time.

Distancing patients from one another when they arrive - whether they are in their car or in the office

The pandemic has prioritized the need to keep up with exactly where a patient is in the check-in process, whether they are waiting for room availability, are finished with screening, or even if they've made a visit to the restroom. When you have effective systems in place that make it easy to view and respond to each patient’s status, all team members are assured that precautions have been taken to minimize patients’ contacts with one another.

A waiting room timer that starts the moment that each patient calls from the parking lot helps the team view which patients have been waiting longest. This way no one person has to manage the workflow, and it's easy for the back office see who is next, and then to let the front office know when an exam room has opened up. All of this information transfer is handled by updates to the waiting room status, as opposed to having to pass a note back and forth that may or may not get seen.

Getting a doctor's attention quickly, especially if you don't know where they are

This is a common problem for healthcare, actually, that existed even before the current crisis. Typical instant messaging systems are directed towards individuals with the expectation that the recipient will be stationary, or at the very least, engaged with their instant messaging device. But in clinical practice, this is rarely the case. Often, notifications may not even target a specific person, and it can be confusing to determine whether or not a message was even received and acknowledged.

The solution to not knowing which computer, tablet, or phone needs to be involved in the delivery of a message or notification is simply to use a common bulletin board or panel, where questions can be posted. This panel is then visible on every device, regardless of who is using it. And when a message is taken down from the panel, that means that its query is completed.

Communications needs to be insistent and persistent, so that it's very difficult to ignore or miss especially time-sensitive messages. It helps if each message can be directed in a way that only certain colors, tones, or even phrases catch the attention of the specific person or role. Messages that have personalized tones, such as a doorbell for a patient arrival or a wind chime to indicate that a specific room is ready for the doctor on call, create a stereo effect throughout the practice that reduces the need to visually engage a notification alert. When “everyone knows everything,” running on time is much more likely. In other words, social pressure is intentionally used to create positive outcomes!

Limiting the number of patients at check out

Financial arrangements can certainly be made ahead of an appointment, or even afterwards. This is how many practices are having patients avoid the front desk, simply because there's not a good way to manage the order in which patients are being released from the back office. To return to a sense of normalcy in the billing process, the persons responsible for patient checkout value the ability to have complete control over the order in which patients arrive at the checkout desk. Queuing-style workflow allows administrators to dismiss patients remotely, one at a time, in the order that they are ready, to allow for adequate disinfection of work areas, yet continue to personalize treatment and payment plans.

Another way to regulate the checkout process is for each financial coordinator to post a signal that a checkout zone is occupied, thereby placing a block on the ability to bring further patients up until this obstacle is removed. The obstacle can simply be the phrase "Checkout 2 is Occupied" set as a status that will disappear as soon as Checkout 2 has been disinfected and is ready for the next patient.

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Implementing an effective communication tool provides a consistent framework in which team members can continue to have meaningful dialogue with one another, even when social distancing strains traditional methods of collaboration. The nuance of a smile or a smirk may be hidden behind a mask, but we are all gradually acclimating to new social cues, ones that we are learning to use, so that we may guide one another to better understanding of the needs of our coworkers and patients. We are adapting, we are growing, and it is important in this time of change to retain our sense of connection to one another.