COVID-19 Outpatient Visit Guidelines
As UMMS continues to manage the COVID-19 crisis, we must continue to provide access to in-person outpatient care while minimizing the risk for exposure to the COVID-19 virus for both patients and team members. This guideline combines two previous guidelines – the Pre-Outpatient Visit Phone Screen and the In-Person Screening for Outpatient Visit – and outlines the processes and procedures that should be put into place in all ambulatory care practices.
This guideline outlines two main workflows to guide outpatient care: pre-visit screening processes before a scheduled in-person appointment and in-person screening for patients and care partners (visitors) upon arrival to the in-person appointment.
A screening script and questionnaire attached to the guideline are provided to facilitate conversations with patients and/or care partners to determine their COVID-19 risk and status. You will find these items attached at the bottom of the guideline linked below:
- COVID-19 Pre-Visit Screening Script
- COVID-19 In-Person Visit Screening Questionnaire
This guideline was most recently updated on February 3, 2022, to acknowledge updated CDC recommendations on isolation and post-exposure quarantine durations for the public. These updates provide guidance on delaying a non-urgent in-person visit if a patient has had a COVID-19 infection for at least 5 days with improvement of symptoms, or if the patient has had a high-risk exposure, for at least 5 days and until COVID-19 testing is obtained. Patients being seen in outpatient clinics within 10 days of COVID-19 infection or exposure should be asked to wear KN95 or N95 masks if tolerated.
Click here to view the COVID-19 Outpatient Visit Guidelines.
What are the suggested methods for screening patients prior to a scheduled in-person appointment?
There are a number of ways to screen patients for COVID-19 prior to an appointment. In addition to pre-visit screening, ambulatory providers should continue in-person patient screening protocols for COVID-19.
The Tavoca reminder system may be used to ask patients to contact the practice if they are experiencing COVID-19 symptoms or may have been exposed to COVID-19. Patient schedules should also be reviewed daily and patients with respiratory illness and fever should be triaged prior to the scheduled appointment. In the absence of an appointment reminder system, ambulatory care practices should establish a process to pre-screen patients by phone. Scripting to guide pre-visit screening is provided in the COVID-19 Pre-Visit Telephone Screening Script attached to the bottom of the policy.
What measures should be taken if a patient screens positive for COVID-19 prior to their appointment?
Patients that screen positive for COVID-19 require phone triage by an RN or medical provider to determine if the patient can safely be monitored at home, or if they require an in-person visit. Please review the policy in full for additional guidance on telephone triage protocols.
What measures should be taken if a patient screens positive for COVID-19 upon arrival?
If a patient screens positive for COVID-19 during the in-person screening, team members should isolate the patient from others immediately. This could include escorting the patient to an exam room, asking the patient to return to their vehicle to wait for further instruction or, if no other options are available, moving the patient to a designated sick area in the waiting room at least six feet away from others. If possible, the visit should be converted to a telemedicine appointment.
Are patients and care partners in ambulatory practices required to wear a mask?
Yes. Patients and care partners in ambulatory practices must follow the UMMS Policy for Expanded Use of PPE for COVID-19 and the guidance on masking outlined in the UMMS Tiered Approach. That means that all persons must wear a face mask when required by the above policies. UMMS team members should ensure that both patients and care partners are wearing a mask and doing so correctly by covering both their nose and mouth.
Should care partners also be screened for COVID-19?
Yes. Care partners must also be screened using the same protocols as used for patients. If care partners fail to comply with screening or choose not to wear a mask, they will be asked to leave the practice or the patient’s appointment will be rescheduled.
What PPE protocols should ambulatory practices follow?
The proper use of PPE has been a foundational part of our COVID-19 response in order to keep our colleagues and patients safe. Please review the Infection Prevention Guidance for Ambulatory Practices During COVID-19 (attached to the bottom of the Outpatient Visit Guidelines in PolicyStat, which are linked above) in conjunction with the UMMS Tiered Approach.