COVID-19: Lessons Learned in the Clinic

Published in Wilmer - Annual Report 2020

The unprecedented circumstances of the COVID-19 pandemic have required quick thinking and effective solutions to keep Wilmer patients and staff members safe during clinic visits. Those leading the charge include patient service coordinators, clinicians and clinic managers, whose jobs transformed overnight. “We all had one goal in mind, and that's to make sure that we are taking care of our patients as well as taking care of our team,” says Percy Jones, manager of the Wilmer Columbia clinic.

The pandemic offered an opportunity to rethink the entire workflow of the clinics and examine the patient experience in minute detail, he says. “Without doing major construction, we literally had to redesign the office,” which in the Columbia clinic involved installing acrylic barriers at the front desk, marking the floor and roping off chairs to ensure physical distancing and lower density. “It was a challenge, but it also had us work together as a team because it couldn't just be one person trying to figure this out,” says Jones.

The stress caused by the pandemic inspired Davette Gray, manager of the Wilmer Green Spring Station clinic, to brainstorm ways to boost the morale of her staff. Even this entailed adjusting to the pandemic environment. For example, Gray has always found that food cheers people, but she could not bring in treats to the clinic. “Instead of having food, this time, we all got together, and everyone brought in a recipe and we made a little cookbook,” says Gray. While the physical changes made to the clinic may be reversed once the pandemic abates, some adjustments to the patient experience could prove long lasting.

In mid-March, Johns Hopkins Medicine restructured how care was delivered across the organization. “At the beginning of the pandemic, we were encouraged to look at the schedules ahead of time to determine the urgency of the patients — if they actually physically needed to come into the office,” says Jones. This triage process was a collaborative effort between ophthalmic technicians, optometrists and ophthalmologists. “The triage is much stronger [now],” says Donna Vierheller, assistant administrator at the East Baltimore location for Wilmer, who oversees the management of all 10 clinics at East Baltimore.

According to Vierheller, doctors have become more accurate when determining how many patients they can see on a clinic day based on how much time they will likely spend in the exam room. This knowledge, paired with a stronger triage process, means Wilmer has been able to accommodate 90 percent or more (depending on the specialty) of the pre-pandemic patient load while still meeting the new requirements for physical spacing and reduced density.

Another important change in the clinic workflow is something called “pre-charting,” says Vierheller. To reduce the length of in-person interactions, some patient information (such as medical history) can be gathered over the phone before the appointment, rather than in person. “We wanted to be able to call the patients a day ahead of their visit and basically start the exam,” Vierheller says.

A final change has involved patient communication. A patient now receives a notification to do a COVID-19 screening. A button appears postscreening that allows the patient to complete an e-check-in. Gray says this has “transformed” the patient experience because when they arrive, “within a few minutes, the technician is calling them because — guess what? — they already went online.”

She believes patients will continue using e-check-ins even when no longer prompted to do COVID-19 screenings because it makes the patient visit much faster.

The challenges of the COVID-19 pandemic have affected everyone across the world in all aspects of life. The way Wilmer staff members have met those challenges has impressed all three clinic managers.

“My team here is absolutely amazing. They’re resilient. They're hardworking,” says Gray. “I’m truly humbled by this entire experience and how everyone just came together to make things happen. And we're still doing that.”