Colleagues,
Last Thursday, Nashville Mayor John Cooper announced the city’s Roadmap to Reopen Nashville. The comprehensive plan calls for a four-phase approach to opening businesses and services. The plan uses objective metrics of disease spread to guide Nashville in advancing to each next phase or reversing to an earlier phase. It incorporates extensive public health case tracing and quarantining, while monitoring local health care system capacity (including beds, ventilators and personal protective equipment).
In the roadmap, certain elective health care and dental services may resume on or after April 30, with specific guidance and requirements. Consistent with the roadmap, VUMC will reinitiate elective clinical services in a phased manner that prioritizes safety for patients and employees on Friday, May 1. Elective ambulatory care will resume, and elective inpatient and outpatient surgery and procedures will be resumed for lower-risk patients less than age 70. These expanded activities include all locations where we offer services in Davidson County and elsewhere in Tennessee.
As we begin scheduling additional visits for the end of this week, we will continue or initiate the following practices in order to maximize safety for our patients and health care workers:
- All patients coming to outpatient clinics will undergo COVID-19 temperature and symptom screenings and will be required to wear masks. Patients without masks will be provided one upon arrival.
- In addition to temperature and symptom screening, patients having elective procedures or surgeries involving general anesthetics will be tested for COVID-19 within a few days before their procedure. Guidance on additional testing requirements for specific patient groups, as well as procedures for testing and reporting, will be provided for all perioperative and procedural areas.
- All VUMC employees will continue to be temperature checked daily and will also be screened at building entry for common symptoms of COVID-19, starting Monday, May 4. In addition, employees will wear masks in all clinical care environments and in all public spaces at VUMC, including hallways, lobbies, meeting rooms and cafeterias. Choice of mask type will be specific to patient conditions, procedure type, and care setting per VUMC guidance.
- As we increase patient volumes, it may be necessary to initiate expanded infection prevention procedures, such as spacing clinic visit times to assure physical distancing is maintained, and even moving some outpatient care to different locations that are better suited to promote safety of patients and staff.
While services will be reopened in a coordinated manner, leaders in all areas will be provided additional guidance specific to their areas to help promote safety as we restart these elective care activities. All practices and procedures will continue to be guided by the Centers for Disease Control & Prevention, Tennessee Occupational Safety and Health Administration and will follow all requirements of the Tennessee and Metro Nashville Departments of Health.
Physical distancing has reduced the rate of COVID-19 transmission to the point where Nashville can consider reopening other businesses. Later this week, Mayor Cooper is expected to announce a date for moving certain businesses identified in the Roadmap to a “Phase 1” level of limited on-site activity. Until that date, work-from-home guidance throughout VUMC non-clinical areas is unchanged. In another upcoming announcement, we will provide additional guidance for certain nonclinical VUMC areas to reinitiate limited on-site activities in coordination with the Mayor’s announcement.
In the future, we look forward to expanding elective procedures and surgeries to include additional, higher-risk patient groups. Phase 2 of the roadmap will be triggered after a minimum of 14 days in Phase 1, assuming progress or sustainability in infection-related metrics has been achieved. At that time, elective surgeries and procedures can resume for all age groups. We anticipate continuing all other safety precautions for patients and health care providers throughout all roadmap reopening phases.
Please know that extensive work-from-home activities will continue at VUMC throughout all four phases of the roadmap, and more detailed work-from-home guidance for non-clinical areas will be forthcoming. Our own epidemiologists and infectious disease experts agree that in the absence of strict physical distancing, Tennessee’s numbers of COVID-19 cases are likely to surge. It is essential that personnel at VUMC and all other health care organizations maintain strict physical distancing practices even as we begin to increase elective care activities.
At all times, and particularly during this pandemic, we are all seen as community leaders. It is vital that we set a good example for our community by monitoring ourselves for symptoms and reporting any health concerns early, wearing cloth masks in public places, and practicing frequent hand hygiene. It is particularly important that we maintain appropriate (6 ft) physical distancing when in public spaces or when patronizing businesses. Except when performing essential services, those age 65 and older and those in high-risk categories should stay at home.
As work continues, here and around the world, to develop effective treatments and eventually a vaccine, for the foreseeable future living with COVID-19 is the new “normal.” Our success will depend on our adaptability and creativity as we find ways to conduct the vital work you do, while keeping our environment as safe as possible. We are confident VUMC will rise to this challenge and will continue to set the standards for many in our region and across the nation to follow.
As we begin this next chapter, we wish to again express our admiration for the many ways everyone has come together in this time of crisis. Please continue to be safe and well.
Best Regards,
Jeffrey R. Balser, MD, PhD C. Wright Pinson, MBA, MD
President and CEO Deputy CEO and Chief Health System Officer
