Leading UAE healthcare facilities have made changes to help reopen hospitals for people with other health conditions
Since mid-March, nearly all elective surgeries and medical procedures in the UAE were delayed to create capacity for the first wave of Covid-19 patients. As the curve has started to flatten, facilities are now allowed to reactivate these procedures, but face a new challenge. Patients are hesitant to seek in-person care for fear of infection. As a result, many patients with both chronic and acute conditions are avoiding hospital trips and delaying essential treatment. For the healthcare industry, this is a concern in terms of both its impact on patient care and revenue.
The UAE cannot afford to continue putting its wider healthcare system on pause in the face of the pandemic. So what solutions could help keep appointments and procedures on track? One of the most important factors to encourage in-person non-coronavirus care is projecting a sense of safety and security. This is what a number of leading healthcare providers are doing.
Prompt clinical assessment of patients followed by appropriate care is the name of the game. Medcare hospitals was closely monitoring the outbreak since mid-January. “Our doctors and nurses were and still are extremely vigilant in detecting possible symptoms of Covid-19. Suspected Covid-19 patients are triaged as per the risk assessment, Covid-19 case definition, and severity scale, and referred to other facilities,” says Dr Shanila Laiju, CEO, Medcare Hospital and Medcare Orthopaedics and Spine Hospital. Medcare formed a special Covid-19 task force committee to monitor the situation and take necessary action. Smart technologies have been adopted to screen patients. “Appropriate infection control measures are followed, and our entire workforce has been trained in recommended infection control practices,” says Laiju.
Our entire workforce has been trained in recommended infection control practices.
As a DHA-certified non-Covid facility, Burjeel Hospital for Advanced Surgery has put in place several protocols to handle suspected cases. All patients and staff have their temperature checked at the main entrance. “Patients are required to fill a screening questionnaire to determine any Covid-19 symptoms,” says Dr Nayzak Raoof, Chief Medical Officer, Burjeel Hospital for Advanced Surgery. “Those who do are screened and referred to another VPS healthcare facility for further treatment. When it comes to transport, ambulances undergo terminal disinfection and fumigation routinely and after every transfer of a suspected/confirmed case.”
Regular patients need to be assured that they are not exposed to infection, Thumbay, for instance has set up a fever clinic to isolate and examine patients who show mild Covid-19 symptoms. “This means that they do not enter the main areas of the hospital,” says Akbar Moideen Thumbay, Vice-President, Healthcare Division, Thumbay Group. “On the basis of the evaluation, patients suspected of being infected are appropriately dealt with, which includes referring them to the Ministry of Health facilities.”
Our entire workforce has been trained in recommended infection control practices
Screening patients at the entrance of a facility is critical for post-Covid management. Aster does this in three ways. “Screening patients for Covid-19 symptoms at the entrance of facilities, ensuring that workers involved in transportation wear PPE, especially those who are in close contact with the patient and enforcing safety protocols and social distancing inside facilities,” says Dr Sandeep Pargi, Pulmonologist, Aster Hospital, Mankhool.
Precautions undertaken at facilities
At Medcare, housekeeping staff are trained in cleaning and decontamination procedures and the hospital is equipped with recommended PPE and disinfectant agents. Medcare has also implemented changes in air and ventilation systems by building more negative pressure single rooms and converting existing air handling systems to prevent air contamination and cross-transmission.
On the basis of the evaluation, patients suspected of being infected are appropriately dealt with, which includes referring them to the Ministry of Health facilities.
Burjeel staff are encouraged to perform self-monitoring for any symptoms and undergo Covid-19 screening whenever applicable. PPE is mandatory, depending on the level of activity and exposure. “Patients are required to have Covid-negative swab results for a maximum of 72 hours prior to surgery and admission to the hospital,” says Dr Raoof. “Social distancing of two metres is implemented in the whole hospital, along with routine deep cleaning and fumigation of clinical and common areas, using Dubai Municipality approved biocides and disinfectants.”
At Aster, all employees working in emergency rooms are required to wear PPE, including doctors, nurses, paramedics and cleaning staff. There is also a minimum two-metre distance between beds. “Across Aster facilities, staff handling patients are required to wear PPE, while support staff who are not in close contact with patients must wear N95 masks,” says Dr Pargi. “All suspected patients are immediately admitted to the isolation ward dedicated to Covid patients. Only authorised persons with PPE are allowed in this ward.”
Across Aster facilities, staff handling patients are required to wear PPE, while support staff who are not in close contact with patients must wear N95 masks.
At Dr Michael’s Clinic, fumigation is performed in the operating rooms, dental and endoscopy areas and after patient discharge.
Thumbay is focusing on regular sanitisation, hand hygiene and social distancing protocols and the use of facemasks are ensured at all times for both patients and staff.
Covid-19 patient protocol
Earlier this month, Medcare decided to become a Covid-free facility. At Medcare, if any patient has any symptoms of Covid-19, he/she is isolated and immediately transferred to other facilities. Covid-19 PCR testing is performed for every patient scheduled for the surgical procedure. The patient must test negative for the last 72 hours before the procedure. Clinical management of Covid-19 patients includes prompt identification of infection control measures and supportive care, including supplemental oxygen and mechanical ventilator support.
Dr Michael’s Dental Clinic has implemented protocols to minimise risk to patients, doctors and staff based on DHA guidelines.
Medcare has rolled out teleMEDCARE, a telemedicine platform that gives patients access to value-added videoconferencing health services on their laptops and mobile phones. In just a few steps, and without the need to book an appointment, patients can speak with a doctor immediately, get the care they need, order lab tests or x-rays, and get their medication delivered to their homes. Medcare has also launched three services to reassure patients. The Lab@home and Vaccinations@home services allow patients to book lab tests and vaccinations to be administered in their homes, at their convenience. A qualified nurse will visit a patient’s home to either collect a sample or administer the vaccination as per the patient’s vaccination history. “This service is available to both children and adults and is designed to allow standard healthcare services to continue in an environment where patients feel completely at home,” says Laiju “Another service is Covid-19 testing at home, which allows patients, after an online screening to have their swabs collected from home and sent to a Medcare certified lab for results within 24-48 hours.”
Burjeel Hospital Dubai is using telemedicine and e-appointments to provide consultation and medical advice to patients who do not need to receive in-person care.
Thumbay has launched telehealth services for patients with minor illnesses. It has also launched drive-through pharmacy service and home delivery of medicines.
Aster also offers teleconsultation to stable patients, or patients who need regular medications for chronic health conditions.
With elective procedures such as dental treatment now permitted, Dr Michael’s Dental Clinic has implemented protocols to minimise risk to patients, doctors and staff based on DHA guidelines. “These include use of PPE, deep sterilisation, extra buffer time and assistance in between the appointments to have the time to clean each and every surface, keeping social distance in waiting area,” says Dr Imneet Madan, Laser Specialist Paediatric Dentist at Dr Michael’s Dental Clinic Dubai. “This was facilitated by requesting patients to wait in their cars and come in only when the dentist and the room is ready. Floor cleaning is carried out multiple times in the office during the day, as well as routine sterilisation of instruments and equipment.”
All healthcare providers are spacing out appointments to prevent crowding in waiting areas and adequate seating arrangements in line with social distancing norms are provided as well. Sanitisers are placed in strategic locations, especially where there are touchpoints. Frequent cleaning is performed across waiting areas and high-touch surfaces including doorknobs, elevators buttons, etc.