In order to provide greater support to our staff, the BILH COVID-19 Staff Hotline is expanding its availability.  As of Tuesday, March 24, the hotline will operate seven days a week, between the hours of 8:00 a.m. – 9:00 p.m.  The hotline, which is staffed by BILH nurses, is available exclusively to physicians and staff as a resource for obtaining answers to questions you may have related to COVID-19.

In conjunction with this expansion, all COVID-19-related calls that would normally be handled by Employee Health should be directed to the hotline at 617-278-8888, effective immediately.  This includes:

• Providing notification of travel to/from high-risk areas
• Reporting staff or community exposure
• Returning to work after quarantine

If the nature of your call falls within these or other categories that require consultation with a member of Employee Health, the nurses at the hotline will facilitate the connection.

To reach the BILH COVID-19 Staff Hotline, please call 617-278-8888 between the hours of 8:00 a.m. and 9:00 p.m., seven days a week.

Dear Colleagues,

As a part of our ongoing commitment to do all that we can to support and protect you throughout the duration of this crisis, we are sharing enhanced and new resources to support you during this challenging time.

COVID-19 Resources

In addition to resources already implemented, today we are making available the following:

• Enhanced Supplemental Leave Policy that will now allow employees to use Earned Time/ PTO up to a maximum of two (2) weeks negative for COVID-19 related issues, including childcare issues.
• Enhanced Supplemental Leave Policy Form.
• Updated FAQs including information on enhanced Employee Assistance Resources (EAP) and information on how to access your 401(k) for hardship loans. The information in these FAQs may change as Beverly and Addison Gilbert Hospitals’ response to the coronavirus situation progresses. We will provide updates to the workforce.
• For COVID-19 Human Resources-related questions, please email covid-19-hr@lahey.org or call the HR hotline (978-816-2398).

We will continue to look for new ideas and ways to support each of you. Please direct specific questions to your supervisor or Human Resources on any of these programs or to make suggestions on how we can better support you. Thank you for your dedication to our patients, community and each other during this challenging time.

Sincerely,

Philip M. Cormier
President

Althea C. Lyons
Vice President, Human Resources

This morning, Massachusetts Governor Charlie Baker ordered the closure of all non-essential businesses.  He also instructed the Department of Public Health to issue a statewide Stay-at-Home Advisory under which all state residents are expected to limit all unnecessary activities. Both measures are intended to slow the spread of coronavirus and ease mounting pressure on our state’s health care system and go into effect tomorrow, Tuesday, March 24, at 12 p.m. until at least Tuesday, April 7.

These measures do not apply to health care workers, who are essential employees during this public health crisis.  You are expected to report to your worksite as usual, unless you are symptomatic; quarantined; or you have a management-approved work-from-home arrangement.

In order to ensure that we can continue to deliver vital services to our patients and communities, please be sure to have your employee ID badge with you at all times, as you may be asked by local authorities to show proper identification documenting that you are an essential employee.  All employees should wear and ensure their ID badges are visible while on company property.

Thank you for everything you are doing during these very difficult times.

Beth Israel Lahey Health, along with health care providers across the country, is in the trenches in the fight against the COVID-19 and preparing for a significant increase in the number of patients who will need us for life-saving care. Every day, we are faced with the difficult challenge of managing critically low Personal Protective Equipment (PPE) inventory in light of current national shortages, as well as a future state that still holds a great deal of uncertainty.

We are relentlessly pursuing a number of domestic and international sources to build our PPE inventories while also conserving our supplies through recently implemented PPE preservation, extended use and re-use guidelines.

In addition to aggressive sourcing and thoughtful planning, we are continuously identifying and assessing opportunities to make real-time adjustments to our PPE guidelines in order to enhance the safety of patients and staff, not only today but for the days, weeks and months to come.

While some other hospitals in the city have opted to have all staff wear masks throughout their facilities all day, we are taking an alternate approach to ensure that our front-line staff directly caring for suspected and confirmed COVID-19 patients continue to have the PPE they will need going forward.

After thorough evaluation, we are:

• ​Enhancing efforts to cohort suspected and confirmed COVID-19 patients together on inpatient units
• ​Updating our PPE Guidelines to provide additional PPE to all staff in areas with the greatest potential of exposure to suspected and confirmed COVID-19 patients, which include cohorted inpatient areas, emergency departments and urgent care locations.  All staff in these units will wear a surgical mask and/or an N95 respirator, as appropriate, for their entire shift – one surgical mask per day, unless the mask becomes visibly soiled or damaged.  New guidelines on this enhancement are forthcoming.

This approach will allow us to prevent the spread of the disease to staff and other patients while appropriately conserving vital PPE inventory.

Our highest priority is keeping our staff and patients safe, and our decision is based on best practices endorsed by the CDC and DPH, infectious disease specialists and other experts. Our approach is also consistent with those being introduced by Tufts Medical Center and Boston Medical Center.

Please know how committed we are to protecting our staff, while also providing the very best care for our patients. Thank you for everything you are doing and for your commitment during these challenging times.

To:BILH Clinicians

From:Richard Nesto, MD
Chief Medical Officer, BILH
Incident Commander, BILH

Meg Femino
Senior Director, Emergency Management, BIDMC
Incident Commander, BILH

Subject:Updated COVID-19 Testing and Evaluation Guidance Now Available  

Beth Israel Lahey Health (BILH) has posted new clinical tools and guidance online. Please visit BILH’s COVID-19 website to see the tools and guidance noted below, and check back often as guidance continues to evolve rapidly.

Algorithms for Patient Screening and Evaluation

Updated algorithms for evaluating and testing patients for COVID-19 are now available.  The inpatient algorithm below should be used by staff to perform symptom screens of all patients on each inpatient unit each shift when rounding.  Any patient who fulfills criteria should be isolated and tested.  Patients may be in the incubation period for COVID-19 on presentation and could develop symptoms after admission. Regular symptom screening will help reduce exposure risk to staff.

• BILH Inpatient Evaluation COVID-19 Testing Algorithm
• BILH Ambulatory COVID-19 Testing Algorithm
• BILH Emergency Department and Urgent Care COVID-19 Testing Algorithm
• Outpatient Assessment and Management for Pregnant Women with Suspected or Confirmed COVID-19 (from the American College of Obstetrics & Gynecology)

COVID-19 Testing

Additional guidelines outline indications for testing for SARS-CoV-2, the virus that causes COVID-19, in patients and healthcare providers who are symptomatic.  A testing prioritization strategy is provided that includes five priority levels, which can be used by clinicians and laboratories to guide testing based upon clinical need and test swab availability.

As our test swab supply has improved from earlier in the week, tests may now be performed on symptomatic patients and healthcare providers in priority levels 1-3 as defined in the testing prioritization below.  Please watch your email and the BILH COVID-19 website frequently for future updates.

• BILH COVID-19 Testing Guidelines
• BILH COVID-19 Testing Prioritization

Personal Protective Equipment

Our highest priority during this outbreak is protecting our staff, and we continue to purchase new Personal Protective Equipment (PPE), whenever available, while simultaneously exploring multiple avenues for potential reuse.

While PPE continues to be at critical levels, our reuse protocols – available under the PPE section of BILH’s COVID-19 website – have been able to stabilize the supply.  Instructions on how to perform a user seal check for an N95 respirator have been added to the website. While seal checks are always important when using a respirator, they are especially important when enacting an extended use or reuse protocol.

It is imperative that staff continue to use the right PPE, and the right amount of PPE, at the right time. BILH has issued guidance on the appropriate use of PPE to keep staff safe and to preserve our supply. Please see the Interim PPE Reuse Guidelines under the PPE section of BILH’s COVID-19 website.

Cohorting of Suspect and Confirmed COVID-19 Patients on Inpatient Units

All BILH inpatient facilities are in the process of creating units for cohorting patients with signs and symptoms of respiratory illness. By placing patients identified upon admission or daily symptom screens who are likely to have COVID-19 in the same geographic area, protocols can be more easily developed for care and additional PPE can be deployed to protect staff without depleting the supply.

We very much appreciate the efforts of all staff as we continue to respond to this rapidly evolving situation. Please direct questions to your local Incident Commander. Thank you.

The world is turned upside down.

Obviously, this column and most everything else you read — both now and in the near future — will be about COVID-19 and its impact. Schools have closed, restaurants and other businesses have either shut down or are offering limited hours/options, travel restrictions are in place. It has affected every aspect of our daily lives, in addition to causing illness and suffering (or worse) for many.

The impact on our healthcare system including our hospitals, clinics and physician practices is even more profound. We expect and are constantly preparing for an increased need for us to care for patients as the pandemic affects more of our neighbors, friends and even family.

Many steps have been taken already. We’ve postponed non-urgent elective procedures, visits, appointments and surgeries. We’ve set up telehealth capabilities; this will enable patients to be cared for while maintaining social distancing. Staff are being trained to care for patients in a different setting (and space is being repurposed to care for those patients). We’ve also taken steps to procure and preserve resources including equipment and supplies for the anticipated surge.

We have taken these actions in concert with BILH leadership and local government agencies, while also receiving guidance from the CDC, WHO and other experts.

I cannot express how much I wish I could thank each and every one of you individually for what you’ve already done — and what we may ask of you in the days, weeks and potentially months ahead. Unfortunately, under these circumstances I cannot do that. I realize yet another email is not the most  personal way to express my gratitude, but please know that every word I am writing here is from the bottom of my heart.

This situation reminds me of a couple quotes from one of my favorite books. Some of you may recognize the following exchange from it:

Character One: “I wish none of this had come to me; I wish none of this had happened.”

Character Two: “So do all who live to see such times, but that is not for them to decide. All we have to decide is what to do with the time that is given to us.”

We will get through this time together, because I know each of you will do your part to care for our patients, and care for our families, neighbors, friends and each other.

Thank you all again,

Phil

Dear Colleagues,

When I wrote to you last week, COVID-19 had just been officially declared a pandemic by the World Health Organization. Since then, life across the United States – including in Massachusetts – has changed dramatically. Emergency declarations have been announced at the federal, state and city levels. Schools have turned to remote learning. Restaurants and other businesses are empty.

We know that, for those of us in health care, most of our true challenges lie ahead – although the strain of hard work and uncertainty is already very, very real. We are caring for patients with suspected and confirmed cases of COVID-19 across our system, and we know we will see many more.

Without a doubt, our extraordinary workforce is braving unchartered territory. You are being called upon to serve our community selflessly as critical supplies are running low. You are rising to the occasion in heroic ways, and we are and will continue to do everything in our power to bring you the support and resources you need.

For example, despite national supply constraints, we now have the ability to do in-house testing and are conducting the highest volume of testing in New England. We are sourcing personal protective equipment as quickly and creatively as we can. We are also in the process of converting our orthopedics specialty hospital, New England Baptist, into a general medical hospital so that we can ease capacity pressure on our other sites and keep patients and staff safe.

Of course, we are just now moving into the thick of the battle, and we will emerge to the other side together by distinguishing between worry and panic. Worry can galvanize us and drive action, while panic will only stop us in our tracks.

Given everything the world and our country is going through, I’m certainly not saying, “Don’t worry.” I do hope, though, that we can take our worry and find in it motivation to do what each of us does best. For many of you, it’s using your clinical training and knowledge to care for ill patients. For others, it’s making nutritious food to sustain colleagues working a 12-hour shift or keeping our staff connected electronically and our systems running. No matter what your role in this organization, you are contributing in meaningful ways to our ability to successfully face the profound challenges at hand.

I also hope we will continue to show kindness and understanding to one another, because taking on an enemy too small to see requires that we find strength in our common humanity. Together, we will come back from this. And we will be stronger because of our hard work, patience and compassion – both as individuals and a community.

I am amazed – though, not surprised – by how you, our Beth Israel Lahey Health family, have come together in ways both big and small in these difficult times. Please know how equally committed I am to continuing to do all that I can to support and protect you throughout the duration of this crisis.

Thank you for inspiring all of us to take on what lies ahead.

In gratitude,

Kevin

BILH COVID-19 Hotline Now Available

Beth Israel Lahey Health (BILH) has created a COVID-19 Hotline and it is now live. BILH staff and providers can call the BILH COVID-19 Hotline (617-278-8888) to ask general questions related to COVID-19. Open from 8 a.m.-6 p.m. Monday-Friday, the call center is staffed by BILH nurses who are trained to answer clinical and operational questions and to connect with subject matter experts to address barriers or further clarify a process in question. For non-urgent questions regarding the call center, please email eoc@bilh.org.

Stress Management Session for Colleagues – March 20 An Employee Assistance Stress Management drop-in session will be offered by ComPsych Corporation on Friday, March 20, from 2-4 p.m. in the Beverly Hospital Board Room. This session is open to all colleagues to assist in managing additional stress you may be experiencing due to the ongoing COVID-19 situation.

Important COVID-19 Human Resources Information

Please see below for the following updates from Human Resources that are related to the ongoing COVID-19 situation.

COVID-19 Email Box and Hotline:

Our Human Resources team has created an email box for employees so they are able to submit COVID-19 questions. The email address is COVID-19-HR@Lahey.org. In addition, there is a Human Resources COVID-19 Hotline: (978) 816-2398.

Employee Assistance Drop-In Session:

Please be advised that there will be an Employee Assistance drop-in session tomorrow, Wednesday, March 18, from 7 – 9 a.m. in the Beverly Hospital Nursing Administration Conference Room.

Children at Work:

This is a reminder that Beverly and Addison Gilbert Hospital colleagues – who work either at our hospitals, other affiliated facilities, or offsite locations – are not allowed to bring children to the workplace. We understand the difficulty the current COVID-19 situation presents to parents, but for the safety of everyone involved, children must not be with staff at work.

General Guidance for Coding COVID-19

Please use this resource for diagnosis coding for COVID-19. This is subject to change as the situation evolves.

COVID-19 guidance changes rapidly. We are providing regular updates as needed.

Guidance on Curtailment of Elective Procedures and Visits

In an effort to confront emerging challenges related to COVID-19 transmission in the community, all BILH facilities are initiating emergency measures to prevent avoidable transmission of illness. As part of these measures, beginning today, clinical teams – on a rolling basis – should reschedule all non-urgent elective surgeries, procedures and clinic visits scheduled within the next two weeks until this directive is modified. Our intent in rescheduling these elective visits is to adhere to social distancing recommendations; to protect patients and staff; and to help us preserve supplies, including personal protective equipment.

“Non-urgent elective” encounters are defined as any surgery, procedure or clinic visit that can be safely delayed or deferred, without threat to the immediate health/safety of the patient. All attempts will be made to reschedule these surgeries, procedures or clinic visits once we return to routine operational capacity.

Click here for detailed guidelines for BILH inpatient facilities.

Click here for detailed guidelines for Outpatient Facilities and Ambulatory, Non-OR Procedures, Diagnostic Radiology and Interventional Procedures.

For guidance from the ACS, please visit: https://www.facs.org/about-acs/covid-19/information-for-surgeons.

For Leaders: Volunteer Services Program Suspended

In light of the rapidly evolving COVID-19 situation, as of today, we have decided to suspend our Volunteer Services Program indefinitely. If you have any questions, please contact Jennifer Boucher, Manager, Volunteer Services, at 978-922-3000 ext. 2308 or jennifer.boucher@lahey.org.

Patients & Visitors’ Guide
Information for Visitors

New Visitor Policy:

To protect the health of patients and staff from the rapidly evolving COVID-19 situation, we are restricting all visitors — unless pre-approved by each patient’s care team under extenuating circumstances (i.e. receiving end of life care).

Certain exceptions to these restrictions apply to our Pediatric, Maternal Newborn Services and Ambulatory areas, and are as follows:

• Pediatrics: Patients will be allowed one parent or guardian for the duration of their visits.
• Special Care Nursery: Patients will be allowed to have both parents present for the duration of their stay.
• Labor and Delivery: Patients’ significant other will be allowed for the duration of their stay.

Patient escorts in ambulatory areas will be actively screened and permitted if:

• They do not have any cold or flu-like symptoms (fever, cough, difficulty breathing)

OR

• In the last 14 days have not:
  • traveled to a COVID-19 high-risk area
  • been exposed to someone who has been diagnosed with COVID-19.

Should you have any questions about these new guidelines, please contact the department where the patient is located.

Thank you for your understanding and assistance in helping to keep our patients, their families and our staff healthy.

Beverly and Addison Gilbert Hospitals:

COVID-19 Updates March 12, 2020

COVID-19 guidance changes rapidly. We are providing regular updates as needed.

Heads Up: Tents Near Emergency Departments

As you are aware, the current COVID-19 situation is rapidly evolving. Our hospitals are working diligently to assess and care for patients while protecting other patients, staff, visitors and our community. One initiative that may be visible to you and our local campus offices is the installation of tents outside of our Emergency Departments. These will be used in case extra space is needed for patient and visitor screening.

If you have questions, please contact your manager. Thank you for all you are doing and continue to do for our patients and each other.

Carry Your ID Badges

Colleagues should keep their ID badges with them at all times so they are able to be easily identified and access all entrances to our facilities. Please be prepared to show your badge when you enter the hospital. Thank you!

FOR LEADERS: VOLUNTEER UPDATE

Please note that our volunteers are being reassigned to non-clinical areas. Leaders who are able to utilize volunteers should contact Jennifer Boucher, Manager, Volunteer Services, at 978-922-3000 ext. 2308 or jennifer.boucher@lahey.org.

What You Can Do to Protect Yourself and Others

Be vigilant about prevention:

• Wash your hands often with soap and warm water for at least 20 seconds.
• Cover your coughs and sneezes.
• If you are sick, stay home and contact Employee Health at 978-922-3000, ext. 2313 to report the following symptoms:
  • Fever
  • Cough and shortness of breath
  • Pneumonia (in severe cases)

For the latest information on COVID-19 cases in Massachusetts, visit the Massachusetts Department of Health website. Additional information is available from the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

Awareness of Novel Coronavirus (2019-nCoV) and Beverly and Addison Gilbert Hospitals’ Preparedness Efforts