Implementing Physical Distancing in the Hospital: A Key Strategy to Prevent Nosocomial Transmission of COVID-19

Multidisciplinary Rounds

As multidisciplinary rounds typically occur either at the bedside or in a conference room, it is key to ensure that these occur virtually whenever possible. One option is to use conference calls or video chat (eg, Zoom) for multidisciplinary rounds whenever possible. Calendar invites or paging reminders can be used to prompt teams when to call in to discuss patients. Because multiple people are entering a virtual room at once, it is important to establish an order or have a leader orchestrate who is next. In addition, given the importance of multiple people contributing to the discussion, it is also equally important for those speaking always to announce who they are and their role (eg, social worker, case manager, physical therapist) since it may not be possible to recognize people’s voices alone. This is where visual recognition can be helpful through use of institutional video conferencing that enables hearing and seeing someone. Further, it is important to ensure that the platform being used is HIPAA compliant.

Call rooms in hospitals can be particularly challenging if they are shared. Finding additional call rooms may require use of cots or reallocation of patient rooms. It is also possible for hospitalists to consider air mattresses in their offices or other private spaces to avoid sharing call rooms. Consider assigning the same call room to the same few people over the course of a rotation or period to avoid many people sharing one room. If a hospital is converting units to group patients under investigation or those who are COVID-19 positive, reallocating call rooms may be necessary to accommodate new teams. Lastly, it is important to communicate proactively with environmental services staff to make sure all call rooms are equipped with cleaning supplies and hand sanitizer and are cleaned daily to avoid nosocomial transmission.