Hello everyone –

As you all know, COVID rates are rising and we’re working with leadership to respond appropriately, both for the protection of us as residents and for the protection of our patients. After discussion with program leadership and attendings on service, we have decided to make the following temporary changes to the outpatient, inpatient, and non-covered services. We hope that these changes will reduce potential resident exposure to COVID while still maintaining high patient safety standards and preserving the residents’ educational experience.

NOON CONFERENCE

• Noon lunch will continue to be provided but residents and APPs must pick up their food from the room and return to their respective work rooms to attend conference via Zoom.

UNIVERSAL MASKING POLICY

• All individuals in the work room must remain masked at all times.
• All patient interactions require a minimum of a face mask and eye protection.
• If masks need to come off for eating or drinking, individuals must remain 6 feet apart and masks should come off as briefly as possible.

COVERED SERVICES

• General neurology and stroke service: Only the attending and the FCP will round on the patient. Seniors should round on high acuity patients as they see fit. Walking as a group is okay, as long as social distancing is maintained.
  • For non-urgent inpatient consults, the PGY-2 on-call will discuss with the senior if it is appropriate to convert the consult into a telephone consult in lieu of a full in-person evaluation. For now, ED patients will still need to be evaluated in person.
• Neurology consults: Only the attending and the primary resident will round on the patient.
  • For non-urgent inpatient consults, the PGY-3 on service will decide along with the attending if it is appropriate to convert the consult into a telephone consult in lieu of a full in-person evaluation. For now, ED patients will still need to be evaluated in person.
• NeuroICU: Bedside rounding will continue, with emphasis on maintaining social distancing.
• Peds Inpatient: Changes to the service will be made at the discretion of the Peds neurology team.
  An e-mail recently went out regarding judicious ordering of labs, CXRs and other studies. This should also apply to EEGs in order to reduce EEG tech exposure.

CLINIC & NON-COVERED SERVICES

• Clinic: New patients will continue to be seen in-person but return visits will be converted to video visits.
• Northshore: We are waiting to hear from NorthShore leadership regarding changes to the NorthShore rotations.
• EEG: We will discuss the possibility of reading EEGs offsite and rounding with the attending via Zoom to go over reads. There will be no EMU next week.
• EMG: No one is on EMG this week or next. If the surge continues, we will reach out to the EMG attendings to determine whether any changes will be made to the rotation.
• Peds Outpatient: Changes to the service will be made at the discretion of the Peds neurology team.
• Elective: Clinical inpatient electives can continue with adherence to PPE guidelines.

COVID TESTING PROTOCOL FOR HOUSESTAFF

• If you have flu-like symptoms, let us know immediately and schedule a COVID test via MyChart or calling OccMed,
• Attached to this post are the current UCMC policies on: Infection Control Guidelines, COVID exposure risk assessment, Sick Healthcare Worker Guidelines, Employee COVID-19 testing, Early Return to Work for COVID+ employees.

VACCINATION & BOOSTER

• Please get your booster!

JEOPARDY SYSTEM

• The jeopardy system is currently strained due to the holidays and illness in the residency. If coverage is needed and there is no one on Jeopardy available, we will likely reach out to residents on non-covered services. Hopefully, reducing exposure in non-covered services will provide us with an adequate back-up pool if multiple residents get sick.

We realize that these changes are not easy and we expect that you will have questions, concerns, and suggestions. Please reach out to us at anytime, we are happy to talk about them. Thank you all for your flexibility and working with us through this, we hope that this will help keep us all safe so we can continue to serve our patients. Happy holidays!

Best,

Ruth, Ribal, Jasmine