Coronavirus Resources


The Coronavirus pandemic is impacting every aspect of our lives and many members are questioning how it will impact the practice, staff, clients, and patients. Since concerns about the virus were first raised, members have been posting their questions, advice and resources to MemberConnect. To help members find trends and best practices quickly, VHMA staff have identified "gems" of information and organized them by topic.

VHMA encourages members to review daily discussion threads for assistance in navigating these uncharted waters.
   

Trends and Best Practice "Gems"

Appointments and Patient Services

  • We are rescheduling all non-essential appointments. Sick appointments only. (Penny Baertsch)
  • As of March 17, we are scheduling health wellness exams at least 3 weeks out. Only sick appointments for now. We are not cancelling the ones already scheduled but not scheduling anymore. (Amanda Murphy)
  • As of March 17, we are not seeing wellness cases except for puppy vaccines and health certificates if needed for travel and have also discontinued elective surgical and dental procedures. We sent a letter out to every client. We are calling all wellness appointments going forward and …. are keeping a list of clients to call as soon as the restrictions are lifted. (Joanne Prellberg)
  • We are a surgical referral and emergency hospital so we will not be putting off elective procedures IF the client is comfortable. (Scott Burton)
  • As for canceling elective procedures, we are not there yet. I am fully staffed, no employees with known exposure, no employees with small children to supervise, and a full schedule for now. I am watching closely, and we are cleaning a LOT more than usual. (David Hawkins)

Client Messaging

  • "Our core value of community involvement reminds us of the need to reassure you of our commitment to offering a safe environment for both pets and their families. This current coronavirus is species specific so pets should not be affected by it. Our team members have received updates on how to protect themselves and the public from potential threats from COVID-19. (Debbie Hill)
  • COVID19 Alert! With our first case of COVID 19 showing up in Knox County, and out of an abundance of caution, we are asking our clients to please refrain from coming into our hospital if you, or anyone with whom you have had close contact, has any of the following symptoms: sore throat, coughing, shortness of breath, fever. We are taking every precaution to keep our staff and clients safe. If your pet has an emergency and you are sick, please let us know so that we can take steps to see you and your pet in a safe manner. (Carol Newsom)
  • We are going to bring in big art easels and place them in front of the doors telling clients to call first. I'm thinking they will be a little harder to miss than signs on the door. (Kelli Swanson)

Client Procedures

  • We posted a list of Covid-19 symptoms on the door. Only one person per pet is allowed and we escort them into the building. We are not allowing clients to wait in the waiting area.  If a room is not available, then they are to wait in their car.  (Penny Baertsch)
  • Clients arriving for an appointment with their pet must call upon arrival. A sign is posted on the locked clinic door with instructions. (Judith Kelly)
  • The clinic’s Covid-19 policy is posted around the clinic and on Facebook. Patients are instructed to stay in the car and a staff member brings the pet into the hospital. (Carol Neusom)
  • Only employees allowed in the clinic and the doors are locked. (anonymous)
  • We are no longer allowing clients in the building. A staff member checks them in and out at the car. Also doing RX refills and food refills that way. (Nicole Ward)  
  • No clients in exam rooms (Our rooms are small), They can wait in the lobby, we will bring their pet to the back, do the exam, and Dr. will come and speak to the client afterwards from across the counter. (Amanda Murphy)
  • Limiting transfers of objects from one person to another is another good way to not come in contact. For example, using the hospital’s leashes when handling pets and not owners’ leashes. As much as possible, limit items coming from outside the hospital from owners that will have to be handled by staff. (Brian Morris)
  • We are requesting our clients to wait in their vehicle until the exam room is ready.  Once ready, we are having them use a side door and putting them directly in the room.  We want to avoid congregating in the lobby area as much as we can.  We are staggering our scheduling of tech appts. as well so we do not have multiple people at the same time in our lobby. (Kelly Marquardt)
  • We have been having clients call when they are in the parking lot and we deliver medications to their car. We recently discovered that our portable credit card machines do not have Wi-Fi outside the building. We're now moving towards having clients pre-pay when we call to tell them their medications are ready for pick up to alleviate the problem. (Kelli Swanson)
  • We are currently doing curbside service but not fully. No humans in front lobby, appointments go straight into room. (Jessica Woernley)
  • We are telling our clients to call from their car when they arrive, someone will be out to escort them into an exam room.  No one can wait in the waiting area.  Also, we only allow 1 owner per pet to come into the building.  We do our invoicing in each exam room.  If clients are picking up food or meds, we take payment over the phone and make delivery to them in the parking lot.  We are using our online pharmacy for some of the scripts.  (Peggy Baertsch)
  • We can do curbside pickups on medications and diets.  Clients can also request to wait in their vehicles.  (Vanessa Yarusso)
  • We are offering curbside (call us and we will come get your pet and bring them inside and do the exam. Dr will call you while you wait in the comfort of your car). We have a portable cc machine we will go out and charge them out.  (Amanda Murphy)
  • Euthanasia has been our ONLY exception to curbside service. We use our largest exam room, which is currently unused for anything else, and has a window we open for additional fresh air. We maintain as much interpersonal distance as possible.(David Hawkins)
  • Euthanasia - This is the only time a client enters the building. We ask that only 1 family member, but do allow two, are present. We put these in exam 6 which is part of our isolation suite with 100% fresh air. We use full PPE along with social distancing. We also use an IV extension set. (David Andrews)

  • Euthanasia - This is our one exception to curbside. We are allowing one person with the pet. We are giving the client a mask if they don't already have one. We are doing it in our exam room on the end of the hall by the exit door. We have not changed the actual procedure though. We dont use catheters for euthanasia normally. (April Allen)

Human Resources and Staffing

  • The idea is floating around in my head to split my staff into two teams: Team A and Team B, during this time of Coronavirus concerns.  The plan is to have each team working at the same time and not to overlap, so that if someone from Team B falls ill, for example, that the entire staff isn't wiped out, and Team A could continue helping the community. I'm leaning towards Team A working 3, 12 hours days then having four days off.  Then Team B step in for the next 3 days, then having four days off.   Full-timers can get hours, part timers can work half days during their three days.  I'm still figuring it out.... (Carey Kidwell)
  • Check your state laws regarding your responsibility to pay wages if you send a sick employee home. If they are sick and show up for work, you can send them home, but you may have to pay for some or all of their scheduled shift if you don't let them work and they don't have available PTO to use.(David Hawkins)
  • We split up our team into 3 groups of 10. Two doctors, 2 techs, 2 assistants, 3 reception and 1 kennel. Each group will work 2 consecutive days. If one person falls sick on the team the rest of the team will quarantine for 5 days which will be the amount of time before they are on the schedule again. If any others have symptoms after the 5 days we will probably shrink to 1 doctor and less staff before contaminating the other groups. We are not sure if it will work or how long we will continue to function but it seems like it's worth a try. (Megan Howell)
  • I split our team up base on our doctor schedule. So the team that came in on Monday with our 2 doctors because team A. I changed their schedule to line up with the 3 days those doctors are on. The rest of the staff moved to team B with the other 2 doctors. Right now they are on 2 days. Each team rotates on the Saturday based on the hour. This has cut some hours which is the hardest part but I keep trying to explain that some hours and us being able to stay open longer is far better then zero hours if we are all exposed. We are still working out the logistics for hours for my FT employees at this point we are paying their benefits and still counting them full time because we reduce them down to 3 days. (Peg O’Keefe)
  • We started this today: Team A is working 8-8 Monday and Thursday and 8-3 Saturday. Team B is working 8-8 Tues and Wed and 8-6 Friday. Each team has 2 DVMS, 3 CSRs, 3 Techs and 3 Assistants. I lead one team (and count as a CSR) and my POs lead the other. The hours aren't quite even, but that's because our DVMs wanted to keep their surgery days since procedures were already scheduled. We had a meeting with staff explaining this option, and they all agreed to take fewer hours temporarily to keep everyone working for as long as possible. If one member of one team gets sick (or someone in their hoousehold does) we will have to shorten hours so that the other team can cover. We tried to create the teams so they'd have equal strength and tried to avoid obvious personality conflicts. We are trying to explain to the staff that it is IMPERATIVE that they don't socialize across teams outside of work. I'm not sure the younger ones get how important this is. We shall see. (Joan McCue)
  • We had to cut everyone by about 1/3 of what they usually make. But we were able to include everyone and cover it so no one should be without pay even if they have to quarantine for 5 days. And we can stay open if someone were to get sick. I figured that 1/3 was usually spent on extra curricular activities that aren't taking place right now anyway. :) (Megan Howell)
  • We are starting this today and talked to all staff individually yesterday-- talking to staff individually did take a long time but it gave employees a forum to individually discuss their concerns, fears, and anything else that they weren't sharing. I think after individual discussions there are more on board and see the benefits of doing it this way. As for making sure FT staff get hours, I would get really creative with your ideas-- staff could potentially come in early to work on any emails, texts, electronic client requests before you open to the public. If you offer boarding and have pets in need of care, some of your FT staff may want to pick up any Sunday hours. A thorough cleaning Wednesday night before your Th-Sa team comes in and Saturday night before your M-W team comes in could also add an hour or two. If staff have any PTO, they could add a couple hours here and there to add up to full-time hours. Good luck! (Kelli Swanson)

Insurance

  • Time to crack out the insurance policies and check for business interruption coverage.  In general, business interruption due to virus or pandemic is not covered.  However, business interruption caused by civil authorities may be covered. If you have business interruption coverage and you are shut down by authorities, file a claim!  It may be denied but there could be some wiggle room in getting something from your policy. (Tracey Sheffield)
  • I suspect the "civil authorities" coverage would be interpreted to mean close while a manhunt occurs in your area, etc. I am guessing that the moment this was declared a pandemic, all insurance policies will successfully invoke that exclusion - the actions of the civil authorities are due to that declaration. (David Hawkins)

Inventory and Supplies

  • Think outside the norm. I found paper towels, but they are the tri-fold ones.  That is better than nothing but not as absorbent. Shredded paper or sand will work for cat litter it’s just not as clean and needs to be changed more often. (Jennifer Young) 
  • I am surprised at the array of products on Staples.com, including toilet paper. Be creative on your product sourcing and substitution. Don't forget local janitorial supply stores and restaurant supplies - especially if they are true wholesale and require a business license for purchasing. (David Hawkins)
  • We need to be creative. We are sending electronic invoices after checkout instead of handing clients paper ones (at checkout). Cat Litter - we'll go to sand or shredded newspaper. Laundry Detergent - One of our staff makes her own…out of vinegar and some other stuff. Trash Bags - U-Line has all sizes available. (Ashley Keith)
  • We have been advised by our accountants to keep track (as best as possible) of things that are needing to be ordered in excess. (anonymous)

Operations

  • A clearly defined shut down plan is also key. What is the threshold to shut down? What indicators, that once hit, will trigger an automatic shutdown? Having these in place before the threat exists is a better idea than waiting until the threat is already there and then making the decision. The likelihood of making a good decision at that point is lessened, so disassociating the decision to shut down from the situation helps make better decisions. There still must be flexibility. (Brian Morris)
  • This falls in line with any major catastrophe planning that should be in place for any practice.  Technology can assist keeping the doors open "virtually”, so we are trying to add this into a practice’s disaster recovery plan.  I'd advise talking with your IT provider now assuring they have the access needed to fix things remotely, and you have the ability to remotely access your Practice Management system and possibly remote connect to clients should you need to do so.  (Joseph Axne)
  • We have already decided how we would handle a local outbreak so I thought I would share our plans. Plan A:Ride it out like an ice storm - Continue business mostly as normal knowing that business will be VERY slow, and staff will call out. Plan B Staff Furloughs that furloughs staff eligible for unemployment…and follows the lead of our Mayor and ISD.  Plan C Permanent Lay-offs- This decision would be made based on our local school system.  If they close for an extended period, we will lay-off a previously decided number of employees… and the plan could be enacted quickly and without panic. (Rebecca Bunker)
  • You need to have a criterion in place for the layoffs and staff reductions… something like, last hired, first out, or the person with the most write-ups in their file is first out.  When you do a RIF (Reduction in Force) without criteria you can set yourself up for discrimination lawsuits. Additional thoughts: ability to remotely access PMS and forward phones to a cell phone. Double check computer backup systems and check with suppliers now to see if you can be put on 90-day billing if needed to manage cash flow during a shut down. (Tracy Sheffield) 
  • We are not allowing any clients in the building. Our bottlenecks are excessive phone traffic, tech/assistant appointment efficiency, and clear direction for clients.

    First efforts to improve bottlenecks:
     - Texting clients link for payment and emailing invoice. See our merchant online payment option here: https://paylink.paytrace.com?m=87132&amount=&invoice=
     - Directing clients to schedule appointments and rx refills through their portal instead of calling.
     - Tying to mirror our normal flow as much as possible to stay efficient
     - Utilizing rooms and cages to confine animals and free up hands while waiting for doctor orders
     - About to send out a client letter and update all appointment confirmation communications to explain new flow
     - Ordered parking lot signs with station numbers to designate where clients should park
     - Be bold about telling clients exactly what to do, i.e. "Don't leave, stay parked where you are, have your phone ready to answer our call, we'll be in touch in about 20 minutes." (Abby Suiter)

    Sanitizing the practice

    • We disinfect hourly and replace the mop bucket water 3-times daily (Heather Woodard)
    • We are disinfecting before clinic starts and several times during the morning clinic. We mop and clean the entire office during the 11 am to 2 pm surgery time and continue to disinfect during the afternoon.  We wipe the counters, credit card machine, door handles, chairs, light switches, etc., in addition to our usual cleaning. (Laura VanOrsdal) 
    • We have a box of Clorox or Rescue wipes, and disinfectant bottles at each front desk.  We have taken away our coffee station, client handouts/materials on the counters, and all treat and human candy jars.  We are routinely disinfecting counters, keyboards, CC machines, door handles, etc. (Jennifer Houghton)
    • Exam rooms are thoroughly cleaned after every appointment: door handles, doors, counters, benches, credit card machines. We have removed our coffee station and treat jar. (Penny Baertsch)
    • We are cleaning as normal and pay close attention to door handles, chairs, credit card machines, and keyboards etc. and check the CDC website for updates on cleaning and disinfecting. (Adam Davila)
    • We have staff wiping down EVERYTHING 3 times a day minimum (door handles, benches, chairs, cc machines, phones, counters, etc.) (Amanda Murphy)

    Cleaning Products

    • Rescue (LaDawna Lawton)
    • Provet for cleaning and Dirty Dog Laundry detergent from Provet. (Mariza Saenz)
    • We use Terg-O-Cide from Nuetron Industries. (Kim Jacobs)

Payments

  • We are planning a day at a time and will develop policies as situations present themselves.  A lot of our clients use third-party payment providers, but I do not plan on starting AR with clients.  I feel that carrying accounts internally ends up being more work than benefit.  (Scott Burton)
  • Certainly, we are navigating issues never seen in most of our lives.  I don't think that billing or reducing fees will serve you well.  Use Scratchpay or Care Credit for these transactions.  Trust me, you do not want to shoulder the burden of loaning money - which is precisely what you are doing if you allow “billing.” (Ashley Keith)
  • We currently utilize care credit and VetBilling and we are very pleased with both services.  For VetBilling we do not have to run a credit check; the client puts 30% down and then they arrange monthly or twice monthly payments.  All is handled by VetBilling…It is a wonderful and inexpensive option for our clients, and we see a full return on payment and our rate of payoff is 98%!  (Lori Anthony) ​
  • I think you are correct to think that clients are going to be seeking care with even less money than they have had in the past.  Our practice has embraced multiple payment options, including payment plans managed by VetBilling, for several years… I want to ensure that my practice is a business that clients WANT to support… We offer Care Credit, ScratchPay, and VetBilling because we care about the people who trust us to care for their pets.  We want to find a way to make our standard of care affordable to anyone who desires that for their pet. My PO and I are in full agreement that the empathy and compassion we have shown our team and clients for the past two decades is NOT something we are willing to compromise.  (Carrie Bowgren)

Staff Morale

  • I have been reaching out desperately to all of my reps for some sort of a reward system for my team to show appreciation for their bravery and hard work during this crisis. I have had amazing responses and am super grateful! I've gotten them multiple gift cards, some of the reps are allowing them to purchase food for delivery to their homes and I even had one ask for a list of items for each that they use frequently who will be sending some stuff for them to the office. Stay positive, strong, safe and healthy! (Celeste Hein)
  • I brought lunch on Thursday. It really helped perk everyone up. (David Hawkins)
  • I created a scavenger hunt for my team. I give them a clue, they have to give a team answer its, not individually. The team can ask 3 questions to try and get more clues. Each day the team has from 8 am to 12 pm to submit their answer. And each day is a new scavenger hunt!! (Adan Davila)
  • On the serious side, once a week I privately ask each team member what is their biggest stress this week. Then I work on getting them what they need or at least praying with them for the return of health for a loved one. On the fun times side, we are buying the team lunch once a week and playing Jenga. Fun times! (Terri Hepburn)
  • We are currently growing individual peat pots of sunflowers in our breakroom. Each staff has two pots. They had to plant the seeds, but the soil was already in the pots. Various types of sunflowers. Prizes for various things (first to sprout, tallest at two/four weeks, etc.). Pot can't leave the clinic until the end of the contest, responsible for your own, can't move or mess with anyone else's, can bring in outside 'help' (fertilizer?). It's been fun (I'm winning!). We also have a coloring contest going on. Multiple adult coloring books in the break room and colored pencils. Have to be colored at work, last name goes on the back of the page, they'll all get hung up and judged by all staff. These are ongoing games trying to keep up morale. Everything we're doing we are trying to ensure keeps staff apart from each other as much as possible. (Erika Bolin)
  • We have been insane like most of you it seems. Our staff and Doc/s are exhausted. We made the decision to close half day on Wed...we take appts until 11:45, and close the doors at 1:00. I order in lunch and we give our team 2 hours for lunch and catch up on notes, call backs, Rx refills, etc...and then they can have an early out..to just relax..we have done this for 3 weeks now and they look forward to that little break mid week. We have not reopened on Sats since this started. and we are planning to remain closed. We also have closed the hospital from 12:30-1:30 for lunch for the entire team to break at once Sometimes my Sx tech isn't quite done, but they go soon after...all these little breaks have helped morale. Good luck! (Denise Blankenship)
  • Thanks for the uplifting message. I'm doing my best to keep a sense of humor and thick skin. I started a contest at our clinic... staff submits the crazy story of the week. Could be a rude client, a really gross job, or an unbelievable medical experience. Doc and I choose the winner and they get a coffee shop gift card. Helps to laugh! (LaDawna Lawton)

Reopening

  • Clients call upon arrival - we advise if they need to wait, or if they can enter the facility. I plan on only allowing one client per appointment (the exception would possibly be euthanasia) and the client(s) must wear a mask. Clients will be required to maintain social distance from staff. (Denise Sharp)
  • Our practice completes payment in the room. I would highly recommend dedicating a receptionist to obtaining payment while the owners are in the room, so they can exit immediately. (Heidi Todd)
  • Call first, when ready one client per pet, face masks required. For checkout, we usually do that in the room already so we will just be able to do it as usual. We'll try to limit contact between clients by bringing them straight into exam rooms and then straight out so none in the waiting area. (Karen Munsell)
  • So for us, adding back services, without a doubt will begin very soon, but clients will not be allowed in until we are confident it's safe to do so. And when we move to allowing them back, a plan for how to minimize exposure as discussed in the thread will be part of that! (Pam Bendock)
  • Limit of one client with patient for visit; still asking clients screening questions for respiratory illness to decide how to best handle case/client; client will call upon arrival and we will advise to enter into a particular exam room to avoid people waiting in lobby; client is checked-out in exam room to limit contact with other staff; all medication/diet food pick-ups will remain curbside service with payment taken over the phone; we will still offer pet-only entry to clients who do not want to come in or to those who have illness in household; staff must continue to wear masks at all times and other PPE as deemed necessary. (Katie Chamberlin)
  • We will ask all clients to remain in their car until we can escort them directly into an open exam room. This will help to prevent congregating in the lobby. All clients will be required to wear a mask and only one person with the pet for the appointment. We will remove the coffee station as well. Plexiglass will be installed at the front desk to help protect our Client care Specialists. (Genel Less)
  • I think that if/when the lobbies open back up, we are going to post a sign that clients have to disclose any symptoms and screen our clients for coughing/upper respiratory symptoms. (Shelby DeHaan)
  • We also have a small bottle of hand sanitizer in front of each receptionist desk and a sign that reads "Please use the hand sanitizer before using pens" clients really like that :) (Mariza Saenz)
  • My staff has to confirm the following daily before reporting to work each day. "To my knowledge, I have not been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or has had symptoms of COVID-19. I have not tested positive for COVID-19 in the past 14 days. I have not experienced any symptoms of COVID-19 in the past 14 days. I have taken my temperature this morning and do not have a fever." (Caitlin Shaw)
  • We have a basket on a bench by the front door. We are asking that all prescriptions and food items be pre-paid by phone. The items are then bagged up, the receipt is placed in the bag and the bag is labeled with the clients name clearly printed on the outside. These are then put in the basket on the bench. Food bags are labeled and the receipt is taped to it. The front desk has a clear view through the window of the pick-up point. The client is instructed where to find their items. They pull up, get out of the car, go to the bench and pick up their bag. No phone calls needed and very time efficient for the clients. The clients are very happy with this and it really reduces the number of phone calls. (Tracy Sheffield)
  • We have someone that we pay minimum wage to sit out in our parking lot, under a canopy, checking in cars and either texting our hospital cell phone and or using a walkie talkie to let us know when the appointment has arrived. This has freed up our phone lines and has made checking in easier on us and the clients. (Anonymous)
  • We now allow uniform Bermuda shorts and hats with our logo. It has helped with moral. (Jennifer Sweet)
  • Yes, we recently bought cooling towels for all our staff and they love them. Hadn't even thought of wearing them as a mask though, that is a great idea and regular masks get so hot. (Karen Marshall)
  • I bought a hose and sprinkler to have outside for patients, clients and staff to take advantage of as needed. We don't mind working with a wet dog. Staff actually are enjoying it. They will walk through it as they go out to get a patient. Plus, it helps the lawn as we haven't had much rain lately. (Penny Baertsch)
  • I've used the cooling towels at horse shows, and my husband, who works as a firefighter on Pit Road at a couple of NASCAR races every summer swears by them. My staff isn't outside all that long; we allow them to take histories by phone on really hot days. They use thier cell phones and the CSRS alert clients to expect a call from a blocked number. To make it a little more bearable for clients, we offer them cups of ice cream on hot afternoons while they wait. That's a big hit! (Joan McCue)

Telemedicine

  • Telemedicine options for clients that need non-urgent care may be in order to keep revenue flow occurring for a practice. There are simple online meeting solutions to telemedicine specific software solutions that integrate with our practice you may want to consider. (Joseph Axne)