TO: Ballad Health All
FROM: Senior leadership
DATE: Thursday, Dec. 28, 2023
TITLE: Implementation of contingency staffing
We are experiencing a material increase in respiratory illness – influenza, COVID and RSV (respiratory syncytial virus infection) – among both our patient population throughout the region and among our team members. As a result, increases in team member absence due to illness, combined with an increase in respiratory patient volume, can have an impact on patient care.
- Due to the combination of increased team member absence due to illness and the increased incidence of respiratory-related admissions, Ballad Health will upgrade to contingency staffing for team members who test positive for COVID, effective Thursday, Dec. 28.
- As we move to contingency staffing, we will continue to require team member masking for all team members and care providers in patient care areas and clinical departments in all acute-care and long-term care facilities. This covers our hospitals, outpatient clinics, long-term care facilities, home health and hospice, and Ballad Health Medical Associates (BHMA) locations.
Masking for visitors to our facilities is strongly recommended (but not required at this point). We also want to make visitors and patients aware that, for both our safety and theirs, our team members are masking in these critical places. This will help protect vulnerable patients from the spread of seasonal respiratory illness.
As per usual policy, anyone presenting with fever or cough should be asked to mask.
Contingency staffing guidelines
Contingency staffing is being implemented for team members diagnosed with COVID. Guidelines for returning to work for other illnesses such as flu are not changing at this time. It is imperative that all team members exhibiting symptoms of illness contact Team Member Health, who can guide you through the appropriate return-to-work guidelines based on your symptoms and diagnosis.
Contingency staffing is applied when increased clinical staffing needs are occurring or are expected due to increased absenteeism due to staff illness. High-risk areas, such as cancer centers and oncology units, will follow conventional guidelines when determining if COVID-exposed team members can return to work. Team members working with the Ballad Health Niswonger Children’s Network, inclusive of Niswonger Children’s Hospital, must contact their manager for an appropriate low-risk assignment before returning to work during contingency staffing.
Here are the contingency staffing guidelines for allowing healthcare personnel with SARS-CoV-2 infection who are well enough and willing to work to return to work:
1) Healthcare personnel with mild to moderate illness who are not moderately to severely immunocompromised:
- At least 5 days have passed since symptoms first appeared (day 0), and
- At least 24 hours have passed since last fever without the use of fever-reducing medications, and
- Symptoms (e.g., cough, shortness of breath) have improved.
2) Healthcare personnel who were asymptomatic throughout their infection and are not moderately to severely immunocompromised:
- At least 5 days have passed since the date of their first positive viral test (Day 0).
- Considerations for determining which team members should be prioritized for this option include:
- The type of healthcare personnel shortages that need to be addressed.
- The types of symptoms they are experiencing (e.g., persistent fever, cough).
- Their degree of interaction with patients and other team members in the facility. For example, are they working in telemedicine services, providing direct patient care, or working in a satellite unit reprocessing medical equipment?
- The type of patients they care for (e.g., consider patient care only with patients known or suspected to have SARS-CoV-2 infection rather than patients who are immunocompromised).
- If healthcare personnel are requested to return to work before meeting all conventional Return to Work Criteria, they should still adhere to the recommendations described below.
- They should self-monitor for symptoms and seek re-evaluation from Team Member Health if symptoms recur or worsen.
- Until they meet the conventional return to work criteria:
- They should wear a respirator or well-fitting facemask at all times, even when they are in non-patient care areas such as breakrooms.
- If they must remove their respirator or well-fitting facemask, for example, in order to eat or drink, they should separate themselves from others.
- To the extent possible, they should practice physical distancing from others.
- Patients (if tolerated) should be offered a mask while interacting with these healthcare personnel.
Vaccines and boosters
It is recommended that team members stay up-to-date on all vaccinations and booster shots. COVID boosters are not mandated, but remain an option for protecting yourself from serious illness.
Updated COVID vaccines from Pfizer-BioNTech and Moderna were released in the fall and are available at most drugstores, primary care offices and at Health Department locations. Please consult with your care provider if you have any questions about the appropriateness of the COVID booster based on your own situation or risk status.
Questions
If you have questions, contact your local Team Member Health office or your facility infection preventionist.
