to main content Coronavirus (COVID-19) Guidance and Resources | 91㽶Ƶ

91㽶Ƶ

91㽶Ƶ recognizes the incredible challenge that health care organizations and front-line workers face with the COVID-19 crisis.

Statements to Support Our Health Care Providers 

August 14, 2020 – Removal of Position Statement

May 27, 2020 – Regular Surveys and Reviews to Resume in June — With Some Changes to Protect Safety

May 12, 2020 – Statement on Removing Barriers to Mental Health Care for Clinicians and Health Care Staff 

For additional statements, please see Webinars and Communications from 91㽶Ƶ below.

COVID-19 Lessons Learned: A Resource for Recovery 

This new whitepaper, co-authored by Deloitte & Joint 91㽶Ƶ Resources, covers specific actions that organizations have taken to address issues and provides access to guidance and tools that health care leaders can use to create and enact their own plan to address these challenges.

Offsite (Formally Virtual) Survey and Review Framework: A New Approach for Conducting Surveys and Reviews During the Pandemic

More information on what you can expect:

  • Podcast: Take 5: Discussing Offsite Surveys from 91㽶Ƶ
  • Video:
  • Video:
  • Video:
  • Video:
  • Infographic: Offsite Survey

Educational Videos about Vaccination and the COVID-19 Vaccine

CDC and National Alliance of Healthcare Purchaser Coalitions:

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Resources related to personal protective equipment:

IDSA recommendations on PPE when caring for COVID patients

Face Mask Posters and Infographics

Videos - Consistent with CDC recommendations as of March 24, 2020 

As of March 24, 2020, CDC recommends:

  • Contact Plus Droplet plus Eye Protection when providing routine care to known or suspected COVID-19 patients. 
  • Airborne Plus Droplet plus Eye Protection when performing aerosol generating procedures on known or suspected COVID-19 patients. 

These videos provide an example using disposable gowns.  It is essential that the instructions to employees take into account the specific PPE the facility is using (e.g., reusable versus disposable gown, N95, PAPR, or surgical mask, goggles, glasses with side shields, or faces mask) being used as well as the physical layout (e.g., ante-room, no ante-room, multiple patient room) and how the organization is utilizing the PPE (e.g., single use, reuse, or extended use). 

Combinations of PPE should be considered.  For example, if practicing extended use of N95 respirators (recommended by NIOSH) the organization should consider using face shields that will protect the respirator from splashes or splatters and prevent staff from inadvertently touching surfaces of the respirator while in use.

CDC Guidance on Managing Critical Shortages

CDC Guidance on Optimizing the Supply of PPE During Shortages

  • Summary Strategies to Optimize the Supply of PPE during

FDA Guidance on Managing Critical Shortages

Note: In reviewing FDA guidance on strategies to conserve gloves, you need to know what type of gloves you use in your facility (e.g., latex, vinyl and nitrile). It is safe to use alcohol-based hand rub on latex and nitrile gloves. But the FDA states that alcohol is not recommended for cleaning vinyl gloves because it may degrade them.  

Guidance related to ventilators:

There are intensive efforts underway across the country to try to ensure that the supply of ventilators in the U.S. will be adequate to meet the needs of all COVID-19 patients requiring one. Healthcare leaders and clinical directors should review the FDA’s guidance and the other resources below on mitigation strategies when facing ventilator shortages.

If Shortages Occur Despite Mitigation Strategies
Even with these mitigation strategies, the possibility remains that shortages will occur, and clinicians and healthcare leaders will face the decision of whether to place two patients with COVID-19 on a single ventilator. Experts have differing opinions about whether ventilator sharing can be done safely and effectively. 91㽶Ƶ does not endorse any position because there is not sufficient evidence to guide us. In such situations, we usually remain silent, but we think it is important to provide resources for those who might be facing this difficult decision.

The Society of Critical Care Medicine, in partnership with several other organizations, : “Attempting to ventilate multiple patients with COVID-19…could lead to poor outcomes and high mortality rates for all patients cohorted. …it is better to purpose the ventilator to the patient most likely to benefit than fail to prevent, or even cause, the demise of multiple patients” (March 2020).

However, SCCM’s Mechanical Ventilator Strategies page also included a section labeled “When You’re Out of Options” which provided links to resources for mechanically ventilating two patients with a single ventilator in crisis situations.


Other organizations have drawn different conclusions and have provided advice on how to set up systems to share ventilators in March/April 2020:
  • ECRI: on setting up mechanical ventilator sharing
  • FEMA: During a Critical Ventilator Shortage
  • Greater New York Hospital Association (GNYHA)/NY Presbyterian:  (version 3)

More recently, the FDA released a letter to Health Care Providers in February 2021, containing the following text and a link to the most current version of the GNYHA/NY Presbyterian Ventilator Sharing Protocol (version 6):

  • FDA:  

The FDA is informing health care providers and health care facilities about up-to-date information concerning multiplexing ventilator tubing connectors, also known as ventilator splitters, in situations in which no alternatives for invasive ventilatory support are available. Although the FDA has not received any adverse event reports related to the use of ventilator splitters authorized for emergency use during the COVID-19 pandemic, recent literature describes risks that may be associated with using certain ventilator splitters. After considering this recent literature, the FDA is informing health care providers and health care facilities that the literature indicates that certain features are associated with better performance.

High Flow Nasal Oxygen

  • Some patients can be effectively managed on nasal oxygen including high flow, but the risk of aerosolization should be considered and managed.
  • An FAQ from the ASA says that if patient oxygenation is not maintained on low-flow oxygen, higher oxygen flows may be unexpectedly needed that might increase aerosolization of COVID-containing respiratory secretions. Each patient will need to be evaluated on a case-by-case basis to consider the balance of aerosolization at the oxygen flow needed to maintain a satisfactory oxygen saturation, and whether to convert to a more closed airway system (LMA or ETT). ? (View under Clinical Care section)

FDA Guidance

Other Guidance

Resources related to staffing and telehealth:

Joint 91㽶Ƶ FAQs

Joint 91㽶Ƶ Quick Safety

Center for Connected Health Policy


US Health and Human Services Resources

  • Telehealth: for Patients and Providers on Using Telehealth

CMS Resources

Additional resources available regarding COVID-19:

Ambulatory health care-specific resources:

Note: For resources regarding PPE, please see the PPE section. For resources regarding Telehealth, please see the Staffing and Telehealth section.

Joint 91㽶Ƶ Webinars

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, environment of care/life safety and Joint 91㽶Ƶ standards.

Joint 91㽶Ƶ FAQs

CDC Resources 

Note: CDC Updates regularly. Please refer to this guidance in addition to the resources listed here.

  • for Critical Infrastructure Workers who may have had Exposure to a Person with Suspected or Confirmed COVID-19
  •  — Note: Interim guidance on breastfeeding for a mother confirmed or under investigation for COVID- 19 can be found on the CDC website.

CMS Resources

  • Guidance for Infection Coronavirus Disease in Outpatient Setting:

FDA Resources

  • Managing drug shortages:

Preparing for COVID-19 Vaccination

Other Resources

  • National Institute for Children’s Health Quality (NICHQ):
  • Assistant Secretary for Preparedness and Response (ASPR):
  • Ambulatory Surgery Center Association:

Resources Specific to Re-opening/Continuing of Services

  • American College of Surgeons, American Society of Anesthesiologist; Association of periOperative Registered Nurses, American Hospital Association — Joint Statement:
  • American Medical Association COVID-19:
  • American College of Surgeons:

Resources Specific to Secondary Disasters (e.g., Hurricanes)

  • Healthcare System Preparedness for  During COVID-19

Behavioral health care and human services specific resources:

Home care-specific resources:

Note: For resources regarding PPE, please see the PPE section. For more resources regarding Telehealth, please see the Staffing and Telehealth section. 

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, 1135 waivers and telehealth.

Infographics

Joint 91㽶Ƶ FAQs

CDC Resources

Note: CDC Updates regularly. Please refer to this guidance in addition to the resources listed here.

  • for Implementing Home Care of People Not Requiring Hospitalization
  • for Persons with COVID-19 Not in Healthcare Settings

Preparing for COVID-19 Vaccination

Resources Specific to Hospice

  • Concerning Coronavirus Disease 2019 by Hospice Agencies

Resources Specific to Pharmacy Infusion/Specialty/Ambulatory Infusion

Joint 91㽶Ƶ FAQs

FDA Resources

  • Managing drug shortages: 

Hospital-specific resources:

Note: For resources regarding PPE, Ventilators and other relevant topics, please see the appropriate section on this webpage.

Joint 91㽶Ƶ Webinars

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, life safety and 1135 waivers.

Disease-Specific Care Q&A Webinar

Recommendations on Hospital Surge Capacity

Infographics

FDA Resources

  • Managing drug shortages:  

Preparing for COVID-19 Vaccination

Note: CDC Updates regularly. Please refer to this guidance in addition to the resources listed here.

Laboratory services-specific resources:

Note: For resources regarding PPE, please see the PPE section.

Joint 91㽶Ƶ FAQs

Joint 91㽶Ƶ Webinars

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, environment of care/life safety, CMS 1135 Waivers, and Joint 91㽶Ƶ standards.

CDC Resources

Note: CDC Updates regularly. Please refer to this guidance in addition to the resources listed here.

  • (DLS) – Laboratory Outreach Communication Systems (LOCS)
  • - Interim guidance and resources for laboratory professionals working with specimens from persons under investigation (PUI) for coronavirus disease 2019 (COVID-19)



FDA Resources


CMS Resources


  • During the COVID-19 Emergency

Nursing care center-specific resources:

Note: For resources regarding PPE, please see the PPE section.

Joint 91㽶Ƶ Webinars

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, environment of care/life safety, CMS 1135 Waivers, and Joint 91㽶Ƶ standards.

PPE Videos

Consistent with CDC recommendations as of March 24, 2020

Joint 91㽶Ƶ FAQs 

CDC Guidance

Note: CDC Updates regularly. Please refer to this guidance in addition to the resources listed here.


CMS Guidance

FDA Resources

  • Managing drug shortages:

Preparing for COVID-19 Vaccination

Other Resources

  • Leading Age:
  • American Health Care Association: 
  • OSHA:

Infographics

Blog

Resources Specific to Re-opening


Some communities in the United States have not been hit with the COVID-19 pandemic yet. These materials are targeted for those who are still preparing:

Staff Health and Wellbeing resources:

Watch webinar replays and read communications from 91㽶Ƶ:
Webinar Replays

Hospital Q&A Webinars

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, life safety and 1135 waivers.

Home Care Q&A Webinars

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, 1135 waivers and telehealth. 

Laboratory Q&A Webinar

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, environment of care/life safety, CMS 1135 Waivers, and Joint 91㽶Ƶ standards.

Behavioral Health Care Q&A Webinar

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, environment of care/life safety, CMS 1135 waivers and Joint 91㽶Ƶ standards.

Nursing Care Centers Q&A Webinar

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, environment of care/life safety, CMS 1135 Waivers, and Joint 91㽶Ƶ standards.

Ambulatory Health Care Q&A Webinar

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, environment of care/life safety and Joint 91㽶Ƶ standards.

Disease-Specific Care Q&A Webinar

Leaders from 91㽶Ƶ answer questions on topics including infection prevention and control, 1135 waivers and Joint 91㽶Ƶ standards.

Communications
  • October 26, 2020 – Status of Onsite Survey Activity
  • August 14, 2020 – Removal of Position Statement
  • May 27, 2020 – Regular Surveys and Reviews to Resume in June — With Some Changes to Protect Safety
  • May 12, 2020 – Statement on Removing Barriers to Mental Health Care for Clinicians and Health Care Staff.
  • April 23, 2020 – Universal Masking Statement.
  • April 6, 2020 – FAQ in Response to 91㽶Ƶ Statement on Use of Face Masks Brought From Home.
  • April 1, 2020 – All Joint 91㽶Ƶ surveys and reviews will remain on hold until the end of May.
  • March 31, 2020 – Joint 91㽶Ƶ Statement on Use of Face Masks Brought From Home.
  • March 27, 2020 – Public Statement on the Shortages of Critical Medical Equipment.
  • March 16, 2020 – 91㽶Ƶ is suspending all regular surveying.
  • March 9, 2020 – 91㽶Ƶ continues to actively monitor COVID-19 activity.
  • February 25, 2020 – 91㽶Ƶ believes it is time for hospitals to prepare for a possible surge of Coronavirus patients.
  • February 14, 2020 – Information and guidance on what your organization needs to know about COVID-19.

Joint 91㽶Ƶ Advocacy Actions to Aid Health Care Organizations in Response to COVID-19:

For more information, visit our Federal Relations and Public Policy page.

Federal Relations and Public PolicyLearn more about Federal Relations and Public Policy

CDC Resources

  • that allows users to view and filter through CDC guidance on COVID-19
  • webpage, which includes links to webinars and other resources on topics including clinical care and infection control, PPE, nonpharmaceutical interventions, emergency preparedness and response, and others
  • that will be updated each Friday and will summarize and interpret key indicators, including information related to COVID-19 outpatient visits, emergency department visits, and hospitalizations and deaths, as well as laboratory data


FDA Resources

OSHA Resources

– NEP ensures that employees with increased potential exposure to SARS-CoV-2 are protected from contracting the virus and are able to reporting issues without retaliation.

Additional resources:
  • Webinar: : Treating Suicidal Patients During COVID-19: Best Practices and Telehealth
  • American College of Surgeons COVID Resources:

Real Voices. Real Stories.

Just like many of you, Joint 91㽶Ƶ enterprise staff who are also working on the front lines are facing real challenges. We’d like to share some of their personal experiences.

View storiesRead stories from Joint 91㽶Ƶ staff working on the front lines of COVID-19

 

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