UCSF Division of Geriatrics Weekly Updates (3/20/2020) from Chief Dr. Louise Walter
In the spirit of coming together and social solidarity during this time of physical distancing, I’m launching the inaugural Geriatrics Division Weekly Update to keep everyone more informed about what is happening across the Division. This is a difficult, unsettling time and the ageism in some media reports is disheartening. However, the Geriatrics Division is stepping up in so many ways to help elders across multiple settings during this pandemic.
UPDATES ACROSS THE DIVISION
UCSF outpatient programs: All Geriatrics programs are continuing but at reduced capacity and have transitioned to >95% video visits. Clinicians are also working diligently to develop ways to outreach to our most vulnerable older patients. We are working on processes to test homebound patients at home for COVID-19 and collaborating with our community partners.
UCSF inpatient Programs: While our Acute Care for Elders (ACE) unit on 15 Long has been converted into a closed COVID-19 unit, we are running a Mobile ACE program to assist higher risk older adults on all units of Moffitt-Long hospital. Geri-Ortho Co-management and Geriatrics Consult Services are running as usual, with a lower census due to halting of elective orthopedic and ortho-spine procedures. We are trialing GrandPad tablets to prevent isolation for hospitalized older adults next week and assisting hospitalists. Our workforce is healthy.
San Francisco VA: Ken McQuaid awarded John Newman a Hero Award for stepping in at the last minute to cover a medicine ward team whose attending was pulled to cover COVID-19 activities. Outpatient clinics have transitioned to telephone visits.
ZSFG: ZSFG and community clinics have created new patient flow protocols through primary care, urgent, and emergent care to cohort people with respiratory symptoms. All outpatient clinics are doing as many telephone visits as possible. With guidance from Anna Chodos and Carla Perissinotto some clinics are doing targeted outreach to older patients.
Fellowships: We are proud of the dedication to the very high-risk patients that our fellows take care of at multiple sites. Our goal is to ensure that our fellows and their patients remain safe. Currently, no fellow is allowed to see patients suspected to have or confirmed to have COVID-19. Fellows’ clinics have shifted to telemedicine and all our didactic learning has shifted to Zoom. Lynn Flint is developing a distance learning leadership curriculum. We do expect that all our fellows will graduate on time. Lynn Flint and Eric Widera attend UCSF fellowship directors’ huddles three times a week for fellowship updates and best practices. Should an otherwise healthy fellow need to be quarantined due to exposure to COVID-19, we plan to create an individualized learning/study plan for that time, which will not be counted as Leave or Deficits in Required Training Time.
RESEARCH: Ashwin Kotwal and Carla Perissinotto will be conducting a survey to learn about how social distancing for COVID-19 is affecting the health and well-being of older adults to determine how to mitigate these effects.
GWEP: Anna Chodos is the Geriatrics Lead for the SF Department of Public Health. She is part of the Department of Disability and Aging Service’s response team helping support on-going community services and create new programs (e.g., training home care workers to care for older adults with COVID-19), as well as providing community outreach to support SNF and RCFE responses to COVID-19.
POLICY: Brie Williams’ team is working closely with California Department of Corrections and Rehabilitation to develop policies and procedures to stem the risk of COVID-19 transmission to patients and staff in correctional facilities (e.g., decreasing the number of incarcerated older adults, improving ability of residents to communicate with family members and friends, and optimizing health and safety). Hospitals must remember to include prisons (which are outpatient facilities) in their disaster preparedness planning.
STAFF: All Division staff are now working from home unless they are providing direct patient care. Staff are checking in with their managers regularly. Several staff, fellows and faculty are using Slack to stay up to date on announcements (it’s a chatroom with different channels).
CLINICAL UPDATES FROM OUR HEALTH SYSTEMS
San Francisco VA: No confirmed cases of COVID-19 at SFVAMC.
UCSF Health: 7 hospitalized cases at UCSF; https://coronavirus.ucsf.edu/
ZSFG: Number of cases not reported.
GERI HALF DAY on Wednesday March 25th 1-4pm on Zoom
1-2pm: Messaging about Geriatrics stepping forward to be part of the solution during this pandemic.
2-3pm: Case Presentations by Geriatrics Fellows
3-4pm: Well-being Check-in
CRAFTING HEATH SYSTEM ALGORITHMS FOR ELDERS
Leah Witt and Geriatrics colleagues created a dot phrase for EPIC to provide guidance about COVID-19 and older adults (.gericovid). Word document is in UCSF Box link below. Please send me news about your work to geriatricize policies and procedures in our health systems and communities.
MAXINE’S WEEKLY TIPS
UCSF’s Back Up Care program has been extended to support essential on-site staff who do not have alternative child care options. It provides center-based or in-home child care. Faculty, residents, and clinical fellows can continue to access this program. To learn more please visit this UCSF Family Services page. Also, see attached Life Continuity Resources for Individuals and Families for links to resources about self-care, family care, COVID-19 and remote work tips.
RESOURCES ABOUT COVID-19 AND ELDERS
Sarah Ngo has created a UCSF Box folder to store/collate resources about COVID-19 and older adults. GWEP is working on developing a webpage to make these resources available to the public. We will continue to add to this as we get more resources: https://ucsf.app.box.com/s/2ttrkxnmfp9rsfb5qwwslhqnmo6vr13v
If you have other suggestions for maintaining our social connectedness during this time, please email me. Also, please do not suffer in silence. This is a challenging time for many reasons so if you need help or have concerns please reach out to me or your clinical leaders.
Take care!
Louise