Reopening your office amidst the COVID-19 pandemic can be more stressful than closing your office to begin with.  Taking the appropriate precautions, making modifications to all aspects of your practice, and planning ahead can help ensure the safety of you, your office staff, and your patients. Determining where to start can be overwhelming; the following tips were developed to help guide you in making plans for your own reopening. Be sure to check out all of APMA's COVID-19 Response resources.

Practices must still comply with state-mandated social distancing guidelines.

• Limit the number of patients in the office reception area by utilizing a phone or text check-in process allowing patients to wait in their cars.
• For patients without a car, consider placing them immediately in an exam room.
• Send insurance/patient forms in advance of the appointment time so patients can complete them at home prior to arriving, limiting time spent in the reception area. 
• Prepare a list of information to be shared with patients during their appointment confirmation that includes updates to your office check-in/arrival process. 
• Schedule appointments far enough apart to limit patient overlap; schedule telehealth appointments during downtime in between in-person patients. 
• Check with your state's social distancing guidelines in the most recent executive order issued by your state.  
• Brainstorm and collaborate with other office staff to determine ways to continue to make your office as contactless as possible.

Require all patients to report any known exposure to COVID-19 and establish a protocol for isolating and/or treating infectious patients. 

• Consider surveying all patients of symptoms, including temperature checks with a touchless thermometer prior to entering the office.

Modify staff work areas and schedules to limit shared work spaces and promote physical distance.

• Consider installing plexiglass shields at the front desk counter.
• Re-think the check-in/check-out process to limit the use of shared pens, clipboards, and electronic signature equipment.
• If possible, have patients provide insurance/payment information via phone prior to the appointment.
• Modify office traffic patterns to limit cross-traffic by patients and staff.

Ensure social distancing in the reception area.

• Remove excess chairs from your reception area so patients are not sitting directly next to one another.
• Remove shared magazines, toys, complimentary beverage stations, etc.
• Reserve specific appointment times/days for elderly, immunocompromised, or other patients considered high-risk.

Make sure to be well-stocked with the appropriate supplies.

• Provide hand sanitizer for patients and staff.
• Require the use of masks or cloth face coverings for all office staff and patients.
• Consider providing disposable masks for patients who may not have one. 
• Evaluate what PPE is required for staff conducting exams or routine treatments. 
• Check out the medical suppliers in the APMA Buyers' Guide as additional resources for acquiring necessary supplies.
• Anticipate supply needs earlier than normal to allow for more time to source required materials.
• Expect to order supplies in limited quantities as many suppliers are placing limits on high-demand items. 

Only allow adult patients in the exam room alone, unless an aide or companion is required.

• Require office staff to disinfect doorknobs and other shared surfaces in the exam room in between patients.
• Consider implementing more rigorous nightly cleaning routines for all areas of your office.