practice management

Preparing Your Pediatric Practice for Winter

Are you ready for winter weather? Before your practice can handle the flocks of families coming in, be sure you’re fully equipped to handle anything the season throws at you. When it comes to winter at your practice, your locale may determine the weather outside, but indoors, every pediatric practice can benefit from a few simple preparations from the lower temperatures and seasonal sniffles. Whether you want to take a renewed look at your staff schedules or make a final push for flu vaccines, it’s always a good time to get ready for winter.

Winter Weather Preparation

Vaccines, Materials, Supplies

If your practice is running flu clinics through the end of the fall season, make sure your vaccine registry data is up to date and you have enough vaccines ordered and safely stored.

In addition to the vaccines and safe storage solutions, what other winter supplies will you need? You might for example decide to make the switch to a 2D scanner to make your vaccine records more accurate and efficient.

The COVID-19 pandemic may have prevented some of your patients from keeping up to date on their vaccine schedules. If your practice offers options such as drive-thru clinics or evening hours, make sure families know! The convenience of these services could help parents make the decision to come in.

Safe measures for the pandemic may require other unique supplies. In addition to masks and hand sanitizer, you could even consider physical barriers such as at the front desk or between chairs in the reception area. The simplest way to do this might be with colorful tape. Outdoors, you might need to set up signs outside for clear instructions on how to enter and exit safely, mask requirements, or even a table and tent for outdoor registration and checkout. 

Don’t forget toys and books -- if you decide using the reception area indoors is safe for your patients, you may still choose to remove highly-touched items like toys, magazines, and books. Non-contact entertainment “supplies” might include links to educational videos or games for appropriate developmental stages. 

Preparing for Weather

You’ll also need to make sure your practice is weather-ready. No matter the weather, it pays to have an emergency plan to help keep the lights on and keep seeing patients. Your plan will be unique to your practice and will help guide you and your staff when things seem bleak. 

To prepare for snow, your practice likely considers factors such as local school closings, road conditions, and parking lot safety. When reviewing your plans for this winter, remember that a strong telemedicine practice can help patients complete their visit, even if the kids are at home and school is closed. You can learn how to get started with telemedicine here

Remote work may also be useful for your practice during inclement weather. Be careful and review your payors’ policies -- some payors require a physician to take telemedicine visits only while physically present at the office. If this situation applies to you, it may be best to close the office and reschedule your patients. However, administrative tasks like these can be begun remotely straight away.

If you decide to keep the office open, review your parking plan. If snow prevented patients from easy access to the office last year, a call to your landlord or your chosen snow removal service may result in a solution. If you pay for your office’s heating, you can make small changes to save money in winter with these tips from the U.S. Office of Energy Efficiency and Renewable Energy.

If winters in your area are mild, you can still prepare a plan in order to keep seeing patients during an emergency, whether that’s a loss of power or a weather event. You might put a plan in place to print your schedule for the coming week, check emergency supplies, and message your patients your updated office hours and alternate ways to reach the office. Check out our post on Weathering Storms and Other Emergencies to learn more about preparedness at your practice.

Drive-thru Flu

Hosting a drive-thru flu clinic could be a great way to wrap up the fall season with a final push for flu vaccination, especially if your practice experiences mild winter weather. You don’t have to make a drive-thru clinic only for flu vaccines -- you can extend this service to include anything your practice is prepared to offer, from well visits to physicals. One PCC practice even set a patient’s cast outside in a tent.

Wondering how to set up your very own flu clinic? Learn how to start from scratch or improve on your past successes with vaccine storage strategies, practical safety tips, and overcoming administrative hurdles with our previous post.

Practices in locales with harsher winters -- you may still be able to host a flu clinic indoors if you have adequate space and if patients pre-register. You can prepare for a safe and effective clinic with this Best Practices for Vaccination Clinics checklist from the National Adult and Influenza Immunization Summit, recommended by the CDC for temporary and off-site vaccination clinics.

COVID-19 Testing & Precautions

The COVID-19 pandemic is likely to be a major concern as your practice prepares for winter. Experts have warned the public that a potential rise in COVID-19 cases could occur in fall and winter, which means that both testing and safety at your practice can help prevent the spread. With precautions and clear messaging as reassurance for families, you can be ready to help everyone stay safe at home, at school, and at your practice.

COVID-19 Testing

If your practice is offering COVID-19 testing, you may have questions about how and what to bill for. Visit PCC’s COVID-19 Links & Resources page for the latest COVID-19 coding and billing recommendations from our resident coding expert, Jan Blanchard, CPC, CPEDC, CPMA.

For patient and staff safety, you may wish to take into consideration the same preparation and set up for COVID-19 testing as you would for a drive-thru clinic, as related above. Precautions during a drive-thru clinic or indoor testing might include asking if anyone present at the visit has had any COVID-19 symptoms as well as recording everyone’s temperature. Your office may mandate face coverings for attendees, discontinue walk-in appointments, or close the waiting room and require families to wait in their cars (more on this below).

Children can be asymptomatic spreaders of COVID-19 as well as adults, so the need for thorough testing remains important for your community and practice. If you do not have the facilities or materials available for testing, you can help your patients by researching sites where children may be tested in your area and referring your patients there.

Practice Management Concerns

Winter can be an important time to review your practice’s policies, staffing needs, and management operations. Knowing your policies ahead of time will help your practice stay on top of last minute childcare needs, sick days, and more. 

Policies your practice should review or record in writing include:

  • Childcare, School, FFCRA, & FMLA 

Together with the need for your practice’s staff to be present for their families as schedules shift, you may find that events at the practice require more manpower to operate effectively, such as during clinics or testing, a rise in demand for telehealth, or simply to respond to waves of sick visits or vaccination appointments. 

When reviewing your schedule for the coming season, consider the staff you already have and their availability -- could your practice do with a temporary or part-time hire to cover the busy season of flu clinics and sick visits? You might also consider staggering schedules in a “firm” and “flexible” cycle. For example, a staff member might volunteer to commit to working one cycle, but gains flexibility in their schedule the following cycle, where they might care for children if needed. Whether the cycle is a day, two weeks, or a month depends on your practice. 

Since each new year comes during winter, it’s also a good season to consider your practice’s goals for the coming months. Consider your budget, revenue, and financial goals for the year -- what challenges could you prepare for ahead of time? Be sure to visit the AAP’s SOAPM forum and more AAP resources for all of your practice’s management needs and to confer with your colleagues.

Your practice’s needs will vary, and as the school year continues, be prepared to be flexible. As staff needs change and school districts make changes, your office schedule will also have to adapt, too.

Winter Safety for Kids and Families

Winter safety this year extends past the usual precautions of bundling up for the cold, as families will need to continue to practice measures to prevent the spread of COVID-19. Kids may also be spending more free time unsupervised, which could result in accidents indoors or out. Your practice can prepare families for a safe winter by encouraging social distancing, mask wearing, and putting an emphasis on safe play.

COVID-19 Safety in Winter

Face covering and social distancing will remain important prior to the widespread use of a pediatric vaccine for COVID-19. Kids may resist mask-wearing less often as they become used to the practice, or as the weather turns and masks keep faces warm, but ongoing educational support from your staff and physicians can help kids understand the importance of the practice.

Precautions should be taken to protect kids and families as they retreat indoors in the winter. This may include a renewal of office sanitization procedures and requirements for masks, limiting the number of occupants in the reception area, or requiring patients to wait in the car for their appointments. If your office can manage it, safe distances of six feet or more inside in the reception room and allowing more time between visits could allow more patients to wait inside the office with fewer periods in which families come into contact with one another. 

On this note, it’s not always possible for families to remain in their vehicle, if they have one. Your practice may need to ask families as they make their appointments whether they can safely wait outside, and if not, prepare a safe space for them. In milder climates, this could be a tent in the parking lot; climates expecting snow might use unused office space.

Again, don’t forget to limit the use of high-contact objects, such as toys and doorknobs, without proper sanitization. The best way for everyone to remain on the same page is to set clear expectations and instructions for each visit. Outdoor and indoor signage with instructions for safe entry and exit from the practices can help keep the flow of traffic safe. Online resources to cover visit expectations, such as in a short pop up message or video, may also be convenient for parents to access before they arrive.

Safe Play

Whether patients are attending in-person school or working remotely this year, it’s clear that usual daycare, after-school activities, or sports will be different for many kids. As kids spend more time at home, the winter may bring a similar pattern as the summer in that they will spend more of their free time in unsupervised play, which can lead to injuries or accidents.

It’s especially important to remind families to dress appropriately for the weather, be wary of vehicles including snow plows, lock away unsafe items at home such as breakable holiday decorations or cleaning supplies, and to set physical boundaries for young children playing alone and clear expectations for older kids and teens.

Clinical Concerns

Many of the traditional clinical concerns of the winter season will be changed in 2020, with concerns of COVID-19 infection high and ubiquitous illnesses such as strep throat and colds less common due to mask-wearing, social distancing, and remote learning and working. Here are some clinical concerns to expect this winter:

  • Behavioral and mental health concerns. Whether due to seasonal affective disorder or in response to a difficult year, your patients may experience more behavioral or emotional symptoms than in previous years. See our previous post for pediatric resources.
  • Frostbite/hypothermia. In communities that experience colder temperatures and snow, these winter concerns are a risk especially for the youngest patients. Resources from the AAP include safe indoor heating and dressing children appropriately.
  • Exercise. Whether your town gets snow or more modest dips in temperature, colder weather can drive more sedentary habits in children. While playing outside is great when safe and supervised, learn how kids can get active inside too!

Inside and out, in the office and at home, there’s a lot to prepare for, come winter! Whether you want to send out messaging on drive-thru clinics or start up a social media campaign to remind patients to dress warmly, your practice can help make this winter safe and fun for everyone with the right preparation and communication. 

Often, the best way to consistently find new and better ways of connecting with your patients is by taking a look at what others are up to. Find out how to keep your finger on the pulse of the pediatric world by checking out our webinar hosted by PCC’s Chip Hart, Build a Better Business by Walking Out Your Door.

Build a Better Business  by Walking Out Your Door

Allie Squires

Allie Squires is PCC's Marketing Content Writer and editor of The Independent Pediatrician. She holds a master's in Professional Writing from NYU.