From: The changing landscape of pharmaceutical alternatives to the unregulated drug supply during COVID-19
Changes to services | iOAT N = 19 | TiOAT N = 3 | SS N = 60 | Total N = 82 |
---|---|---|---|---|
Staffing totals | 12 | 1 | 77 | 90 |
Added positions | 8 | 1 | 29 | |
Reduced/redeployed positions | 3 | 0 | 24 | |
Staff worked from home | 1 | 0 | 23 | |
Staff hours staggered | 0 | 0 | 1 | |
Ancillary services totals | 32 | 4 | 91 | 133 |
Referrals delayed/canceled | 5 | 3 | 10 | |
Community meetings eliminated | 2 | 0 | 1 | |
Care moved outdoors | 1 | 0 | 2 | |
Virtual ancillary care | 12 | 1 | 45 | |
Reduced services/activities | 5 | 0 | 21 | |
Bulletin board, books, fabric, art supplies removed | 3 | 0 | 14 | |
Food services reduced/take-out only | 4 | 0 | 4 | |
Program operations totals | 102 | 18 | 222 | 342 |
No new client intakes | 12 | 1 | 7 | |
Screening upon entry or pre-screened by phone | 17 | 3 | 35 | |
Staff required to wear PPE | 15 | 3 | 30 | |
Clients encouraged/required to wear PPE | 16 | 3 | 31 | |
Increased access to/expectation of hand sanitizer use/handwashing upon entry | 15 | 3 | 23 | |
Reduced laboratory hours | 6 | 1 | 7 | |
Video/phone appointments | 12 | 3 | 44 | |
Reduction in frequency patients seen by physician | 6 | 1 | 32 | |
One clinician covers all in-person appointments | 0 | 0 | 2 | |
Mobile team created to support clients at home | 1 | 0 | 9 | |
Limited/restricted outreach to clients at home | 2 | 0 | 2 | |
Use of physical space totals | 121 | 21 | 226 | 368 |
Reduced/repositioned furniture | 14 | 3 | 23 | |
Reduced # of clients in clinic/injection room | 18 | 3 | 32 | |
Reduced # clients in chill out/waiting/shared activities room | 14 | 3 | 23 | |
Bathrooms closed to patients | 2 | 2 | 2 | |
Client entry denied/discouraged for non-treatment purposes | 10 | 3 | 16 | |
Creation/use of isolation room | 8 | 0 | 12 | |
Physical distancing enforced | 13 | 3 | 20 | |
Plexiglass installed | 6 | 0 | 16 | |
Additional/enhanced cleaning | 18 | 3 | 52 | |
Decreased amount of space available for treatment | 5 | 0 | 15 | |
Limited tours/fellowship placements | 13 | 1 | 15 | |
Client protocols totals | 129 | 13 | 205 | 347 |
Reduction in urine drug test frequency | 12 | 1 | 26 | |
Swabbing clients suspected of being COVID+ | 11 | 1 | 16 | |
Stop/reduce post-dose adverse reaction monitoring period | 15 | 0 | 13 | |
Take-home/carries to stable patients | 13 | 1 | 27 | |
Reduced # of injections (with patient consent) | 7 | NA | NA | |
Less frequent dose pickup | 2 | 1 | 12 | |
Extending/renewing prescriptions at the pharmacy | 0 | 0 | 14 | |
TiOAT/iOAT patients offered safe supply | 6 | 1 | NA | |
Daily delivery | 3 | 1 | 25 | |
Shorter titration schedule/expedited dose increases | 8 | 0 | 33 | |
Transition to oral OAT encouraged | 10 | 1 | 1 | |
Pre-filled syringes | 2 | NA | NA | |
Provide/replace oral hydromorphone in addition to iOAT | 14 | NA | NA | |
SROM administered as full capsule (no sprinkles) | 12 | 3 | 16 | |
Changed overdose response/Code Blue procedures | 14 | 3 | 22 |