Pediatric Associates of Richmond

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Archive: Mar 2020

  1. Change is in the Air

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    PARdon me…. but have you noticed that change is in the air?  Spring is here.  The trees are in full color, bulbs are blooming and things are coming to life.  Our world is bathed in impossible shades of green. 

    We are also experiencing far more than a change of season.  It seems as if our whole world is undergoing transformation.  Schools and businesses are closed.  Things we have taken for granted, like toilet paper, of all things, are hard to find.  We are spending lots….and lots….and lots… and lots of quality time with our loved ones – a mixed blessing.  No one could have predicted the extent to which COVID-19 could bring change to so many aspects of our lives.

    It has brought change to PAR as well.  We have had to adjust our hours to meet the change in patient needs.  We have moved our well visits to the Bell Creek and Short Pump locations and have kept our Three Chopt office ready for sick visits.  We have initiated telephone check in at all three locations to limit or eliminate time in the waiting room.  We have asked families to send one parent and no siblings to visits to support social distancing.  Every day we look for ways we can make our service to families safer, stronger, better. 

    There is no denying it, change is stressful.  Here at PAR, it has brought out the best in our families and team.  Families are rising to the occasion.  Many are calling in for advice and self-triaging before coming to see us under the circumstances.  They are switching offices and providers with very few complaints.  I cannot count the number of times I have overheard a parent ask about our well being or encourage us to be safe.  Our team is meeting the challenges on all fronts.   Nicole Midulla, our reception and scheduling manager, with help from her team, quickly and without complaint accomplished the herculean task of moving appointments and locations on short notice.  Our office staff are seamlessly adjusting to the change in flow while maintaining their pleasant demeanor on the phone.  Our nurses continue to provide conscientious care while adjusting to seemingly daily changes in schedules and procedures.  Our providers are continually looking for ways to improve care while supporting each other.  We cannot avoid change but we can control how we respond to it.

    Recently, many of us participated in a virtual meeting of pediatric inpatient and primary care providers in the Richmond area to discuss COVID-19 best practices and recommended standards of care.  I came away from that meeting impressed that our practice, led by our COVID-19 response team (Ashley Sullivan, MD and Jenna Ornelas, RN), is ahead of the curve in following those practices. 

    Wayne W. Dyer says “Change the way you look at things and the things you look at change.”  It is easy to immerse ourselves in the barrage of news and information out there and become completely overwhelmed.  This blog is an attempt to help families manage that.  We had thought that each week we would share with you a new study or information on COVID-19 but soon realized that things are changing on a daily basis.  Instead we want to use this blog as an ongoing opportunity to address an aspect of our new normal and refer you to simple no nonsense resources.  This week, I encourage you to check out the AAP’s (American Academy of Pediatrics’) website HealthyChildren.org under 2019 novel Coronovirus (COVID-19).  It is regularly updated and contains information on the virus, how to care for your family, as well as how to deal with the social and emotional consequences of sheltering in.

    We are here for you.  Please reach out if there is information you need or a topic you would like covered in a future blog.  In the meantime,  PARdon me……….

    Laura Duke, CPNP, IBCLC

  2. Office Hours Changes

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    Beginning Monday, March 30, the following changes will go into effect:

    Three Chopt location: Monday – Friday 7:30 am – 5:00 pm Saturday 8:30 am – 12:00 pm

    Bell Creek and Short Pump locations: Monday – Friday 9:30 am – 5:00 pm

    Appointments will not be scheduled later than 4:30 pm. Beginning at 4:30 pm, all urgent medical concerns will be addressed by the on-call provider by phone.

    We know that many parents rely on our evening hours for urgent, same-day sick visits. However, due to recent diminished demand, and to help meet the child care needs of our staff, evening hours will be temporarily suspended. We will notify parents by email, here on this blog, and on social media when we return to our normal extended hours schedule. Thank you for your patience and understanding with all these changes. We will continue to be as adaptable as possible, and thank you for the honor of providing healthcare for your children.

    -The Staff of Pediatric Associates of Richmond

  3. Parking Lot Check-In Now Available @ All 3 Offices

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    Online check-in from the parking lot of all 3 office locations is now available. This resource allows you to wait in your car until your exam room is ready. It minimizes the number of people in the waiting room at a given time, and optimizes safety for you, your children and our staff.

    The host, waitlistme.com, does not see or store your information. Only PAR staff will be able to see the information you submit.

    Below are instructions for checking in for you child’s appointment.

    1. Park in lot of scheduled office location
    2. Visit our homepage PARpeds.com
    3. Click on “Parking Lot Check-In”
    4. Select the appropriate office from the drop-down menu
    5. A new tab/window will open
    6. Confirm you clicked on the correct office location
    7. Enter the patient’s name & your phone number and click “+Add”
    8. You will receive a text acknowledging you’ve been checked in
    9. You will receive a second text when your exam room is ready
    10. Come in and receive further instructions from front desk staff

    If you do not receive a confirmatory text stating you have been checked in, try the process again. If still no confirmatory text, call our main number (804-282-4205) or come in to see a front desk staff member. This is obviously a new procedure for us. Please bear with us as we troubleshoot any issues that arise.

    Please do not use this service until you are parked in our lot. This should not be used to let us know you are on your way.

    Do not leave your child unattended in your car for any reason.

    Previous COVID-19 Blog entries:

  4. Sick Visit Parking Lot Check-In

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    Beginning Thursday, March 19, we will offer online check-in for sick visits. This will be encouraged but optional, and will apply to the THREE CHOPT OFFICE ONLY. Online check-in allows you to wait in your car with your child until your exam room is ready.  It minimizes the number of people in the waiting room at a given time, and optimizes safety for you, your children and our staff.

    The host, waitlistme.com, does not see or store your information. Only PAR staff will be able to see the information you submit.

    Below are instructions for checking in for you child’s appointment.

    1. Park in the Three Chopt office parking lot
    2. Visit our home page PARpeds.com
    3. Click on the blue button that reads, “Three Chopt Parking Lot Check-In
    4. A new tab/window will open up
    5. Enter the patient’s name and your phone number and click “+Add”
    6. You will receive a text acknowledging you’ve been checked in
    7. You will receive a second text when your exam room is ready, asking you to proceed to the front desk for further instruction.

    This is obviously a very new procedure for us. Please bear with us as we troubleshoot any issues that arise. You may either call our main line 804-282-4205 or come to the front desk if you do not receive a confirmatory text stating you have been checked in.

    Please do not use this service until you are parked in our lot. This should not be used to let us know you are on your way.

    Do not leave your child unattended in your car for any reason.

    Helpful COVID-19 Links:

    CDC COVID-19 Landing Page

    CDC FAQs regarding COVID-19 & Children

    Children’s Hospital of Richmond – What You Need to Know

    JAMA Pediatrics Patient Page – What does COVID-19 mean for families?

    Virginia Department of Health COVID-19 Landing Page

    Previous COVID-19 Blog Entries:

  5. Virtual Prenatal Class

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    Dear Parents-to-be,

    Happy St. Patrick’s Day, and congratulations on the upcoming arrival of your baby! Thank you for your interest in Pediatric Associates of Richmond. We wish we could do this month’s prenatal visits in our office, but we feel it’s safest to exercise an abundance of caution. On the relative short notice we were unable to organize/coordinate the Facebook Live feed for tonight. Instead, later today Dr. Grabill will be posting an introductory video of topics usually covered at our prenatals. He will be logged into our Facebook account from 7:30 to 8:00 pm tonight, March 17, to answer any follow up questions. If they are general questions that you think would benefit other viewers, please ask the questions in the post’s comments section. If they are unique or personal questions, you can ask them via Facebook messenger.

    Again, we thank you for your interest and for your understanding with the last-minute changes. We hope to have the privilege of walking alongside you these next 18 years – helping you navigate the joys and stresses of parenthood.

    Sincerely,

    The Physicians and Staff of Pediatric Associates of Richmond

  6. Office Hours, Locations & Appointment Changes

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    Beginning Wednesday, March 18 all well child office visits will be scheduled at the Short Pump and Mechanicsville offices. This includes routine check ups, medication checks, conferences and lactation visits. If you have one of these appointments scheduled 3/18-3/27 for the Three Chopt location, or if we have to change your appointment time or provider, we will call you to reschedule. We are beginning to make these phone calls this weekend.

    Sick visits will be exclusively at our Three Chopt location.

    Any child with symptoms & known or potential exposures to COVID-19 will not be evaluated in our offices. These patients will remain in their car with their parent. Parents should call us upon arrival to the Three Chopt office parking lot. We will then send a member of our clinical team out to your car to assess your child. ***As with all other visits, these will be by appointment only, and should be scheduled prior to your arrival to the parking lot.***

    Please be advised of the following changes to office hours:

    • Mechanicsville and Short Pump locations will be open 8:30 am-5:00 pm
    • Three Chopt location will be open 7:30 am-6:00 pm

    In an effort to minimize exposure risk, we have designated certain providers for well child visits only. We appreciate this may mean a different provider will see your child than previously scheduled. Or, that your appointment may have to be moved to an alternate office location or time. We will accommodate any secondary provider, location and time preferences when possible. We apologize for any inconveniences these changes may cause. We will continue to be as safe and proactive as possible.

    These provider, location and office hours changes will be revisited on a week-by-week basis. At minimum, the above changes will be in place through March 27th.

    Previous Blog Posts are below

    For more information on COVID-19 we recommend the following websites:

    https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

    CDC FAQs regarding COVID-19 & Children

    Children’s Hospital of Richmond – What You Need to Know

    JAMA Pediatrics Patient Page – What does COVID-19 mean for families?

  7. COVID-19 (Coronavirus) Initial Steps

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    The following risk-minimizing processes we are implementing effective today, March 12, 2020:

    1)      1 patient, 1 parent. Whenever possible, we ask that only the patient and 1 parent/guardian come to the office for visits. We understand that due to child care availability and other extenuating circumstances, this may not always be feasible. But when possible, we believe this is a great way of minimizing potential or unnecessary exposures.

    2)      All books, magazines, toys and coloring materials removed from our waiting rooms. Please bring your own activities to keep your child occupied – electronic devices welcome, if need-be.

    3)      Check-Ups for sick children.  At this time, we are not canceling any previously scheduled well child check-ups. However, if your child has any illness symptoms on the day of their check-up, please call us ahead of time so that we may appropriately triage.

    4)      Phone Triage. When calling in for a sick visit you need to disclose to us if you have reason to believe your child has or might have COVID-19 based on symptoms AND exposures:

    • Recent travel (international, domestic, or cruises)
    • Contact with someone who has, has been formally tested for, or is suspected of having COVID-19

    5)      Put It In Park.  Any child who has risk factors for COVID-19 based on phone triage will NOT be seen in the office. Rather, we have set up a system for your child to be assessed by our clinical team while you and your child are parked in our side lot, near the water towers. Our clinical team will determine on a case-by-case basis who needs to be tested for COVID-19. Not everyone seen in our Put It In Park protocol will need COVID-19 testing. Until further notice, this protocol will take place at the Three Chopt office location only.

    • NOTE: due to laboratory processing constraints, we are not able to provide testing after 3:30 pm on weekdays, nor during weekend hours.

    Click here for our COVID-19 testing FAQs

    Helpful COVID-19 Links:

    CDC COVID-19 Landing Page

    JAMA Pediatrics Patient Page – What does COVID-19 mean for families?

    Children’s Hospital of Richmond – Coronavirus: What You Need to Know

    Virginia Department of Health COVID-19 Page

  8. COVID-19 Testing FAQs

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    1)       Who should get tested? At this time only patients with symptoms AND exposure risk factors.

    2)       How is testing done? We obtain a sample from the back of the nose and/or throat using swabs similar to the strep and flu swabs.

    3)      How long does it take to get results? Expected turnaround time is now (as of 3/30/2020) 7-10 days.

    4)      What should we do while awaiting test results? Stay home so that friends, family and neighbors are not exposed. Monitor your child’s hydration and breathing closely. If you have concerns about your child being dehydrated or having difficulty breathing, call our office. If our clinical team believes your child needs urgent evaluation, we will refer you to a local emergency room and we will inform that ER team prior to your arrival.

    5)      What are “next steps” if my child tests positive? Fortunately, there have been little to no known serious outcomes in pediatric patients. We should, nevertheless, remain vigilant. Your child should remain quarantined in a specific room, and ideally use a separate bathroom from every other family member. As noted above, monitor your child closely for signs of dehydration or breathing difficulty. The duration of home quarantine will be based on recommendations of your local health department at the time of confirmed positive test.

    Helpful Resources/Links:

    PAR COVID-19 Blog Home

    https://www.chrichmond.org/blog/coronavirus-what-you-need-to-know

    JAMA Pediatrics Patient Page – What does COVID-19 mean for families?

    https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

    http://www.vdh.virginia.gov/surveillance-and-investigation/novel-coronavirus/