Coronavirus — Pre-Arrival Screening — Clinical Pathway

Pre-Arrival Screening (Epic Travel and Exposure Navigator, Secondary Screening, Testing)

All patients should be screened for travel and exposures using the Epic Travel and Exposure Navigator within 72 hours of their visit.
Patients not screened by phone prior to arrival who have a concerning symptoms or exposures can be seen with appropriate PPE and room engineering per the pathway.
Patients identified by primary EPIC screening with concern for symptoms or exposure to COVID-19 should be called by a clinical team member of each division’s discretion and utilize the Epic Secondary Screening SmartForm to determine if there is true concerned for COVID-19 disease or exposure.
COVID-19 positive (and not cleared) or exposed patients who cannot have their care postponed can be brought to a clinic using the PPE and room engineering per the pathway. Escort from point of entry is recommended at University City.
Pre-Testing
- Any patients undergoing AGPs at their visit are recommended to have pre-visit testing, unless the AGP is planned to be carried out with the appropriate PPE and engineering controls per the pathway.
- Patients with repeated, frequent visits (e.g. PT, OT clinic, PCAM): Utilize local processes of clinic to dictate testing frequency.
Any patients who have a tracheostomy or are ventilator dependent should be provided guidance on how to reduce AGPs in the facility.

Guidance for Patients with Tracheostomy/Ventilator Dependent
Patients Sprinting	Utilize the vent until the parking lot Sprint while in CHOP while wearing HME Bring the vent into the clinic in case it is needed, and also so for the provider to can review.
Patients Not Sprinting	Bring inhaler, not nebulizer, utilize inline suctioning First visit to CHOP outpatient should come via an escort if at university city campus
Patients Arriving Via Transport/Facility	Review aerosol limiting procedures with transport nurses Do not arrange escort if family is familiar with clinic and will come directly to the clinic space

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.