Patient Safety Guide for Medical Appointments

This guide provides practical steps to help you stay safe during medical appointments and reduce your exposure to COVID-19 and other pathogens present in healthcare facilities. Every infection matters, and everyone faces risks, including the potential for Long COVID.

Types of Medical Appointments

Different kinds of appointments require unique considerations based on their nature and urgency. Use this list to identify challenges and prepare accordingly.

1. Telemedicine (Preferred Option Where Possible)
   • Examples: Consultations, routine follow-ups, medication management.
   • Key Considerations: Opt for telemedicine whenever possible to eliminate exposure risks entirely. Discuss with your provider whether your needs can be addressed remotely.
2. Routine Checkups or Follow-Ups
   • Examples: Chronic condition management, lab tests, regular physicals.
   • Key Considerations: Plan your safety measures in advance and confirm the clinic’s protocols. Focus on necessary care to address immediate health needs while considering how to manage non-urgent items effectively.
3. Urgent or Emergency Care
   • Examples: Sudden illness, injury, or severe symptoms.
   • Key Considerations: Prepare for emergencies by identifying facilities with strong protocols, keeping a “go bag” with essential items, and focusing on safety measures within your control.
4. Specialized Procedures or Diagnostics
   • Examples: Imaging (e.g., MRIs), infusion treatments, minor surgeries.
   • Key Considerations: In addition to taking personal safety measures, coordinate with providers to ensure a safer environment during your visit.
5. Major Operations or Extended Stays
   • Examples: Surgeries requiring anesthesia, hospital admissions.
   • Key Considerations: Plan and negotiate safety measures in advance. Avoid general anesthesia unless absolutely necessary, and pack essential items for prolonged stays.
6. Dental Appointments and Other Unmasking Situations
   • Examples: Dental cleanings, oral surgery, or procedures requiring mask removal.
   • Key Considerations: Refer to the WHN Dental Guidelines for specific precautions.
7. Home Care Services
   • Examples: Home visits for blood draws, vaccinations, travel dentistry, and home care nursing.
   • Key Considerations: Discuss safety measures with providers in advance to establish clear expectations, including when it may be possible to meet outdoors.

Pre-Visit Planning

Preparing ahead of time can help make your medical appointment safer. Seek advice from others on strategies and new technologies for safety in online communities and forums, as well as through programs and meetings hosted by the World Health Network (WHN).

When time allows, call the clinic before your visit to understand their airborne disease prevention protocols and inquire about accommodations if needed. Use email or phone to address questions in advance, reducing the length of your appointment. Plan ahead and bring the tools necessary to support your safety.

An essential part of safe medical care is identifying providers who prioritize precautions and accommodate special requests. Seek advice from trusted networks and resources to find providers known for their proactive safety practices.

The World Health Network (WHN) offers a Provider Database and a business directory on CovidMeetups.com, where you can share and find information about providers. Additional websites and community networking resources are also available.

Levels of Action for Safety

Without precautions, the risks of exposure in the close quarters of medical appointments are high. Take precautions based on your time, resources, and capacity, as every infection prevented is a win. Each level of precaution, no matter how basic, contributes significantly to reducing your risk. These levels build upon one another, empowering you to choose the measures that best suit your situation.

1. Basic Safety Measures
   These measures are generally accessible and provide foundational protection for in-person medical visits.
   • Wear a High-Quality Mask:
     • Use a well-fitted respirator, such as an N95, FFP2, KN95, or KF94. Respirators with head loops (e.g., N95s) generally provide a better fit than those with ear loops.
     • Bring extra masks: Have spares on hand in case one becomes wet or soiled, and to offer to others who may be willing to mask.
   • Schedule Wisely:
     • Request first of the morning, first of the week, or off-hours appointments to avoid crowded waiting areas.
     • Ask about options to check in virtually and/or wait outside until called.
   • Practice Waiting Room Safety:
     • Sit away from others, ideally in a well-ventilated space.
     • Bring extra masks to offer to waiting patients and any unmasked staff who may be willing to wear one.
     • Avoid touching high-contact surfaces and use sanitizer.
2. Enhanced Safety Measures
   These steps offer additional protection for those able to devote additional effort and resources.
   • Bring a Portable HEPA Purifier:
     • Use a handheld purifier with a built-in battery, or bring a larger HEPA filter plugged into a power bank to ensure it’s always on.
     • Position the purifier close to your face with airflow directed at your mouth and nose, or place it nearby to improve air quality near you.
   • Use Higher-Grade Respirators:
     • Opt for respirators with higher filtration efficiency, such as N99 or elastomeric masks.
     • Elastomeric Masks: These reusable masks provide an excellent seal but require proper fit testing due to their rigid structure. While fit testing is advisable for N95s and other respirators, good protection is generally achieved without it.
   • Assess the Environment in Advance:
     • Call ahead to inquire about the clinic’s safety measures, such as air filtration, ventilation, staff masking, and patient distancing.
     • Confirm that healthcare workers wear masks properly and consistently.
   • Request Accommodations:
     • Ask if the facility can make adjustments, such as masking, testing, adding HEPA filters, limiting staff interactions during your visit, or opening windows where possible.
3. Advanced Safety Measures
   These steps provide a very high level of safety for in-person medical visits and require additional effort or resources.
   • Use Advanced Personal Protective Equipment (PPE):
     • Eye Protection: Wear goggles in addition to an N99, N95, or half-face elastomeric respirator. Alternatively, use a full-face elastomeric respirator, which includes built-in eye protection.
     • Powered Air-Purifying Respirators (PAPRs): Consider using a PAPR, which offers high levels of protection. While their cost is significant, discounts and sales can make them more accessible.
   • Ask About Provider Testing Prior to Appointment:
     • Inquire if your provider can test for COVID-19 before your visit.
     • Many providers have experience with testing and may accommodate a respectful request.
     • Timing is crucial: testing within 24 hours of the appointment is helpful, but testing a couple of hours beforehand offers the highest accuracy.
   • Coordinate Care and Facility Arrangements:
     • Request that your procedure or visit takes place in a room with proper ventilation and HEPA filtration for optimal safety.
     • Communicate clearly with healthcare staff to ensure they are informed of and agree to the safety measures during your visit. This may require more than one communication.
   • Bring Additional Tools for Protection:
     • Bring a portable HEPA filter and use directed airflow to create a safer personal environment. If the availability of electrical outlets is uncertain, bring an appropriately sized power bank.
     • Try not to eat or drink, or opt to go outside when you do. If your appointment is too long or you have medical conditions that require you to eat and drink more often, drink and eat while over airflow from HEPA purifiers and ensure no one else is in the room for as long as feasible before you eat.
     • Although healthcare facilities generally prioritize disinfection, consider bringing disinfectant wipes for shared equipment or high-contact surfaces.

General Safety Tips

These general practices can enhance your safety during in-person medical visits, regardless of the specific measures you choose to take.

1. Communicate Your Needs in Advance
   • Call ahead to discuss your concerns and inquire about the clinic’s safety protocols, including ventilation, masking, and air filtration.
   • Politely request accommodations, such as scheduling appointments during less busy times or waiting outside until your turn.
2. Plan Ahead to Minimize Time On-Site
   • Complete any paperwork or pre-visit forms online if available.
   • Use email or phone to resolve questions or concerns that don’t require being in-person.
   • Prepare a list of questions or concerns to make your visit efficient.
3. Monitoring and Precautions Post-Visit
   • Watch for any symptoms of illness in the days following your appointment and consider testing for COVID-19 if symptoms develop.
   • If the visit involved significant exposure risk, test even if asymptomatic, and limit contact with others for two weeks as a precaution.
4. Document Your Experience
   • Take notes on any safety concerns or challenges during the visit, including staff compliance with agreed-upon measures.
   • Consider whether and how to provide constructive feedback to the facility or use the information to make informed decisions about future care providers. Additionally, share your experiences on provider databases or online platforms to help others make safer choices.
5. Leverage Telemedicine When Possible
   • For non-urgent consultations, choose virtual appointments to eliminate in-person exposure risks entirely.

By adopting the safety measures that align with your resources and priorities, you can take proactive steps to protect yourself during medical appointments.