Restoration of Operations - UT Southwestern Medical CenterLast Updated Saturday, 9 May 2020 at 3:00 pm Page 1 Restoration of Operations Executive Summary On Monday, March 16, UT Southwestern

Last Updated Saturday, 9 May 2020 at 3:00 pm Page 1

Restoration of Operations Executive Summary On Monday, March 16, UT Southwestern Medical Center moved to modified operations in response to changing circumstances brought on by a spread of COVID-19 cases in the community. Out of an abundance of caution, leadership implemented many guidelines to protect our patients, visitors, and employees.

We recognize that there are disruptions across our UT Southwestern Medical Center operations but believe that these disruptions prioritize health and safety and, further, are intended to reduce the spread of COVID-19. It was a difficult but necessary decision to institute a number of nonpharmacologic interventions and put a pause on some of UT Southwestern’s significant activities. We should remember that this extraordinary personal and professional sacrifice has contributed to reducing the number of cases across North Texas from what early models predicted, thus saving lives.

As our institution now begins the process of ramping up on-campus activities, we must do so while keeping health and safety as our paramount priorities. As the community environment stabilizes, UT Southwestern will gradually restore operations in all mission areas as outlined in the phases below. We will have guidance and trigger points in place for each measured phase, and these plans will be made publicly available.

It is important to understand that the pandemic will alter the way we do business for the near future and possibly longer. Ultimately, we expect to move to a “new normal” way of working.

All communication across the campus is available at utsouthwestern.edu/covid-19/. Please visit this site for the most recent information on the virus as well as additional materials to assist you and your team.

PLANS AVAILABLE Phase 1 – Essential personnel only (current state) Phase 2 – Limited occupancy with safe distancing and nonpharmaceutical interventions (NPI)

PLANS IN PROCESS

Phase 3 – Full occupancy with nonpharmaceutical interventions, but limited distancing restriction Phase 4 –“New normal” operations

Assumptions for All Phases As a part of this campus wide plan, there are basic assumptions that guide decision-making across all of the phases. These assumptions

are listed below.

Recognize This as an Endemic Presence

An endemic presence of COVID-19 will continue for at least the next 6-12 months.

Approach Restoration as a ‘Team of Teams’

“Team of teams” concept will support the recovery/restoration of operations. Functional areas will each operate as a team, and

functional teams will share collaboratively with each other.

Structure as a Phased Reopening

The recovery will be phased/sequenced with trigger points based on COVID-19 disease information, infection rates, hospital

capacity, availability of personal protective equipment, testing capacity, and effective interventions at each phase.

o It is possible that UTSW will return to an earlier phase as needed to keep patients and the campus community safe.

o After each phase of restoration of operations, we will continue to review the numbers for new COVID-19 daily case

counts, hospitalizations, and personal protective equipment carefully, along with other syndromic surveillance tools

available to show changes in community transmission.

https://www.utsouthwestern.edu/covid-19/


Understand the Fluidity of Operations

A return to operations will not be linear. It is quite possible that UT Southwestern will move from Phase 1 to Phase 2, and then

back to Phase 1 several times before the situation stabilizes. This may take as long as 12 months.

Align with State Guidelines and Executive Orders

As a state agency, UTSW must conform with executive orders and guidelines issued by the state. When judged appropriate, UTSW will endeavor to also align with county and city guidelines.

Establish Controls to Minimize the Spread

All of the plans listed include controls to provide the best opportunity to reduce the spread of the virus and to minimize PPE burn rate.

These controls are described below, beginning with physical distancing efforts.

Encourage telework and staffing plans that minimize the number of

people in one physical space.

Create physical barriers between people.

Reduce physical contact

by redistributing responsibilities and using technology tools.

Wear nonmedical cloth masks

in spaces where physical distancing is not an option.

Physical distancing

Engineered Controls

Administrative Controls

PPE


Phase 1: Essential Personnel Only

Implementation date: Monday, March 16 TRIGGERS: COVID-19 disease information, infection rates, hospital capacity, availability of personal protective equipment, testing capacity, and effective interventions

AT A GLANCE:

Badge is needed to access any building on campus.

Mask is required.

Maintain the standard 6-foot physical distance.

If you can perform duties remotely, do so. (Check with your supervisor.)

Meet virtually whenever possible.

Group gatherings/meetings shall be limited to five or fewer individuals while maintaining safe distancing of 6 feet and wearing a

mask or cloth face covering.

No travel is permitted for UTSW-related work.

Common areas on campus are closed.

Comply with temperature screening at entry to hospital and clinical buildings.

CAMPUS ACCESS BADGE IS NEEDED TO ACCESS ANY BUILDING ON CAMPUS.

All campus facilities are badge-access only, 24 hours per day.

Police and safety officers monitor building and exterior spaces during reduced activities.

PERSONAL

PROTECTIVE

EQUIPMENT (PPE)

MASK IS REQUIRED ON CAMPUS.

This applies to clinical and nonclinical areas.

Employees in nonclinical settings are encouraged to bring their own cloth face coverings or masks from

home and to be responsible for washing their own masks on a regular basis.

PHYSICAL

DISTANCING

PHYSICAL DISTANCING OF 6 FEET IS REQUIRED.

Personnel shall follow safe distancing practices of maintaining 6 feet of distance between individuals.

The work environment will need to be adjusted to foster safe distancing practices (cordon off seating, sit

every other cubicle, limit personnel on site, stagger shifts, provide signs or markers as indicators or

reminders, etc.).

Department workforce planning will address variable shifts or alternating work from home to

accommodate office distancing requirements.

REMOTE WORK REMOTE WORK IS RECOMMENDED.

Personnel who are able to perform their job duties from home should do so (began March 16).

Determination of eligible personnel is up to supervisors.

GROUP GATHERINGS

AND MEETINGS

GROUP GATHERINGS ARE DISCOURAGED.

Meetings shall be conducted online or via teleconference as the default.

If an in-person meeting is required, groups/meetings shall be limited to five or fewer individuals while

maintaining safe distancing of 6 feet and wearing a mask or cloth face covering.

TRAVEL NO WORK-RELATED TRAVEL IS PERMITTED.

PERSONAL TRAVEL OUTSIDE TEXAS IS DISCOURAGED.

UT Southwestern related travel is restricted through at least May 31. Planning for future (Phase 2) travel


should be limited to mission critical travel pending future direction from the Travel Oversight Committee

and Dr. Podolsky.

COMMON AREAS COMMON SEATING AREAS AND FOOD COURTS ARE CLOSED DURING THIS PHASE.

Available seating has been removed or roped off. Please respect these barriers.

SCREENING

PRACTICES

TEMPERATURE CHECKS WILL BE PERFORMED ON ALL STAFF, PATIENTS, AND GUESTS AT THE ENTRANCE TO

THE HOSPITAL AND CLINICAL FACILITIES.

Employees with a temperature over 100.0°F will be referred to Occupational Health.

PROCEDURES FOR

COVID-19-POSITIVE

EMPLOYEES

CURRENT OCCUPATIONAL HEALTH PROCEDURES WILL BE FOLLOWED.

Occupational Health will provide direction for testing, contact tracing, quarantine, and isolation

instructions.

CAMPUS CLEANING CLEANING FREQUENCY WILL BE ENHANCED.

Housekeeping will continue to provide enhanced frequency cleaning of common areas including

increased disinfection of high-traffic areas and high-touch surfaces.

HYGIENE PRACTICES RECOMMENDED HYGIENE PRACTICES SHOULD BE FOLLOWED.

In addition to encouraging regular hand washing, departments should have hand sanitizer available in key

areas such as entrances and common areas.

Departments should also provide disinfectant wipes or spray solutions to support increased cleaning of

work surfaces.

Facilities has augmented hand sanitizer stations in common areas across campus.

VISITORS VISITATION IS LIMITED.

In the hospital, one visitor per patient, no visitors for COVID-19 patients, no visitors under age 12.

o Hospital visitors will be checked for temperature.

o All visitors are asked to wear a clean mask or a cloth covering that meets the CDC guidelines.

Visitors to other facilities are discouraged.

PARKING PARKING IS OPEN FOR PATIENTS, VISITORS, AND STAFF.

UT Southwestern encourages visitors and patients to the hospital and clinics to self-park. As an incentive,

all self-parking on campus is free.

Valet parking is available at Aston, Zale Lipshy Pavilion, and the Simmons Cancer Center.

VENDORS VENDOR ACCESS TO CAMPUS WILL BE LIMITED.

Access is limited to essential vendors as determined by E/ROC.


Phase 2: Limited Occupancy and Increased Operations

Implementation date: Monday, May 11

TRIGGERS: COVID-19 disease information, infection rates, hospital capacity, availability of personal protective equipment, testing capacity, and effective interventions

CONTINUING:

Badge is needed to access any building on campus.

Maintain the standard 6-foot physical distance.

If physical distancing is not possible, wear a mask.

If you can perform duties remotely, do so. (Check with your supervisor.)

Meet virtually whenever possible.

Group gatherings/meetings shall be limited to five or fewer individuals while maintaining safe distancing of 6 feet and wearing a

mask or cloth face covering.

No travel is permitted for UTSW-related work.

Comply with temperature screening at entry to hospital and clinical buildings.

KEY CHANGES:

Common areas and food courts are reopened.

Nonclinical (“nonessential”) personnel may return to the office, per supervisor directives.

Clinics and the hospital will resume standard services and elective/nonurgent surgeries.

Mask is required on campus when physical distancing is not possible.

CAMPUS ACCESS BADGE IS NEEDED TO ACCESS ANY BUILDING ON CAMPUS.

All campus facilities are badge-access only, 24 hours per day.

Police and safety officers monitor building and exterior spaces during reduced activities.

PERSONAL

PROTECTIVE

EQUIPMENT (PPE)

MASK IS REQUIRED ON CAMPUS WHEN PHYSICAL DISTANCING IS NOT POSSIBLE.

This applies to clinical and nonclinical areas.

Employees in nonclinical settings are encouraged to bring their own cloth face coverings or masks from

home and to be responsible for washing their own masks on a regular basis.

Additionally, on a weekly basis, we will be allocating free of charge one reusable, nonwoven fabric mask

per week per individual authorized to be on campus.

PHYSICAL

DISTANCING

PHYSICAL DISTANCING OF 6 FEET IS REQUIRED.

Personnel shall follow safe distancing practices of maintaining 6 feet of distance between individuals.

The work environment will need to be adjusted to foster safe distancing practices (cordon off seating, sit

every other cubicle, limit personnel on site, stagger shifts, provide signs or markers as indicators or

reminders, etc.).

Department workforce planning will address variable shifts or alternating work from home to

accommodate office distancing requirements.

REMOTE WORK REMOTE WORK IS ENCOURAGED.

Personnel may return to campus if requested by their supervisor, but remote work is still encouraged.

GROUP GATHERINGS

AND MEETINGS

GROUP GATHERINGS ARE DISCOURAGED.

Meetings shall be conducted online or via teleconference as the default.

If an in-person meeting is required, groups/meetings shall be limited to five or fewer individuals while


maintaining safe distancing of 6 feet and wearing a mask or cloth face covering.

TRAVEL NO WORK-RELATED TRAVEL IS PERMITTED.

PERSONAL TRAVEL OUTSIDE TEXAS IS DISCOURAGED.

UT Southwestern related travel is restricted through at least May 31. Planning for future travel should be

limited to mission critical travel pending future direction from the Travel Oversight Committee and Dr.

Podolsky.

COMMON AREAS COMMON SEATING AREAS AND FOOD COURTS ARE OPEN.

Areas will be open but physical distancing of 6 feet must be maintained.

SCREENING

PRACTICES

TEMPERATURE CHECKS WILL BE PERFORMED ON ALL STAFF, PATIENTS, AND GUESTS AT THE ENTRANCE TO

THE HOSPITAL AND CLINICAL FACILITIES.

Employees with a temperature over 100.0°F will be referred to Occupational Health.

PROCEDURES FOR

COVID-19-POSITIVE

EMPLOYEES

CURRENT OCCUPATIONAL HEALTH PROCEDURES WILL BE FOLLOWED.

Occupational Health will provide direction for testing, contact tracing, quarantine, and isolation

instructions.

CAMPUS CLEANING CLEANING FREQUENCY WILL BE ENHANCED.

Housekeeping will continue to provide enhanced frequency cleaning of common areas including

increased disinfection of high-traffic areas and high-touch surfaces.

HYGIENE PRACTICES RECOMMENDED HYGIENE PRACTICES SHOULD BE FOLLOWED.

In addition to encouraging regular hand washing, departments should have hand sanitizer available in key

areas such as entrances and common areas.

Departments should also provide disinfectant wipes or spray solutions to support increased cleaning of

work surfaces.

Facilities has augmented hand sanitizer stations in common areas across campus.

VISITORS VISITATION IS LIMITED.

In the hospital, one visitor per patient, no visitors for COVID-19 patients, no visitors under age 12.

o Hospital visitors will be checked for temperature.

o All visitors are asked to wear a clean mask or a cloth covering that meets the CDC guidelines.

Visitors to other facilities are discouraged.

PARKING PARKING IS OPEN FOR PATIENTS, VISITORS, AND STAFF.

UT Southwestern encourages visitors and patients to the hospital and clinics to self-park. As an incentive,

all self-parking on campus is free.

Valet parking is available at Aston, Zale Lipshy Pavilion, and the Simmons Cancer Center.

VENDORS VENDOR ACCESS TO CAMPUS WILL BE LIMITED.

Access is limited to essential vendors as determined by E/ROC.


Appendix Summarized plans for key areas


Implementation date: Monday, May 11

In addition to the campus approach detailed in this document, individual departments have worked to ensure a collective understanding

of how these parameters will translate to their areas. Plans are included for the following campus departments:

Table of Contents

BUSINESS AFFAIRS.................................................................................................................................................. 9

CLINICAL RESEARCH ............................................................................................................................................. 12

MEDICAL EDUCATION ......................................................................................................................................... 13

GRADUATE MEDICAL EDUCATION ................................................................................................................ 14

GRADUATE SCHOOL ............................................................................................................................................. 15

HEALTH PROFESSIONS ........................................................................................................................................ 16

HEALTH SYSTEM .................................................................................................................................................... 17

INSTITUTIONAL ADVANCEMENT ..................................................................................................................... 18

LABORATORY RESEARCH .................................................................................................................................... 20

LIBRARY ..................................................................................................................................................................... 21

SIM CENTER ............................................................................................................................................................ 22

SIM CENTER FOR MEDICAL STUDENT LICENSING PREPARATION ..................................................... 24


Business Affairs

Auxiliary Services

Auxiliary Services provides the following services to the UT Southwestern campus: Parking Services, Valet Parking, Student Store, Food Service (nonhospital vendors and minimarts), Print Services, and Mailroom.

During the next phase of operations, we plan to bring back Valet Operations slowly, as needed; we will increase Food Service and Mailroom/Print Operations as volume dictates. In order to determine the number of (currently ~200) contractors that will return, we need to know more details on:

Hours of operations for each clinical site

Desired return for valet at each site

Patient volume estimates

Employee estimates for clinical and lab operations to determine Parking, Printing, Food Service, and Mailroom needs

Facilities Management

The majority of the Facilities staff has remained on campus, providing continuous support at Clements University Hospital and throughout the campus. Less than 10 percent of the staff is telecommuting, and those who are telecommuting will remain off campus during Phase 2. Facilities has implemented the following measures in each of these functional areas to properly support the restoration of operations and the return of faculty, staff, students, trainees, patients, and visitors.

Housekeeping: Facilities Management and custodial contractor teams have been working diligently and continuously to clean spaces daily with products and procedures that are based on CDC guidelines to kill the COVID-19 virus. Enhanced measures are in place to wipe down and disinfect high-touch areas three to four times daily in all buildings.

Shuttle Operations: Shuttles have implemented social distancing standards for ridership, limiting the total number of riders to five on a shuttle and roping off every other seat bench. Signage is in place at all shuttle stops and on the shuttles regarding the five-passenger limit and requirement that riders wear a face covering and maintain 6-foot social distancing.

Elevators and Stairwell Access: Signage regarding COVID-19 protective measures including use of face covering and maintaining 6-foot distancing has been placed on all elevator landings next to the call buttons. Building Maintenance is assessing stairwells with Security and Safety to add card readers at exterior doors and other doors to allow greater access for staff to use the stairs instead of elevators.

Signage and Furniture Moves:

Signage reminding staff of COVID-19 protective measures including use of face covering and maintaining 6-foot distancing will be prominently placed in all campus buildings and high-traffic locations outside campus buildings and garages.

Social distancing floor markers have been installed at building screening locations and other areas where people may need to wait in a queue.

Facilities is coordinating with Clinic Managers and Department staff to ensure waiting area seating is spaced to provide a 6-foot separation between chairs or seating on all sides. Excess furniture will be cordoned off.

Facilities is coordinating with Auxiliary Services to ensure food court and dining area seating is rearranged, removed, or cordoned off as necessary to provide 6-foot separation.

Contractor Screening: Construction and service contractors are required to self-screen daily before arrival on campus and are required to follow campus screening procedures when they enter a building or construction site.

Building HVAC Systems and Indoor Air Quality: Each building is actively monitored monthly and the filters are assessed and changed if needed on a more frequent basis. During all filter changes, pressure drops across the filter media are recorded, belts and coils are checked, and the condition of the system is assessed. Building filters (downstream from the pre-filters) are also assessed monthly and changed annually.

Building HVAC systems are equipped with MERV 11 Pre-Filter: The MERV 11 filter media is 65 percent efficient on 1.0–3.0 micron sized particles and 92 percent efficient on 3.0–10.0 micron sized particles. The MERV 11 filter media contains an antimicrobial agent that effectively controls the growth of any mold, mildew, algae, and fungi on the filter. The filters are also equipped with a frame and media system that not only enhances filter efficiency, but also helps to eliminate air bypass by eliminating gaps between the filters.


Financial Services

Accounting & Fiscal Services includes the following departments: Fiscal Reports, Accounting Operations, Asset Accounting, Cash Management, Accounts Payable, Travel & Expense Reimbursement, Accounting Customer Service, Student Financials, and Accounting Compliance.

Accounting currently has about five employees coming to campus on a rotating basis to cover cash management, check deposits, check payments, and invoice scanning. In the next phase, we expect to bring back up to five more employees on a rotating basis to support expanded cash management operations, check deposits, check payments, and invoice scanning.

Financial Services Administration Staff

Approximately 178 of the Financial Services staff are working remotely in Phase 1, with five working on campus. In Phase 2, an additional five staff members will work on campus, with the balance (173) continuing to work remotely.

Budget & Resource Planning provides the following services to the UT Southwestern campus: Support for Departmental Budgets and Ongoing Financial Operations, Capital Planning, and Shared Services for financial operations.

Financial Affairs Administration manages and supports the six departments in Financial Affairs and provides financial oversight, leadership, and support for all financial operations at UT Southwestern and its affiliated nonprofit entities.

Real Estate Services provides the following services to the UT Southwestern campus: leasing of external space, management of internal space leased to tenants, and building and land acquisitions. Two employees in Real Estate Services are working remotely to support operations but come to campus on occasion to tour space/buildings.

Sponsored Programs Administration provides the following services to the UT Southwestern campus: support for pre-awards (grant proposal submissions, subawards, etc.), post-awards (sponsor invoicing, collections, posting of cash payments, reporting, and validation of allowable expenses), support for clinical trials (coverage analysis, contracting, payment application, etc.), customer outreach/service, and research audit and compliance.

Human Resources

Human Resources actions and services throughout the COVID-19 response have been driven by the employee life cycle and needs of our employee and managers. During Phase 2, we will be focused on assisting department operations and employees returning to campus, including transition and continued support around child care needs, employee assistance, workforce planning, and resources to ensure that managers are successful and compliant with the UTSW restoration of campus operations required at each phase.

Talent Acquisition

Assist hiring managers with the position review and management.

Continue to facilitate the temporary reassignment of non-Health System employees to departments with staffing needs.

Continue walk-in services, including I-9, at the Bass Center Talent Acquisition Office.

Continue to support essential hiring and promote virtual interviewing. The Talent Acquisitions team is continuing to work closely with Health System leaders on workforce needs and staying on course with the Clements tower expansion project.

Onboarding

Day 1 New Employee Orientation and Day 2+ clinical orientation has been converted to asynchronous online learning, and EPIC training is now virtual. Orientation will continue to be conducted online and virtually until restoration of normal operations to comply with social distancing requirements.

Positive feedback from employees on orientation format creates the opportunity to streamline the onboarding process after return to normal operations. However, cultural components of UTSW orientation continue to benefit from synchronous or in-person format.

Learning and Development

Faculty and staff leadership development programs have been converted to virtual learning where appropriate (e.g., Faculty LEAD, Leadership Foundations, Department Administrator Professional Development, etc.). Open-enrollment employee courses have been converted to webinars and virtual learning for content that is situationally relevant. Employee usage for on-demand online learning courses increased 607 percent between March and April 2020 through the Academy for Career Enrichment.

Performance Management

https://www.utsouthwestern.net/intranet/services/ace/


Performance appraisal tool and communication/training launched remotely in April, with employees and managers successfully completing appraisals in the online iPerform tool.

Guidance provided to employees and managers regarding performance appraisals considering COVID-19; additionally, all training and support has been converted to live webinars with Q&A sessions, online learning modules in Taleo, and step-by-step video tutorials and tip sheets for convenience.

Classified self-appraisals due May 8 and manager appraisals due May 31, with final discussion and review Aug. 31, 2020. Hospital staff in MICU and COVID-19 units have a flexible due date of July 1, 2020, for manager reviews.

Engagement & Wellness

Timing and next phases for the VIP Engagement Survey will likely shift from the previously scheduled annual survey date of May 18–June 5 to early September (Sept. 7-18) or beyond.

Explore utilizing Glint survey platform and analytics to conduct two- to three-item Transition pulse or “always on” pulse at UTSW (can include Faculty and Staff or targeted audience) regarding employee safety and productivity issues.

Virtual Wellness Challenges to encourage physical activity and Virtual Financial Wellness Sessions have been provided to campus.

Confidential counseling via the Employee Assistance Program (EAP) is available to employees and faculty, in addition to behavioral health services through the department of Psychiatry. [add link to EAP program contact info, hours]

Recognition

UT Southwestern milestone awards and employee recognition celebrations will be rescheduled for the safety of our employees.

An Employee Recognition Toolkit has been created and converted to a webinar format to highlight creative solutions and opportunities for managers to recognize employees, with a focus on remote or socially distanced mechanisms.

Managers are continuing to recognize employees through the PACT process. There have been many opportunities to witness above-and-beyond performance as our exemplary employees rise to the occasion to serve our customers, patients, and their families.

Health Benefits

Implementing resources for parents (essential on-campus faculty and employees) and developing Child Care Resource Toolkit.

Managing the Dallas Mavericks Child Care Assistance Program Leave Administration.

Administering the Emergency Paid Sick Leave (EPSL) and Emergency Family and Medical Leave Act (EFMLA) programs. Preparing for increased use of the Family and Medical Leave Act (FMLA).

Human Resources Walk-in Center

The Human Resources Walk-in Center continues normal business operations providing walk-in services, email, and telephone support for employees, applicants, and retirees.

Employee Relations – Institutional Support

The Employee Relations team will provide coaching and support in the development of restoration to campus plans. Contact will be made with managers planning for the return to campus to talk through plans and options. We will also determine needs for any additional support due to changes in work schedules.

High-level tools and resources will be developed to support transition of departments to Phase 2.

HR Team

Employee Relations will continue to provide virtual support, with a limited number of staff coming on-site daily. Utilizing our escalation process, we will continue to offer 24/7 support to the hospital on urgent matters. Support services to clinics and academic areas will be adjusted as needed to accommodate changes in their work schedules during Phase 2. Approximately 84 individuals are working remotely in Phase 1, with 18 working on campus. This will increase slightly to 30 employees on campus and 72 working remotely.

Information Resources

Information Resources (IR) has provided extended and expanded support to the UT Southwestern and North Texas community during Phase I of the COVID-19 pandemic. IR will continue to provide this support throughout all phases of the return to operations program implementation.


510 Information Resources staffers are working remotely in Phase 1, with 175 on campus. This will continue in Phase 2.

Safety and Business Continuity

Safety and Business Continuity have continued to operate all programmatic areas throughout the pandemic in support of the emergency response and recovery operations. All staff have continued to perform their regular job duties in addition to taking on additional responsibilities to support the continued operations of the institution. Safety will continue its operations in the restoration of operations phased ramp up. Safety currently has 37 staff members on campus with 10 staff members working remotely. Four individuals will return to campus in Phase 2 of the restoration of operations plan.

Safety and Business Continuity provides the following:

Biological Safety

Chemical Safety

Environmental Compliance (regulatory permitting and reporting, regulated waste assessments, environmental compliance plans)

Emergency Management and Business Continuity – E/ROC management, UTSW Alert administration, continuity of operations plans, and emergency operations plans

Fire Safety

Occupational Safety

Laser Safety

Radiation Safety

Risk and Insurance Services

Hospital Safety Officer – Environment of Care leadership, Committee Chair, EOC rounding, injury prevention, and The Joint Commission compliance

The department maintained a full complement of on-campus police officers, public safety officers, police communications officers, police supervisors, and command staff within the patrol division and all access control personnel.

Clinical Research

Clinical research activities must adhere to UT Southwestern ambulatory clinic guidelines and UT Southwestern policies for elective surgeries and invasive processes for the phased reopening of clinical services. This applies to clinical trial activities conducted in hospital-based and ambulatory clinics and in academic space outside of areas approved for clinical space.

As per UT Southwestern policy, participants/patients must have negative nasopharyngeal (NP) swabs for all invasive procedures and procedures that do or might aerosolize sputum or oral secretions and/or require airway management

Patient/Participant-Centric Policies

All research subjects coming to campus must complete the Epic COVID Care Path survey to determine low/intermediate/high risk of COVID-19. Intermediate and high-risk subjects would require nasopharyngeal swabbing to define actual state before participation in interventions.

o Research visits are limited to subject/patient plus one accompanying individual. o Temperatures of both individuals will be taken prior to entry. o Limited points of access will have implications for trial activities conducted in academic space. o Social distancing will be enforced.

Face masks are required for patients/participants, accompanying individuals, and staff. If not brought from home, one will be provided.

For trial participants requiring lab draws or research imaging, visits must be coordinated with appropriate ancillary services.

Staffing Implications

Current circumstances create a need for limited duration of contact with patients, limited number of staff in contact with patients, and staggered work schedules in addition to the universal precautions set forth for all of campus.

Further, there will be an ongoing need for PPE, including N95 masks and face shields for all procedures that potentially aerosolize sputum or oral secretions as well as PPE training for staff.


Medical Education In most circumstances, education support offices recommend continued remote operations for staff who have effectively supported the curriculum for the past several weeks.

To accommodate students at essential in-person educational events, staff will need to return to campus on a limited basis to prepare for and administer on-site exams, facilitate clinical skill and simulation sessions, and maintain technical systems required for events.

Pre-Clerkship Curricular Activities

Lectures, TBLs, PBLs, CBLs, and small group sessions will continue virtually using Realtime Zoom and recorded sessions. Alternatives to gross pathology have been developed this spring.

The importance of in-person activity was assessed and emphasized for gross pathology, cadaveric dissection (Human Structures), high-stakes examinations, training in physical exam, clinical skills training and assessment (Colleges), and simulation (Colleges, IM blocks).

Most exams are provided virtually with/without proctoring, but we will reassess how to administer major quizzes, finals, and national-mandated exams.

Simulation/clinical skills cannot be replaced but are deferred until allowed.

Student Clinical Rotations

Return to clinical rotations are prioritized as follows: o Priority 1: Rising seniors and MSTP students o Priority 2: Students who completed 1/2 of surgery and medicine clerkships in March o Priority 3: Rising seniors who have remaining clerkships o Priority 4: Rising seniors requiring subinternships and electives o Priority 5: Rising juniors needing to complete Clerkship experiences

Students will return to clinical activity that involves lower risk patients as soon as possible. The tentative goal is to begin with the

introduction of some students as early as June 1, 2020.

Clerkships must maximize use of distance learning by using virtual hospital visits and telemedicine wherever possible while preserving student-patient interactions to learn/assess key clinical skills.

Separation of COVID-19 patients and restriction of students to low-risk patients will be required until they can be afforded full PPE necessary for these types of encounters.

Plans for return to other sites (PMH, CH, THD, and VA) are outside the scope of this document.

Considerations:

Phased introduction that prioritizes students that had their 8-week rotations truncated by the shutdown (internal medicine and surgery rotations) and MSTP students (M.D.-Ph.D.) returning to clinical rotations form the lab.

Medical students will not see patients or travel to units where COVID-19 patients are cohorted.

Medical students will not see patients who have a pretest clinical suspicion of COVID-19 that is “High” or “Medium.” This is an EMR risk stratification score that is used to risk stratify patients prior to their COVID-19 test result coming back from the lab.

Medical students will not see patients who require any isolation precautions (gowns or N95 masks).

Student Health will continue to coordinate with Occupational Health around possible exposures and return-to-work determinations.

Visiting Medical Student Rotations

UTSW medical students will be discouraged from pursuing VMS rotations in 2020 but may be considered on a case-by-case basis and with approval from a departmental specialty adviser and a Dean for Student Affairs.

VMS Rotations at international institutions and international students pursuing rotations here will not be approved at least through the end of August 2020.


Medical Student Research & Scholarly Activity Program

The Medical Student Research Programs (MSR) recommends maintaining current restrictions and remote projects for medical student research through the summer.

Student Recruitment

The Admissions Committee proposes virtual interviews for the 2020-21 admissions season employing the current assessment of technology platforms and a single faculty interview.

The on-campus Interview Weekend will be eliminated and online alternatives will be designed for the Ambassador and JAMP programs.

Planning for our normal in-person Second Look (MS0) Weekend to take place in February 2021; will continue unless continued restrictions preclude it.

Medical School Orientation (Aug. 3-7)

The PRE+OP overnight retreat is canceled.

All orientation materials and large group activities will be provided using online technology.

Small group activities required to develop tangible relationships with Colleges group, TBL group, Anatomy dissection group, and PBL group will occur if possible.

If not, the above plan will be modified to eliminate small groups by providing online student panels and small group activities using online breakouts groups.

Team-building and social activities will be deferred to later when social distancing guidance allow them.

White Coat Ceremony (Oct. 3)

A full ceremony is planned but if that is not possible, it will be modified as suits the current circumstances.

Rotations at Graduate Medical Education

All UTSW GME programs must follow guidelines and requirements outlined by our main accrediting body – the Accreditation Council of Graduate Medical Education (ACGME). The ACGME mandates that the following elements must be available for the safe return of residents and fellows:

Appropriate personal protective equipment (PPE) must be available.

Training on proper donning and doffing of PPE must be available to all trainees.

Adequate facilities and resources are available.

Adequate faculty supervision, with the availability for feedback/education, and prompt evaluations must be in place.

In addition, we must ensure the availability of adequate resources for resident education (including sufficient patients and procedures available for clinical learning to occur) and a healthy and safe learning and working environment that promotes resident well-being. A prioritized, stepwise return to clinical operations:

1. UTSW graduating residents and fellows who need to meet certain numbers of patient encounters or procedures will receive

priority. We must ensure UTSW trainees’ needs are met before any outside learners are allowed to participate in clinical

rotations.

2. Second priority goes to all other UTSW residents and fellows as decided by each Program Director based on total

number of trainees allowed at each site/rotation.

3. Non-UTSW residents and fellows (about 200 per year) on campus for rotations that cannot be completed elsewhere and are

required for promotion and/or graduation will be considered next.

4. Non-UTSW residents from international locations will not be allowed to rotate on campus until new guidance is available

from UTSW leadership.

5. Other: Modified rotation availability for residents and fellows who are medically frail (and at risk of severe illness) should be

attempted if at all feasible. These options include telehealth, nonclinical rotations, and enhanced PPE considerations.

6. Program Directors will need to make judgment calls on whether trainees meet graduation/promotion requirements or


whether any trainees will need to extend their training.

Education

All education is now occurring virtually, using a variety of platforms. Until changes to the current UTSW rules for gatherings occur, our

recommendation is that all education offerings continue to occur virtually. When return to campus is allowed, any physical distancing

rules, use of PPE, and hand hygiene guidelines must be followed by those who choose to have in-person educational sessions.

The GME office wants to stress the critical importance of the UTSW Simulation Center for many GME training experiences. Programs

must be able to use the Simulation Center for training and procedures as soon as feasible. The Simulation Center is traditionally used

heavily during intern orientation in late June. Departments will be encouraged to work closely with the Center to plan their activities

within the scope of the Center’s reopening plan.

NOTE: The Office of GME is in frequent communication with the UTSW Simulation Center. We will make sure GME programs are aware

of the currently available resources, especially if those activities are critical to the education of residents and fellows.

Onboarding of the New UTSW Trainees

Most onboarding activities will occur virtually, and the GME office has been in conversations with all the different hospitals. We are

looking into the possibility of early access to the virtual components of onboarding. The portions of onboarding that need to be done in

person will take much longer to complete given the social distancing requirements.

We anticipate there may be delays in the usual July 1 start date for trainees, which may affect physician coverage across all the

hospitals. Other potential issues are being addressed.

Graduation and Promotion

Most programs are planning virtual graduation ceremonies, while some are delaying the actual celebration. The GME office is

gathering ideas that programs can use to plan virtual ceremonies that are meaningful. Training Certificates will be delayed and will

need to be sent by the Departments to trainees at a later date.

Other aspects of graduation and promotion remain unaffected:

Programs are still able to complete verifications of trainings.

Promotions of residents and fellows to the next level are proceeding as usual.

Other Important Considerations

The GME operations have been substantially impacted by COVID-19. When returning to clinical rotations, UTSW learners must

always take precedence. ACGME rules must always be followed. Hospitals and program leadership must take into consideration

issues around supervision, PPE, and availability of procedures and patients when deciding to bring back learners. Program

leadership and/or the GME office needs to be involved in the decisions to reintroduce learners to sites and clinical rotations.

Educational sessions are occurring virtually and will continue to occur that way until UTSW leadership decides on reopening

the campus for gatherings.

Onboarding of new trainees will need modifications to ensure readiness of our new workforce by July 1. We will need the

assistance from ID and Occupational Health leadership in ensuring these incoming trainees are ready to begin their clinical

training by July 1. We might need to assist in other areas as well, such as housing and child care.

For the upcoming recruitment season, the GME office and all training programs will need assistance in the development of

new/innovative recruitment materials and in best practices for virtual interviews.

Graduate School of Biomedical Sciences


The overarching goal is to enable all UT Southwestern Graduate School of Biomedical Sciences educational and training programs to resume as soon as possible and enable learners to make progress toward completion of their programs while ensuring safety and maintaining public health requirements.

Clinical training in graduate programs, e.g., Clinical Psychology doctoral program, will follow applicable guidelines for similar training in Medical School and School of Health Professions programs.

PHASE 2 PLANNING

Resume learner participation in laboratory research activity, allowing up to one person per bay at any given time (or other metric as specified by the ROC plan for resuming research activity).

o Lab personnel may work in shifts conforming to occupancy limit, with disinfecting procedures between shifts as specified by the ROC plan and in coordination with departments.

o Schedules and priorities for learners to be in the lab to be determined by PI, Chair, or Center Director, weighing factors such as whether students and postdocs are close to completing their degree/term of appointment, whether research is critical to meet thesis requirements for a final defense in the upcoming term, etc.

All Graduate School activities and operations besides laboratory research are to be conducted remotely, including classes, exams, meetings, interviews, orientations, and Graduate School office operations.

Graduate School staff may return to campus as per the ROC guidelines. Continue online meetings when possible and observe social distancing during in-person meetings.

o Only personnel with a need to access physical locations to advance education and research should be on-site. Even

those personnel should minimize time on campus. All others should remain sheltered in place and/or off-site to help maintain physical distancing. Meetings should be conducted remotely.

School of Health Professions Overall, the immediate SHP goal is to minimize the numbers of “on-campus” personnel needed to support activities related to academic instruction, clinical operations, and research programs. It is anticipated the SHP will have less than 20 individuals (~15 percent total personnel) returning to campus as part of Phase 2.

Academic Planning

Faculty involved in didactic teaching and those with assigned teaching for the summer have effectively redesigned all courses for online delivery. Currently, we are planning that no “in-person” didactic courses will be taught on campus during the summer semester.

For SHP laboratory/hands-on clinical skills training courses, once social gathering guidelines are modified to allow for groups of 10-12 people at UT Southwestern, the academic programs will design small group facilitated learning classes to enable student to begin to complete their hands-on clinical skills training. Laboratory space will facilitate social distancing of greater than 6 feet per person with groups of 10-12 people.

At present, no out-of-state rotations will be allowed; consideration will be given pending the COVID-19 situation and UT Southwestern guidelines.

Clinical Planning

Physical Therapy Clinics: As surgical departments increase patient volume, PT will place 4 providers, 1 attendant, and 1 staff (reception desk) in the main clinic (3

rd floor V Building). They will place 2 providers and 1 staff (reception desk) in the gait clinic (1

st floor V bldg.). This

staffing distribution allows for 10+ ft. of distancing between patients/providers and represents a 25-30 percent capacity of total clinic capacity. Clinics will coordinate with University stores for PPE supplies. If patient volume increases, PT will expand hours and possibly use Saturdays to sustain lower patient numbers in the clinics and ensure safe distancing.

Prosthetics and Orthotics Clinic: As surgical departments increase patient volume, P&O will place 2 providers, 2 technicians (fabrication) and 1 staff (reception desk) in the main clinic (2

nd floor V bldg.). This staffing distribution allows for 6+ ft. of distancing between

patients/providers and represents a 20-25 percent capacity of total clinic capacity.

Research Planning


There is only one clinical research protocol, which involves two faculty coming to the P&O clinic, typically two to three days per week, for measurement and assessment of infants wearing cranial molding helmets.

Health System

The UT Southwestern COVID-19 Health System Recovery Plan delivers a data-driven, phased return to operations within an environment that maintains an endemic presence of COVID-19. The Recovery Plan outlines the timing, critical success factors, and potential constraints that can slow the Health System recovery in returning to baseline operations and beginning to make up for lost surgical and procedural cases, ambulatory visits, imaging, and laboratory services. It is anticipated that UT Southwestern will maintain a presence of COVID-19 in the hospital setting throughout the entire recovery period. The central resources that have been created to support the campus efforts to provide a safe environment for patients, visitors, faculty, students, trainees, and staff will continue to exist going forward. This includes the central checkpoints for temperature checks and masking at building entrances, the drive-thru testing clinic, and other resources that are needed to support increased activity on our campuses. Surgeries, procedures and ambulatory visits will begin ramping up in mid-May with a goal of achieving 100 percent of baseline volumes by mid-June and continuing growth beyond baseline to recover lost volume incurred over the prior 7- to 8-week period.

While the recovery of lost volume is expected by February 2021, it is acknowledged that the heterogeneity of clinics will affect volume recovery timelines for individual clinics. It is expected that Ambulatory clinics will continue utilizing telehealth visits at their current or increased rate throughout the recovery and going forward as a new model of care. There are multiple risk points throughout the plan that can impact the recovery timeline, including the volume of COVID-19 patients within the hospital, the availability of clinical and administrative staff members, the availability of Personal Protective Equipment (PPE) and the capacity for COVID-19 screening tests. In the absence of a surge and even with aggressive usage scenario analyses, PPE and screening tests are under capacity on all dates of projection. In the case of a surge, PPE and testing shortages would be seen coming well in advance of risks to capacity, resulting in the immediate stop of recovery volume growth. The Recovery Plan will continue to evolve and adapt as more is learned and as circumstances dictate.

Communicating and delivering a safe, consistent experience for patients and staff is the top priority. We expect symmetry of operations in all ambulatory and hospital sites to support confidence in our health care delivery.

The Recovery Plan

UT Southwestern will take the following approach:

We will continue to evaluate postponed surgeries and provide medically necessary care through May 8.

We will expand elective case volume in the ORs beginning Monday, May 11, with the following planned ramp up for the hospital and ambulatory practices:

Week of Hospital OR and Procedural Areas Ambulatory Areas

May 11 50% block 50% template



June 1 100% block + extended hours 80% template



June 22 100% block + extended hours 100% template + extended hours

Considerations include scheduling and preauthorization of patients, pre-surgical COVID-19 testing protocol, availability of N95 respirator masks and expanded fit testing, med/surg and ICU bed availability, available workforce, and patient demand for services.

We will continue to evolve and adapt this plan as we learn more and as circumstances dictate. Expanded COVID-19 Testing. UT Southwestern will be supporting some COVID-19 testing. As such, our expanded internal testing capacity will be subject to outside public health constraints.


Surgical Care and Case Prioritization. Extra precautions will continue in all surgical cases due to COVID-19, including an additional pause during intubation & extubation, infection risk screening protocol and a phased return for elective surgeries and COVID-19 level PPE for high exposure risk procedures. Surgical Chairs established a prioritization policy for canceled surgeries originally scheduled from March 18 to May 8. This prioritization was based on patient clinical need and risk. Some elective procedures will be scheduled in order of cancellation, e.g. first to cancel, first to reschedule. Telehealth. Usage of telehealth should remain at current volumes or increase for all medical and surgical departments throughout the recovery period and ongoing as an enhanced model of care. Leveraging telehealth for appropriate patients allows for managing patients outside the physical facility, which will provide a safer environment for patients who need to be seen in-person. Clinicians are encouraged to complete telehealth visits in their academic offices and at home. Telehealth visits should be mixed with in-person visits when resuming ambulatory care to provide increased separation of patients physically seen in the clinic. All relaxed regulations and telehealth billing updates remain in place and will be consistently re-evaluated to ensure alignment and compliance with regulatory requirements. It is incumbent upon the chair and medical director to confirm visits completed via telehealth are meeting the standard of care as well as the ongoing timing, pace, and increased use of telehealth in the clinical department. Hours of Operation. During the period of recovery as we restore patient access to care, we expect all clinics will commit to a 6-day workweek with extended hours, with all in-person sessions lasting a minimum of four hours. Non-traditional hours should be established using telehealth modalities, where feasible. Valet and Ancillary Services. With in-person appointments ramping up the week of May 11, 2020, valet parking services at Aston, the Cancer Center, and the Zale Lipshy Pavilion will need to resume due to the absence of self-parking availability for patients. We are finalizing a valet parking proposal that will include standards for PPE. The amount of valet parking provided longitudinally will be based in large part on the prevalence of COVID-19 in the community. All other ambulatory locations will utilize patient self-parking as the standard way for patients to park for in-person visits. We will continue to provide self-parking at no charge to the patient to encourage self-parking. Ambulatory Spaces. The physical space and furnishings in clinics will be updated to allow for proper social distancing. This includes the removal of most waiting room furniture, use of clear barriers for check-in staff where appropriate, and new processes that expedite the patient rooming process. Imaging. The coordination of radiology and imaging services along with growth in ambulatory, OR and hospital activity are critical to a successful ramp-up of activity. Workflows for both Inpatient and Outpatients have been developed. These workflows outline the procedures for managing COVID-19 positive patients and PUIs in all imaging modalities at UTSW.

Laboratory. Clinical laboratory services to support COVID-19 testing will continue to grow in support of institutional and regional testing efforts. Additionally, non-COVID-19 testing will ramp-up with both ambulatory and hospital activity. Critical laboratory technicians will be key to managing the growth in testing due to both increases in COVID-19 and routine testing. Workflows will be delineated for the appropriate management of the COVID-19 patients and PUIs who require laboratory services in the outpatient and inpatient settings. PPE Management. The use of PPE in the ambulatory environment will be a shared responsibility between the clinical department and health system leadership. The PPE allocation and distribution will be coordinated via Materials Management/Supply Chain based on availability and need.

Institutional Advancement

This area includes Communications, Marketing and Public Affairs; Government Affairs; Community and Corporate Relations; Development and Alumni Relations; Government Affairs; Office of Equity and Access; and Office of Technology Development. The majority of this team is working remotely, but are accessible to meet ongoing needs. Communications, Marketing, and Public Affairs (CMPA)

The AVP Communications and Public Affairs and the Director of Brand Communications and Public Relations have remained on campus throughout emergency procedures. The Director of Digital and Social Media Communications will return to campus at least three days/week. Other CMPA leaders will continue to work remotely with intermittent office hours as needed to execute priority work. Multimedia photojournalists and production staff will be on campus as needed to capture video and photo assets for communications purposes.


In June, we will begin rotations of staff for Communications, Marketing, and CMPA Operations, with an alternating number of individuals in the office at any one time. Specifically, Creative Services leadership and traffic management return to office two days a week. Administrative teams work from office as needed for onsite business operations continuity. Community and Corporate Relations

Community and Corporate Relations will continue to work remotely until at least June 1. This team helps monitor the City and County guidelines on COVID-19 that impact UT Southwestern operations. Development and Alumni Relations (DAR)

The Development team has been very active with COVID-19 efforts like the receipt of in-kind donations. These Gift Administration staff members have remained on site, as needed, and will continue to do so for the foreseeable future • The majority of DAR will continue to work remotely until at least June, including Data and Systems Management, Constituent and External Relations, Development Programs, and Engagement and Participation. Government Affairs

Government Relations will continue to work remotely until at least June 1. We have been very active in working with State and Federal leaders on COVID-19 guidelines. Office of Equity and Access (OIEA)

OIEA will continue to work remotely until at least May 11. Until that time, staff will continue to report to campus for scheduled appointments and meetings that cannot be accomplished remotely. In anticipation of increased ADA Accommodation requests from employees desiring to continue working remotely after May 11, OIEA will return the Division of Equal Opportunity to campus to assist departments and employees who need help coordinating communication between employees, their medical providers, and managers to ensure that high-risk employees with underlying disabilities are provided with reasonable accommodations based on their medical needs. Accompanying the Division of Equal Opportunity, the Title IX Manager will also return to campus to provide in person assistance to on-campus employees who need prompt assistance with workplace investigations and assistance coordinating assistance and support from local entities that support individuals who experienced violence or abuse. The remainder of the Title IX team and the Equity/Affirmative Action Specialist will return in Phase 2 as determined by the E/ROC. Individuals will perform duties in isolated offices except for when they are conducting work where interacting with others is a function of the job. As the Diversity & Inclusion function can be performed remotely without affecting the efficiency of their work, the D&I team will continue working remotely, but is available on a scheduled basis to assist departments and search committees with their training and programing needs. The D&I team will also be on-campus (in a yet to be determined location) to coordinate the Dr. Emmett J Conrad internship program and the Summer Earn and Learn or LaunchAbility job training programs Office of Technology and Development (OTD)

OTD will continue to work remotely until at least June 1. During this time, both Claire Aldridge, AVP for Commercialization and Business Development, and Brad Phelan, Director of Technology Commercialization, are available to report to campus on an as-needed basis.

Ongoing Institutional Communications

CMPA continues to provide updated COVID-19 information, enhanced activities and social monitoring, included but not limited to: o Daily EOC Update, currently focused on return to operations, this daily email will evolve to become a daily campus update o COVID-19 information on utsouthwestern.edu, utswmedicine.org, and the Health System Portal o Telemedicine rollout, including logistics, patient information, and paid advertising campaigns o Dr. Podolsky’s weekly briefing o Messages from the Office of the EVP of Health System Affairs


o What to Know video series with Dr. Warner o Campus signage and employee yard signs o Virtual Medical School commencement o Community PSA about stroke and heart attack symptoms o Ongoing media relations, reactive and proactive

Laboratory Research

The following guidelines are specific to campus research laboratories and are recommended to take effect May 11, 2020.

Principal Investigators may return to campus provided they work in their private offices. Those who are not actively involved in bench research are encouraged to continue working from home.

Laboratories and core facilities may staff up to 25 percent of normal occupancy (e.g., one person per wet-bench laboratory bay; one person per enclosed tissue-culture room; not to exceed 25 percent of total staff in the lab at any one time).

Shifts are allowed.

o The Principal Investigator is responsible for determining the lengths of individual shifts (e.g., 2 hours, 4 hours, 8 hours, or alternating days). Shared workspaces should be disinfected between shifts as described below.

o The Principal Investigator is responsible for maintaining the above personnel densities and for organizing schedules.

Personnel should wear a cloth face covering or mask, gloves, safety glasses, and lab coats at all times in wet-bench and dry-bench laboratories and maintain social distancing of 6 feet or more. Principal Investigators may remove their masks while sequestered in their private offices. Cloth face coverings should be washed after each days’ use. Standard laboratory safety practices should be followed as normal.

In addition to encouraging regular hand-washing, personnel should make frequent use of hand sanitizer stations located throughout the campus. Between personnel shifts or between uses of shared equipment (e.g., centrifuges, PCR machines, tissue culture hoods, computers), surfaces should be wiped down with a solution of 70 percent ethanol or 10 percent diluted bleach. Keep in mind that ethanol is flammable, and bleach is caustic.

All employees in nonclinical settings must wear cloth face coverings or masks. Supply chain management will provide a cloth mask to everyone who needs one, however we encourage you to bring one from home when possible, to help us conserve PPE.

The laboratory work environment may need to be adjusted to foster safe distancing practices (e.g., use tape to indicate six-foot distances in shared spaces; provide sign-up sheets for common equipment; post reminders to practice social distancing, etc.). Keep laboratory doors closed to hallways whenever possible.

Laboratory meetings should continue to be conducted virtually.

Laboratory administrative-support personnel who can perform their functions remotely should not come to work in this phase. This guideline also applies to researchers and those considered high-risk for COVID-19 infection. Administrators who must come to campus should do so only for the time period necessary, practice social distancing, and wear a mask.

Self-screening for COVID-19-related symptoms should be performed prior to returning to campus. Personnel must not come to campus if they feel sick or if suffering from any of the known COVID-19 symptoms. Affected employees or those who have been exposed to an individual with COVID-19 symptoms should contact Occupational Health and should not return to campus until cleared to do so by Occupational Health.

Faculty, staff, learners, and trainees who are concerned for their safety, or the safety of family members, are not required to return to work at this time and must not be coerced or under peer pressure to do so.

During planning and after Phase 2 is in operation, all personnel should keep foremost in their minds that we may have to return to Phase 1 (i.e., essential laboratory personnel only) if required to keep patients and the campus community safe. Therefore, it is imperative to follow the above guidelines closely.

https://myutsouthwestern.swmed.edu/coronavirus/2019-ncov/symptoms-testing/,DanaInfo=www.cdc.gov,SSL+symptoms.html


Library

The Library recommends continued remote operations due to the ability to complete all mission requirements effectively and efficiently from remote sites while eliminating additional health threats to the personnel. We recommend being a low priority department to return to on-campus work.

Medical Student Research & Scholarly Activity Program

The Medical Student Research Programs (MSR) recommends maintaining current restrictions and remote projects for medical student research through the summer.

In August, participation will be modified on limited occupancy with safe distancing. We anticipate 10 students performing Scholarly Activity (SA) in the fall.

All students will be strongly advised to formulate projects that could also be done remotely or have a backup plan as such in place.

If students are allowed to return to research settings and PPE is required, the mentor will be responsible for ensuring that sufficient PPE is available for student researchers.

For the Deans Research Scholar Program, we expect that mentors of these scholars will integrate the students into all laboratory and clinic phase plans, and will encourage mentees to make alternative, remote research plans should COVID-19 outbreaks recur.

Off-site research experiences:

No medical student research-related travel should be sponsored. Scholarly Activity research will be allowed if travel policies permit but will follow the protocols provided by the Student Affairs

office regarding Off-Site rotations.

If on-campus research is not available in August, SA will continue to be remote.

Student Recruitment

Admissions Evaluation & Selection Process

The Admissions Committee proposes virtual interviews for the 2020-21 admissions season employing the current assessment of technology platforms, AMP by Zap Solutions and Zoom

1) The goal is to interview 750-800 candidates from early September through January. a. Interviews will be conducted by a smaller group of faculty.

(i) Online faculty interviewer training will be provided in August (ii) Flexible interview dates and times will allow for greater participation (iii) Each interviewer is expected to conduct 20-24 interviews

2) The Admissions Committee will function weekly as a Virtual Planning Committee. It will meet in May to review and plan the 2020-21 cycle. Members will receive formal online Admissions Committee training in August

3) The on-campus Interview Weekend will be eliminated, and alternatives designed: a. Ambassador outreach program will pair our current students with applicants virtually. b. Online Virtual student panel will be held for prospective students. c. Associate Deans will provide Online Zoom presentations to cover topics such as Curriculum, Student Life, Support &

Wellness. d. Online Zoom breakout sessions will cover special topics (MD/MPH, Global Health, Research, OSDI, Financial Aid). e. An online resource will be developed for interviewees to view relevant content. f. Online Virtual Tour by YouVisit – pending contract approval *

4) Second Look Opportunities a. Planning for our normal in-person Second Look (MS0) Weekend to take place in February 2021; will continue to monitor

feasibility of this taking place on campus. b. We must define responses to questions about the impact of COVID-19 on clinical training opportunities and availability

of PPE as a trainee. 5) Redesign the Joint Admission Medical Program (JAMP) pipeline program virtually:

a. Moving from a five- to three-week program and moving the curriculum to D2L. b. Offering online enrichment activities facilitated by our JAMP Student Mentors and JAMP faculty Directors/Coordinator


c. Giving online presentations with staff and faculty to cover topics such as Cultural Competence, Interviewing prep, Grit in Medicine, and more.

d. Postponing assessment of MCAT and JAMP summer interviews.

Medical School Events

Medical School Orientation (August 3-7)

Plan A—Mixture of Virtual and Small Group Activities

Assuming that COVID-19 guidance allows for small group activities and is sufficient recommended PPE and hand hygiene product necessary to ensure student safety, Orientation will eliminate the PRE+OP overnight retreat; provide orientation materials using a D2L course with links to training modules; provide large group activities via Zoom

In-person small group activities would allow students to meet and develop tangible relationships with Colleges group, TBL group, Anatomy dissection group, and PBL group

Plan B—Virtual event

If necessary, the above plan will be modified to eliminate small groups by providing Student Panels, Zoom Small group activities via Zoom breakouts groups, and team-building social activities later when social distancing guidance allow them.

White Coat Ceremony (October 3rd)

Plans will be assessed in late summer.

Student Life Activities and Programming and Student Diversity and Inclusion Activities and Programming

These will be assessed against the current environment at time of event.

SIM Center To keep Simulation Center, learners, and instructors safe, while continuing to meet the mission of the UTSW Simulation Center (UTSWSC), the Center will begin to offer courses once the UTSW work from home order expires, following guidelines specified by this plan.

In-person sessions will constitute any sessions that cannot be hosted virtually, based on an activity’s objectives and assessment criteria.

Virtual sessions/meetings will include all work surrounding activities’ such as grading, planning meetings, programing of simulations, staff meetings, SP trainings, and other preparations

Work-from-home time will focus on work aligned with the Center’s current strategic phase, which is “Laying the Center’s Operational and Educational Foundation.” Thus, this work will continue to focus on the development of new curricula, entering data into SimIQ, grading, as well as the development, implementation, and dissemination of new UTSWSC processes.

Overall Plan Assumptions:

1) Guidelines mentioned hereafter will refer to guidelines provided by UTSW, Dallas County, the State of Texas, and CDC.

2) Prior to returning to work, the Center will partner with UTSW cleaning staff to ensure a deep clean was completed.

3) When cleared to return to campus, the first four days will be reserved to test SimIQ, count PPE supplies, and check functionality of manikins.

4) This plan is dependent on the Center’s ability to obtain PPE, particularly gloves.

a. Gloves are required and critical, especially when SPs are touched for physical exams. The quantity will vary based on the number of events and students scheduled. As new logistics are determined, the CDC PPE burn rate calculator will be used.

b. Masks are preferred for learners and sim staff. Cloth masks will be allowed in lieu of clinic-grade masks, if clinic-grade masks are unavailable.


5) The Center will work with UTSW environmental services to ensure a deep cleaning occurs nightly. Every session will have Sim

Staff wipe down surfaces. If available from Environmental Services, the Center will request UV lights be brought in each evening to clean rooms, as the Center has a variety of porous surfaces.

6) Staffing will be based on activity needs and virtual monitoring will be promoted. If possible, core staff will be scheduled for alternate in-person shifts to minimize people in the Center. Administrative staff will work remotely, unless required to assist with an activity, for example proctoring an exam.

Mission critical events will be considered on a case-by-case basis. To be considered, course directors will be required to submit a proposal to the Operations and Medical Director. If the Center directors feel it is a mission critical activity and precautions can be met to keep participants safe, the Directors will carry the proposal forward to the VP, Senior Associate Dean for Education.

May 16 – June 15th, 2020

All Activities:

1. Events will be scheduled or rescheduled on a case-by-case basis, with coordination and approval by the appropriate Simulation Managers and the Operations Director. In the event that the center is not able to host requested activities due to a scarcity of space or resources, prioritization of activities will be directed by the VP, Senior Associate Dean for Education.

2. The maximum number of people per room or open area is five, unless guidelines change, or specific request are approved by the ROC. The maximum number of people must account for required UTSW Simulation Center staff, instructors, and learners. Sim Center rooms include classrooms, debriefing rooms, control rooms, and individual simulation rooms. Individuals should make every effort to maintain six feet distancing within rooms and the number of individuals per room should be minimized whenever possible. No more than five learners may aggregate in common areas, including hallways, corridors, and spaces used for ingress and egress; additionally, spacing of at least six feet must be maintained in all common areas by all personnel and learners.

3. Activities will be scheduled with a corresponding entry and exit point (corridor). These will be reserved for each group of learners in order to minimize hallway congregation and to uphold social distancing standards. Each corridor will be devoted to a single simulation activity for the duration of that activity. If there is not a devoted corridor available during the requested time, the activity will not be approved, and alternative time or date will be offered to course director(s) (Appendices I & II).

4. All corridors will have floor decals, which note six feet distances. Learners will sign-in to their session at the respective corridor while maintaining a six-foot distance. These corridor points will be monitored by UTSWSC staff (Appendices I & II).

5. All sessions will be spaced 30 minutes apart, to ensure appropriate time for preceding groups to leave the building and the next group to arrive. This time will also enable staff to wipe down the surfaces properly between sessions.

6. All learners are expected to wear gloves, utilize hand hygiene and wear a facemask or cloth covering if no mask is available. 7. Temperatures will be taken upon entry to the building. 8. Learners will be monitored by simulation staff to maintain proper social distancing. 9. Any pre-briefs, orientations, assessments, or debriefs should be done virtually to minimize time in the Center via conference

calls, videos, zoom sessions, or etc. 10. All consumables and materials (suture, instruments, etc.) will be locked in cabinets and available upon request.

Simulation Activities

1. UTSW Simulation Center staff will monitor sessions from control rooms, or if possible, virtually. 2. Rooms dedicated to self-practice, such as the suture and VR labs will be available by appointment only. 1. Standardized Patient (SP) Events 1. A maximum of 10 SPs will be in the Center at a given time to promote social distancing. 2. Activities will be reserved to ensure a maximum of five SPs and one test proctor per hallway, with planned routes for

movement between rooms to comply with minimum social distancing of six feet. Using two hallways, the result is a maximum of 10 SPs and 2 proctors.

3. SPs should not be touched, and hence physical examinations will not be allowed. 4. SPs aged 65 or older will not be allowed to participate. Additionally, no SPs with underlying health concerns will be allowed.

Starting June 16th, 2020

1. Five or fewer people per room and six-foot social distancing will be maintained, unless guidelines at that time allow for changes, but reservations will no longer be dependent on the availability of one corridor per activity. (Appendices I & II).

2. Events will alternate start and stop times to minimize the number of individuals in proximity at any single time point.


3. PPE and temperature checks will follow guidelines at that time.

Touching of SPs for critical learning objectives, i.e. physical exams will be allowed when learners wear gloves.

Sim Center for Medical Student Licensing Preparation Medical students take the USMLE Step 2 Clinical Skills examination as part of licensure; passage of this examination is a graduation requirement. UT Southwestern students have been unable to participate in the clinical experiences and practice, in-person, clinical examinations that usually prepare them for the Step 2 CS. Alternatives to in-person clinical examinations are far inferior. Medical students start taking the Step 2 CS in early June.

Recommendation: Proceed with modifications to allow recommended social distancing by decreasing the number of stations on the COSCE from ten to six, eliminating the physical examination, and assuring adequate cleaning of facilities and hygiene.

Documents

Restoration of Operations - UT Southwestern Medical CenterLast Updated Saturday, 9 May 2020 at 3:00 pm Page 1 Restoration of Operations Executive Summary On Monday, March 16, UT Southwestern