CHKD’s clinic initiated a screening process in the beginning of the pandemic to screen patients before entering the workplace. This process was initiated by the administration governing CHKD to protect their staff and employees as well as their patients from any exposure to Covid-19. Initially, the screening process took place outside of the building, located a floor below the clinic. It was difficult to screen CHKD’s own patients because several other businesses were located in that building. Therefore, the registration screeners would screen people multiple times including those who were not their patients. Several patients got upset because of this. In addition, the building had two entrances so two different employees were needed from the original staff for screening processes. Screening processes caused a strain on the staff because they used regular staff to screen patients coming in. This led to lines of 20 patients or more waiting to get screened by one screener which led to upset patients as well as stressed screeners. A few hired screeners encountered aggressive patients because of non-compliance with Covid-19 mandates such as limited visitors and masks; some of these hired screeners left because of the stressful situations that arose. CHKD did have to call the police several times because of aggressive patients, which put additional stress on the staff as well as heightened anxiety for the screeners. The clinic decided to use part-time screening later on in the pandemic, however regular staff was still needed 50% of the time. Later on, the clinic convinced the medical director to move screening procedures to the 2nd floor where the main clinic was located due to the concern of safety for the screeners. This screening station lasted two months, and since then, the registration staff screens patients who enter the clinic on the 2nd floor.
The Covid-19 response that CHKD used was headed by the medical directors of the clinic. They put many policies into place including 100% mask use, increased cleaning protocols, waiting room enhanced cleaning, reduced lunch room/lounge room usage and cubicles 6 feet apart. Some challenges that CHKD faced with Covid-19 restrictions and mandates came from both patients and staff of the clinic. This included public reluctance to wear masks and comply with mask mandates at all times as well as providers and staff not wearing masks completely over their nose and mouth. At times, staff did not notify their fellow staff members of possible exposure or travel during Covid-19. This created tension among the staff because if staff became exposed, many members of the staff would not be able to work. Another problem within the clinic was that some providers did not comply with mask mandates fully. Some were seen not wearing masks or wearing masks without covering their nose. This caused some tension among staff and providers because there was a double standard involved. However, the practice manager of CHKD spoke to both providers and staff, constantly reminding them of procedures and rules that needed to be followed during the pandemic. Additionally, other providers were tasked with influencing other non-compliant providers to wear masks correctly. A large problem regarding Covid-19 protocols included the protocol behind quarantining after possible exposure to Covid-19. This affected both staff and providers alike in the clinic. The parameters around exposure and symptoms were constantly changing before there was a set list of policies that were put in place for CHKD. Initially, if there was any possible exposure, tickets were created and forwarded to the medical directors of the clinic. They made the decision when to come back after quarantining. However, since there were two medical directors for the clinic, one director was known to be very lenient in his processes and the other was very stringent with following protocols for quarantining after exposure. Therefore, this caused mixed signals among the staff in knowing what set of policies to follow and when. Staff members reached out to their providers and only until the providers brought this to the attention of the medical directors did the administration release a statement of standardizing the protocol.