Keeping Fox Army Health Center operational remains a priority as it continues to navigate the rapidly changing guidelines brought on by COVID-19.

Since mid-March when COVID-19 reached Alabama and Redstone Arsenal, the health center has made ongoing adjustments to how the facility operates, said Maj. Todd Eaves, deputy commander for the health center’s administration. As of Friday, services being offered include acute and essential lab work. The Fox Army Pharmacy is fully functional and as busy as ever with a drive-thru option on days there is no inclement weather.

Eaves said he is proud of the way the Fox staff has responded to the rapidly changing environment caused by the COVID-19 pandemic.

“Our staff, they are truly in it to take care of our patients,” Eaves said. “That’s what we’re here for and for our front line staff, it’s their duty, profession and calling.”

He said the staff’s dedication is evidenced in the way everyone has embraced ongoing changes to help, even if the tasks they’re doing are not related to their usual job. For example, since behavioral health and physical therapy staffs are not seeing their regular patients, many of them are helping out in the pharmacy.

Col. Michael Madkins, director for primary care, said it’s reassuring to see the center’s staff stepping outside of their comfort zone.

“This has been an opportunity for our staff to shine in terms of doing things out of the ordinary and being comfortable with it for the sake of our patients, first,” Madkins said. “But also for our facility and fellow staff.”

Inside Fox Army Pharmacy

“The Pharmacy handles on average about 1,500 prescriptions a day,” Eaves said. “Transitioning how our Pharmacy works has been a priority because it is one of the biggest demands of our patient population.”

On March 23, a drive-thru service started for those picking up refills, Eaves said. Starting Friday, patients were no longer allowed to go inside the Pharmacy as new prescriptions and refills were made available at the drive-thru.

“Today was a record day with 278 cars,” Suzette Baker, chief of pharmacy, said following a hectic day on Thursday. “We’re expecting a lot tomorrow too with the new changes.”

Baker said the COVID-19 crisis has forged new working relationships.

“I’d say the morale is awesome,” Baker said. “I’ve always thought of us as one big happy family here in the pharmacy but now it’s a huge family … People who work in a health center in general are always friendly … and it feels like everybody is helping the pharmacy during this time.”

The pharmacy usually has 20 American Red Cross volunteers to assist with daily operations, but they’ve all been sidelined as the COVID-19 crisis escalated. That’s another reason why workers from other departments have stepped in to help.

The drive-thru isn’t a typical drive-up window. It involves someone physically taking a prescription outside to a patient’s vehicle. Since Friday, she said if a patient has a written prescription, someone will take the prescription from the patient and then take it inside to get it filled.

“They can come back at a later time to pick it up, or if they want to wait for it, we will instruct them to drive to the main entrance parking lot and wait there. We will hand deliver it to their vehicle when it’s ready,” Baker said. “If they want to come back another day they can go through the drive-thru line to pick it up.”

To speed up the process, Baker encourages patients to call in refills before they head to the pharmacy.

“But we need them to pick up the refills by the next day because we are running out of places to store them,” she said. “Right now, we’re usually able to complete refills within 24 hours.”

Eaves said patient input has been positive on the pharmacy changes.

“It’s been going extremely well,” Eaves said. “We’ve received a lot of compliments from beneficiaries who say they’re really enjoying it.”

Current Fox operations

In three weeks, Eaves said COVID-19 altered almost every element of Fox Army Health Center operations. One option for care, he said, is for patients to access Tricare online where they can send a message to their primary care team instead of coming to the facility.

“We want everyone to stay at home as much as they can right now,” Eaves said, adding that Fox will continue providing access to care, but may tweak access to services as needed.

“What we’re seeing is unorthodox,” Madkins said. “We are now on a face-to-face basis managing acute visits and lab services only.”

By April 10, the health center’s primary care providers and nurses were managing most chronic conditions and follow-ups through telehealth means.

“As patients are calling in with their needs through our call center, we have a registered nurse with them to help determine which situations are appropriate for office visits or to give nursing advice,” Madkins said. “And there are a lot of questions on COVID-19 in general so having an RN in the call center has helped ease the workload for our call center clerks.”

The provider and nurse teams are also reaching out and handling previously scheduled routine care and follow-up visits by phone or secure messaging as best they can by providing refills, lab results or even scheduling necessary lab work, until things return to normal.

“Most of what is coming through the lab are orders directed from a provider versus walk-ins,” Madkins said.

Although everyone is encouraged to call before going to the health center, Eaves said everyone who enters is required to wear a protective facemask. If they don’t have one of their own, one will be provided. A screening for COVID-19 symptoms will be conducted before a patient is allowed to proceed into the building.

“Our primary goal has been to reduce the traffic inside the facility,” Madkins said. That measure is for everyone’s safetyand to limit potential exposure,” he added.

Eaves said everything that happens at Fox has been done in line with COVID-19 guidance from the CDC, Army and state of Alabama. Some days, he said there have been multiple changes throughout a single day, all focused on the safety of staff and patients, to limit the exposure and spread of the potentially deadly COVID-19.

“I would commend the staff in terms of their flexibility and ability to adjust. They’ve really stepped up and performed well in such a new and very fluid situation,” Madkins said. “We’re very appreciative of our patient’s flexibility too. There’s a level of anxiety associated with the illness itself, and then when mixing that with changes in how how to get things done, so it’s been a lot for everyone.”

How to stay informed

Eaves said Fox will continue to adjust as the COVID-19 crisis evolves. He encourages interested patients to monitor online communications that are posted on Facebook and at www.redstone.amed.army.mil.

“We’ve seen rapid changes in three weeks and we don’t know what the next three weeks will look like,” Eaves said. “Some of the changes happen quickly and these online avenues are the ways we make sure we are are communicating to get all information out as quickly and as accurately as possible.”

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