Omicron Surge Management – Strategies from the Field

On the COVID Listserv, UCA/CUCM Members are sharing strategies for handling the Omicron surge in the midst of staffing shortages.  Nationwide, urgent care centers are seeing up to 250 patients per day, and an increase in staff sickness has required implementation of additional measures to help their care teams.

Here are some excerpts that may be helpful as you make your own adjustments.

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"We handle the excess volume by allowing staff to temporarily close for 1-2 hours. We call that DEFCON. DEFCON 3 is we don’t allow patients in the office, and DEFCON 4 we don’t allow patients in the office OR schedule anymore telemedicine visits. We keep a wait list and when we reopen we are usually able to see everyone waiting. They are told we will call them back if we can and when we do call them back even if it’s been three hours they are very happy to have actually gotten in to see us. This serves two purposes:

One - The staff is not as overwhelmed as if they are looking at an hours long list of patients to be seen.

Two - Patients are happy that they are eventually seeing even if it’s been several hours because we did not make them wait outside our office or by the computer at home for a video call. Also some at that point some have found another place to go and are happy we didn’t make them wait to see us. We also buy staff all meals."


"We have been using the queuing feature on our (software) and it closes or opens the schedule for us based on our throughput and patient volume. All patients register remotely or are put in the queue by our staff if they walk in. If they walk in they are triaged for high risk issues, all others are put in the queue. They wait remotely and (the software) notifies them when they are 4th in line. They typically have 4-5 hour "waits" but they are doing it from home and are happier. Since doing this two weeks ago we have seen more patients but because it is metered, the staff is less stressed, our in-office throughput times are minimal and the most patients we have had in our lobby at one time is 5."


"We are watching our track boards and if we have more than 6 pts per hour per provider we stop registration. We look about every hour and make a “stop for the day” decision about 7pm as we close at 9pm."


"We also have now made a schedule each day at our walk in clinics. Each patient showing up is placed into a slot on the schedule. They are informed of their time slot and to return then. When the schedule is full, non-emergent pts are turned away to the ED or elsewhere or can come back tomorrow morning. We do have a list of conditions that are to be seen regardless of the schedule. This has decompressed the stress levels of the patients and the staff. Providers and staff now get out at reasonable times and patients are not unhappy."


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"All our reserved spots are gone within a few minutes of opening. We use (software) for cueing so two hours before closing, the Provider on shift looks at "Today's Patients" and takes out the "canceled" and "removed" and does a count. At a certain number (it is different for each clinic but the number never changes), the provider has the authority to halt walk-in patients within one hour of closing. If the Provider thinks it needs to be two hours before closing, they text leadership so we can review (the software) from home and decide. Since 12/20, we have halted walk-ins one hour before closing several times. Doing this one hour before close allows the staff to clock out within a half hour of the shift ending. This is so important for morale and so they can extend good customer service to the patients we are able to see. We also have this on our website: 

Due to incredibly high volumes, we may have to stop taking walk-ins after a certain number every day. This will happen within two hours of closing, and this decision is subjectively made by the doctors on staff.

We apologize for any inconvenience and appreciate your patience at this time."