We are also reviewing our onboarding process to streamline.  We call our Medical Assessment:    Preplacement Medical Assessment

• We do not screen for alcohol on hire.  We only require a 5 panel rapid test which results immediately in the onboarding clinic.
• We do not allow any person to start work without the UDS result. But, we get results same day with the rapid and within 24 hours for remote workers.
• Fully remote workers only need a UDS prior to start date, no vaccine titers or or other testing.    We send them to a LabCorp and they must get tested at least 72 hours prior to start date.
• We allow out of state newly hired team members to complete the vaccination titers and UDS at LabCorp so start date is not delayed and we do a telehealth medical assessment review.
• Hybrid remote workers require all vaccination titers as do all other team members
• We do not perform physical examinations with the exception of vital signs, vision testing.  New hires only see a nurse practitioner if they have a complex medical history that requires a clearance.
• Our medical assessment is sent AFTER the job offer has been accepted and sent to the new hire  via email via Adobe e-sign and returned to Team Member Health with electronic signatures.  
• ALL new hires, including remote workers, complete the medical assessment.
• Our medical assessment is comprehensive and we find it extremely useful, since we do not require a physical exam and  our providers refer to the assessment when doing a fitness for duty or evaluation of a work injury or personal illness.
•  We also can determine if an accommodation meeting may be required based on the medical assessment.   
• Our nurse practitioners and nurses refer to the medical assessment every day to review PMH, medications, etc. 
• Our Team Member Health department also offers a personal care clinic as well as occupational health clinic with advanced practice providers so the medical assessment is the baseline tool for the providers.
• We did recently shorten the medical assessment but our People & Talent team wants us to shorten it even more so we are in discussion about this now.   Our nurses are adamant about keeping the medical assessment so we will see how it goes.
• We may integrate with our urgent cares clinics for some of our new hire onboarding  and allow for blood draws and drug testing at urgent care  and have our nurses do telehealth medical assessment reviews.  We know we will miss some of the outliers that have physical conditions, so will see how it goes down the road.  We may have our Occ Health nurses at designated clinics but no decision has been made yet as our nurses will still need to review titers, QFTS, drug tests and do all the follow up.
• We recently open a new onboarding clinic just outside the hospital to streamline the process for new hires and we doubled our capacity plus keep the new hires away from our regular clinic full of ill team members who may have COVID.
• We approve new hires  to start work prior to titer results by giving  a temporary badge and then entering clearance into Taleo so they can get their permanent badge.  So, we can clear a person same day if UDS is passed at onboarding.

Good luck.  It is a challenging time with the need to get new hires started quickly to ease the labor shortage.  

JoAnn Shea, APRN, MS, COHN-S

Director, Team Member Health and Wellness

Tampa General Hospital

Office: 813-844-7692

Cell:      813-789-3441

jshea@tgh.org

We Heal. We Teach. We Innovate.
Care for everyone. Every day.

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Rudnick, Howard L
Sent: Friday, June 24, 2022 10:09 AM
To: mcoh-eh@mylist.net
Subject: [MCOH-EH] Changing of Pre-employment Medical Evaluation and Drug Screen

WARNING: This email came from an external source outside of Tampa General Hospital.

Our institution has changed in many ways since Covid in terms of using off site personnel and the critical need for personnel.  I have proposed changes in our Pre-employment medical evaluation.  I would appreciate your opinion of the suggested changes.

1.  Change of wording from pre-employment examination to Pre-Employment Medical Evaluation:
1. Comprehensive medical history reviewed by an Occupational Health physician
2. Only selectively do a physical exam
3. Most useful information regarding decision to hire from a medical standpoint obtained from the comprehensive medical history.
2. Eliminate collecting vaccination titers on wholly distant/non clinical staff:
1. Process:

i. Email sent to Occupational Health from HR

ii. Occupational Health communicates with the Manager asking for assurance that individual will be totally off site and we communicate to them by email that they may not work in TUHS buildings.

iii. Emails scanned into the employees Occupational Health Medical Record

iv. Suggestions for other processes welcome

3. Eliminate alcohol testing:
1. Very low yield
4. No drug and alcohol testing required for those who will wholly work from distance and not be working in TUHS buildings
5. All applicants who live a significant distance be allowed to start work and obtain their drug screen during their first week on campus.

Howard L. Rudnick, MD,MHA,FACP

Clinical Professor (Adjunct), Department of Medicine

Medical Director, Occupational Health Services

Temple University Health System

Office:  (215) 707-3026

Cell:  (267) 838-7040

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