Awareness, Preparedness, & Safety are Keys to Resuming Elective Surgery

In response to the COVID-19 outbreak, the majority of our country’s medical resources needed to be consolidated and redirected to treat the sudden flood of infected patients. In order to open up beds for overwhelmed facilities and minimize adding to the spread of infection, elective surgeries and procedures have been placed on hold for specialty practices for months. However, as certain states begin the process of reopening and lockdown restrictions are eased, many specialty practices will soon be resuming elective surgeries. In order to aid our readers in this effort, we are providing this blog to offer helpful tips on how to do so safely and responsibly.

Be Aware

Awareness of your local situation is paramount to safely resuming elective surgeries and procedures:

• Know Your Local COVID-19 Numbers – The rate of infection can vary wildly from state to state, and even from one city/town to the next. For example, at the time of writing, there have only been a total of 6 cases and 0 deaths in Moffat, CO, while in Denver, CO there have been 2,890 cases and 150 deaths. Therefore, the situation can be quite different depending on where your practice is located, even within the same state. It is important for you to know (and stay current on) your state and local numbers. The Johns Hopkins University Coronavirus Tracking Map is a great resource tool for conducting this kind of research.
• Be Aware of Local Testing Availability – You also need to be aware of the COVID-19 testing rates in your state, as well as the local availability of tests. You can find details on test availability by visiting the CDC website and/or by contacting your State & Territorial Health Department. Also, be aware of what kind of testing is being used in your area. Nasal swab and oral swab tests, which have been widely used in many regions, have proven to have only roughly 60%-70% sensitivity in a best case scenario. However, nucleic acid tests have shown to be far more effective.
  
  

Be Prepared

You will need to ensure that you are properly stocked and equipped in order to effectively and safely resume operations:

• Personal Protective Equipment (PPE) – Check all polices (see Additional Resources section below) to determine what PPE levels will be needed for you and your staff. Take solid counts of your current on-hand PPE inventory and check with your vendors to confirm the future availability of PPE for your practice. Lastly, be sure to clearly communicate your practice’s PPE policies and procedures to all providers and staff.
• Local Facility Capacity – Confirm the total capacity of your healthcare facility (beds, ICUs, ventilators, etc.) as well as what amount of that capacity is currently being occupied. Also be sure to include estimates for expansion due to anticipated demand.
• Supply Chain & Resources – Be aware that many vendors have limited supplies in stock and that some may even have changed to focus solely on providing PPE. Ensure that you will have an appropriate supply of products available by securing new vendors when necessary. Also note that you will need to secure necessary cleaning supplies for the disinfection of all patient occupied areas.
  
  

Be Safe

Needless to say, safety must take top priority when resuming elective surgeries and procedures. Be sure to consider the following:

• Communication – Frequent and clear communication must be maintained at all times, between providers and staff as well as between providers/staff and patients.
• Protection of Providers & Staff – Be sure that providers and staff are being adequately protected with such measures as the use of PPE, procedures for exposure minimization, proper cleaning, etc.
• Protection of Patients – Be sure that patients are adequately screened for possible COVID-19 infection before scheduling them for surgery. Organize details messaging to patients that clearly communicate expectations on testing policies, procedures for exposure minimization, staff PPE use, post-discharge follow-up, etc.
  
  

Additional Resources

For more detailed and official instructions regarding best practices and processes for resumption of elective surgeries and procedures, readers should refer to the following resources:

ACS: Local Resumption of Elective Surgery Guidance

CMS Non-Emergent Elective Procedure Guidance

CMS Telemedicine Fact Sheet

CDC COVID-19 Guidance Page

CDC PPE Burn Calculator

DISCLAIMER

The information provided in this blog article does not, and is not intended to, constitute legal or other advice; instead, all information, content, and materials are available for general informational purposes only. Information in this article may not constitute the most up-to-date legal, financial or other information. Readers should contact their attorney, financial, tax, or other advisor to obtain advice with respect to any particular matter. This article contains links to other third-party websites. Any such links are provided only for convenience and Nextech does not recommend or endorse the contents of any third-party sites.