Elective Procedures Are Coming Back – Is Your Facility Ready?

Hospitals and medical facilities across the country are putting elective procedures back on the schedule after a long delay due to the coronavirus. The pandemic has forced millions of providers to reschedule these procedures in order to preserve precious resources for those suffering from COVID-19. The virus has created a two-month backlog of elective procedures as these facilities try to bring various departments back online.

So far, over thirty states have loosened restrictions on performing non-essential procedures despite the pandemic. While the risks associated with bringing non-virus patients into the facility remain high, many patients cannot afford to further postpone these procedures. The longer they wait, the further their health will deteriorate.

However, many patients, even those who are chronically ill, may be hesitant to seek out medical care amid the pandemic. If your facility is resuming elective procedures, make sure your patients feel comfortable coming in for a visit.

Performing Elective Procedures During the Pandemic

Most states are resuming elective procedures, but restrictions tend to vary widely from state to state and even from county to county. Some state governors are giving hospitals the green light for certain procedures, such as tumor removal, cancer screenings and diagnoses, and heart valve replacements, while banning others. Hospitals may have to limit the number of non-essential procedures they perform in a day.

Your facility may have to reach specific benchmarks before you can resume elective procedures. For example, hospitals in Iowa can only perform these services if they reserve at least 30% of their ICU beds and 30% of their medical/surgical beds for virus patients.

Contact your local health department to learn more about the latest restrictions and what they mean for your patients. However, local and state guidelines aren’t always clear-cut. Some states are leaving the decision whether to resume non-essential procedures up to providers and facility managers.

In Pennsylvania, hospitals may begin performing elective surgeries and procedures if the hospital “is able to do so without jeopardizing the safety of patients and staff or the hospital’s ability to respond to the COVID19 pandemic.” Guidelines like these can be open to interpretation.

Many facilities are testing their patients for the coronavirus before they perform these procedures. They will then assign patients to different floors or wings based on the diagnosis.

What It Takes to Resume Elective Procedures

Deciding whether to resume elective procedures usually comes down to whether the facility, state, or county has enough resources to care for COVID-19 patients. This includes a number of factors, including:

• Staffing availability
• The number of ICU and surgical beds and ventilators
• Personal protective equipment supplies
• The severity of the pandemic within the local area.

Resuming elective procedures also depends on the individual patient, including their age, overall health, and the severity of their condition and/or disease. If postponing the procedure will likely be detrimental to the health of the patient, it should not be postponed.

The Department of Health and Human Services has released a list of guidelines for resuming elective procedures. If you’re not sure whether you should schedule a specific procedure, you can use these guidelines to assign your patients to specific tiers based on the urgency of the procedure.

For example, if the patient is unhealthy and they need a low acuity surgery, such as an endoscopy, you should consider postponing it. It should also be performed in a hospital or facility with few, if any, COVID-19 patients, in order to reduce the risk of infection.

A Note on Dental Care

HHS says that dental procedures should be postponed whenever possible, considering they carry one of the highest risks of transmission. Providers must be extremely close to the patient in order to perform these procedures. They also use a considerable amount of PPE.

Tips for Reaching Out to Your Patients

Even if you decide that your facility is ready to resume non-essential procedures, your patients may not feel comfortable seeing you face-to-face or seeking out in-person care. As a doctor or nurse, it’s your job to convince these patients to come into the office if they need urgent medical care. Use these tips to keep your patients informed during the pandemic:

• Create a multidisciplinary team to manage your communication efforts. This team should keep track of estimated timelines for resuming various procedures. They should contact individual patients about rescheduling these appointments and procedures and why it’s important for their health.
• If the patient is unwilling to come into the office, go through the latest safety precautions and infection control measures to help them feel more comfortable. Talk to them about what they can expect from the inpatient experience, including whether they will be able to see their loved ones.
• If a patient wants to come into the office but you’re not ready to resume elective procedures, keep them informed as you look for ways to put them back on the schedule. Consider referring them to another facility with more resources and fewer COVID-19 cases.
• If the patient is unhealthy but you’ve decided to postpone the procedure, look for other ways to monitor their health until you can see them in person, such as telehealth and remote patient monitoring. Talk to them about staying healthy during the pandemic, including diet, exercise and at-home physical therapy.
• Many of your patients may be suffering from anxiety. Even if you have to delay their appointment or procedure, ask them how they’re feeling and remind them that you’re still looking out for them even if you can be there in person.

Resuming elective procedures will help the entire healthcare system get back to normal. Hospitals can start earning more revenue, nurses and providers can start going back to work, and patients can get the care they need. Keep these tips in mind to keep your patients safe.