In response to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS), the U.S. Surgeon General and many medical specialties recommended interim cancelation of elective surgical procedures.
However, “when the first wave of this pandemic is behind us, the pent-up patient demand for surgical and procedural care may be immense, and health care organizations, physicians and nurses must be prepared to meet this demand,” The American College of Surgeons, American Society of Anesthesiologists, Association of periOperative Registered Nurses, American Hospital Association said a joint statement.
Facility readiness to resume elective surgery will vary by geographic location. In “Roadmap for Resuming Elective Surgery after COVID-19 Pandemic,” the organizations created a list of principles and considerations to guide physicians, nurses and local facilities in their resumption of care in operating rooms and all procedural areas.
1. Timing for Reopening of Elective Surgery
Principle: There should be a sustained reduction in the rate of new COVID-19 cases in the relevant geographic area for at least 14 days, and the facility shall have appropriate number of intensive care unit (ICU) and non-ICU beds, personal protective equipment (PPE), ventilators and trained staff to treat all non-elective patients without resorting to a crisis standard of care.
2. COVID-19 Testing Within a Facility
Principle: Facilities should use available testing to protect staff and patient safety whenever possible and should implement a policy addressing requirements and frequency for patient and staff testing.
3. Personal Protective Equipment
Principle: Facilities should not resume elective surgical procedures until they have adequate PPE and medical surgical supplies appropriate to the number and type of procedures to be performed.
4. Case Prioritization and Scheduling
Principle: Facilities should establish a prioritization policy committee consisting of surgery, anesthesia and nursing leadership to develop a prioritization strategy appropriate to the immediate patient needs.
5. Post-COVID-19 Issues for the Five Phases of Surgical Care
Principle: Facilities should adopt policies addressing care issues specific to COVID-19 and the postponement of surgical scheduling.
6. Collection and Management of Data
Principle: Facilities should reevaluate and reassess policies and procedures frequently, based on COVID-19 related data, resources, testing and other clinical information.
7. COVID-related Safety and Risk Mitigation surrounding Second Wave
Principle: Facilities should have and implement a social distancing policy for staff, patients and patient visitors in non-restricted areas in the facility which meets then-current local and national recommendations for community isolation practices.