Open AccessSurgical Re-entry Strategy Following COVID-19 Pandemic
Author(s) -
Andrew Wohler,
Jeffrey S. Kneisl,
David M Macknet,
Alexander Hysong,
Kathleen Kaney,
Scott Moroney,
Joseph R. Hsu
Publication year - 2020
Publication title -
medical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.632
H-Index - 178
eISSN - 1537-1948
pISSN - 0025-7079
DOI - 10.1097/mlr.0000000000001471
Subject(s) - elective surgery , medicaid , health care , medicine , pandemic , declaration , medical emergency , emergency surgery , covid-19 , nursing , surgery , political science , disease , infectious disease (medical specialty) , law , pathology
Following the Presidential declaration of a national emergency, many health care organizations adhered to recommendations from the Centers for Medicare and Medicaid (CMS) as well as the American College of Surgeons (ACS) to postpone elective surgical cases. The transition to only emergent and essential urgent surgical cases raises the question, how and when will hospitals and surgery centers resume elective cases? As a large health care system providing multispecialty tertiary/quaternary care with across the Southeast United States, a collaborative approach to resuming elective surgery is critical. Numerous surgical societies have outlined a tiered approach to resuming elective surgery. The majority of these guidelines are suggestions which place the responsibility of making decisions about re-entry strategy on individual health care systems and practitioners, taking into account the local case burden, projected case surge, and availability of resources and personnel. This paper reviews challenges and solutions related to the resumption of elective surgeries and returning to the pre-COVID-19 surgical volume within an integrated health care system that actively manages 18 facilities, 111 operating rooms, and an annual operative volume exceeding 123,000 cases. We define the impact of COVID-19 across our surgical departments and outline the staged re-entry approach that is being taken to resume surgery within the health care system.