The American College of Surgeons (ACS) and CMS have called for a nationwide curtailing of elective procedures during the current crisis. It is paramount that all hospitals, even those without immediate plans to cancel elective surgeries, have a service restriction plan in place in the event of a drastic change in staff shortages or increased demand.
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Below we've outlined some reasons why health systems are choosing to cancel elective surgeries, despite potential financial drawbacks.
Health systems that have announced elective surgery cancellations or postponements (not exhaustive):
1. Conserve supplies
Having enough supplies for the anticipated surge of patients is the top concern for many hospitals. Critical supplies include full personal protective equipment (PPE) such as protective eyewear, ventilators, respirator masks, and cleaning supplies like anti-bacterial soap or alcohol-based hand rubs.
At this point, there may be no such thing as over-preparedness. Phoebe Putney Health System in Georgia recently became overwhelmed with new COVID-19 patients. The CEO stated that they went through five months' worth of supplies in just six days. Minimizing the use of critical supplies where possible and redirecting the use of those supplies is essential in the conservation effort to ensure they are available for use in the future.
2. Protect against transmission
Remaining consistent with social distancing practices, hospitals are reducing the number of people, both staff and patients, who are present, keeping only essential personnel to help prevent the further spread of the illness. This minimizes the risk of the illness being brought into a facility by a patient, which keeps staff safe, as well as minimizes the risk of a patient contracting the illness and then taking it back to the community.
3. Alleviate staff workload
Hospitals are making efforts to protect staff from potential infection, but also to alleviate their workloads as the number of COVID-19 cases increases and spreads to more communities. Hospitals may be preparing to rearrange staff to help cover a more acute caseload, especially as an overall staff shortage has become a looming threat. Ensuring front-line and support staff are healthy and not over-worked is essential in combatting this pandemic.
4. Create more capacity
Currently, many hospitals are at risk of capacity constraints, and therefore may be unable to properly isolate COVID-19 patients and staff from surgical patients and staff. Even hospitals that are currently operating with enough capacity will probably not remain there, given anticipated growth in cases.
As an aside, hospitals may also implement other tactics to address capacity issues, such as using tent-like facilities for testing outside first, re-structuring spaces like waiting rooms for low-acuity and routine patients, doubling up on non-infectious patient rooms, moving non-infectious patients to lower acuity units, and discharging patients a little sooner.
There's no ideal time to postpone surgeries and the decision will likely come with challenges. To help, ACS has provided a guide for triaging non-emergent surgeries that includes an elective surgery acuity scale to help with categorization decisions. Emergent and urgent surgeries may be time-sensitive for patients, where delaying surgery may significantly change their health outcome. Elective and non-urgent surgeries can be rescheduled and likely won't affect the patient's health outcome.
Your top resources for coronavirus readiness
You're no doubt being inundated with a ton of information on how to prepare for possible patients with COVID-19. To help you ensure the safety of your staff and patients, we pulled together the available resources on how to safely manage and prevent the spread of COVID-19.