Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/1275686
David Shapiro, MD, an anesthesiologist based in Tallahassee, Fla., who has extensive ASC manage- ment experience. "The fact that you can schedule elective surgeries in advance doesn't mean they're unnecessary. These people are in pain or have got- ten to the point where they can't function normally. You can wait a week or several weeks to do a joint replacement, but it's not something you can post- pone indefinitely." Dr. Berger stopped performing hip and knee replacements for seven weeks during the shut- down, leaving about 250 patients without new joints they desperately needed. "They had adjust- ed their entire lives to prepare for their surgeries and were devastated at having to postpone them," says Dr. Berger. "Shutting down elective proce- dures was the appropriate move at the time, but now we need to help get ailing patients back to normal life routines." Elective surgeries play a critical role in both the short- and long-term health of patients, points out Sandra Jones, MBA, MSM, CPHRM, LHRM, CHCQM, CASC, FHFMA. "Many people have already delayed surgery," says Ms. Jones, who founded Ambulatory Strategies Inc., a manage- ment firm in Dade City, Fla. "Restricting their access to surgical care because of potential COVID-19 exposure will cause major damage to their long-term health." She has firsthand knowledge of the dangers the shutdown caused. One of her family members in their 50s wasn't able to schedule a colonoscopy dur- ing the early phase of the pandemic. The family member recently had the procedure done, and can- cerous polyps were discovered. "Waiting could've been disastrous," says Ms. Jones. "Here, a timely elective GI procedure was absolutely essential." While some preventative elec- tive cases such as colonoscopies can literally save lives, others can drastically improve the quality of life for patients. The latter shouldn't be underestimated, according to Ms. Jones. "Quality of life needs to factor into the equation," she says. "How long can patients go without reading or watching TV when they delay cataract surgery? How long can individuals with chronic pain issues go without pain management procedures before their quality of life suffers?" Of course, there are procedures that can safely be delayed until the current spike abates — espe- cially for high-risk patients with chronic health con- ditions or weakened immune systems. But how do you determine when elective surgery can proceed and when it should be delayed? Unfortunately, you can't rely on uniform guidance. "Decisions must be made on a case-by-case basis," says Ms. Jones. "Regular communication between patients and their physicians is more important than ever." Allaying patient fears The Manhattan Eye, Ear & Throat Hospital, a 17-OR multi-specialty ASC in New York City that performs 17,000 surgeries a year, lost about 95% of its surgical business during the coronavirus shutdown. It re- opened June 8 and is now at about 75% of its former capacity. Reaching that level wasn't as simple as unlocking the door and flipping on the lights. "It wasn't like we opened the building and had a line around the block," says Joe Manopella, CEO of the Northwell Health facility. "It took a lot of coor- dination. We thought we were going to have an unbelievable influx of patients when the state cleared the resumption of elective surgeries, but there were a lot of patients who weren't reschedul- ing postponed procedures." The facility had set up a team of providers during the shutdown to rank which 5% to 10% of cases — such as detached retinas, bone fractures and liga- ment tears — were emergent and needed to be 2 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 2 0 "The fact that you can schedule elective surgeries in advance doesn't mean they're unnecessary." — David Shapiro, MD