Reinstating Elective Surgeries in MedStar Health: A Roadmap for Healthcare Organizations

Area of Science:

• Healthcare Management
• Surgical Operations
• Infectious Disease Control

Background:

• Global strain on hospital resources due to Coronavirus Disease 2019 (COVID-19) led to suspension of elective procedures.
• Resumption of normal hospital activities requires structured policies and algorithms for safe and orderly return.
• Multi-institutional healthcare systems need standardized approaches for reinstating elective operative and ambulatory procedures.

Purpose of the Study:

• To develop guidelines for the safe resumption of elective surgeries and ambulatory procedures.
• To establish a framework for prioritizing cases and managing resources during the COVID-19 pandemic.
• To create adaptable recommendations for various healthcare facilities and service lines.

Main Methods:

• Formation of a multidisciplinary task force to create guidelines.
• Establishment of a governance structure at each facility for prioritizing procedures.
• Development and implementation of mandatory preoperative COVID-19 testing protocols.
• Creation of an elective surgery algorithm based on a Medically Necessary Time Sensitive score and resource availability assessment.

Main Results:

• Each hospital president empowered local perioperative leadership teams to prioritize elective cases.
• A "go/no-go" assessment system was implemented based on local resources and a simplified scoring system.
• Mandatory preoperative severe acute respiratory syndrome coronavirus 2 (COVID-19) testing policies were operationalized.

Conclusions:

• Hospitals and surgical centers require ongoing COVID-19 screening, testing, and case prioritization post-pandemic.
• Effective supply chain management is crucial for maintaining patient and staff safety.
• The developed guidelines are applicable to diverse healthcare settings, including academic medical centers and community facilities.