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COVID-19 infection and ambulatory surgery: Decision making based on known knowns
Leopoldo Vicente Rodriguez1, Joshua Aaron Bloomstone2
1American Society of Anesthesiologists Committee on Ambulatory Surgical Care, ASA Committee on Performance & Outcome Measures, Society for Ambulatory Anesthesia, UCHealth Longs Peak Hospital, Longmont, CO, USA; Boulder Valley Anesthesiology, PLLC, Nova Southeastern University, Ft Lauderdale, FL, USA.
Insights
The COVID-19 pandemic significantly impacted ambulatory surgery centers (ASCs), reducing patient volume and revenue. This review addresses critical perioperative issues, safety protocols, and supply chain challenges for ASCs during the pandemic.
Area of Science:
- Healthcare Management
- Infectious Diseases
- Surgical Services
Background:
- The Coronavirus Disease 2019 (COVID-19) pandemic caused unprecedented changes in healthcare.
- Ambulatory surgery centers (ASCs) experienced substantial reductions in patient volume and revenue early in the pandemic.
- Despite initial care stoppages, ASCs adapted to provide essential surgical services, including for patients transferred from inpatient settings.
Purpose of the Study:
- To address key perioperative issues related to COVID-19 in the ambulatory surgery setting.
- To discuss the complexities and challenges posed by a novel and evolving virus.
- To outline strategies for patient and staff safety, supply chain management, and facility staffing.
Main Methods:
- Review of perioperative considerations for ambulatory surgery during the COVID-19 pandemic.
- Analysis of the impact of viral infection and vaccine development on surgical outcomes.
- Examination of safety protocols, supply chain logistics (PPE), and staffing challenges.
Main Results:
- Ambulatory surgery faced significant disruptions, including decreased patient volumes and financial strain.
- ASCs played a role in managing surgical backlogs by accepting 'offloaded' patients.
- The pandemic necessitated rapid adaptation in safety measures, supply management, and workforce planning.
Conclusions:
- The COVID-19 pandemic presented unique challenges for ambulatory surgery, requiring innovative solutions.
- Effective management of perioperative issues, safety, and resources is crucial for ASCs navigating infectious disease outbreaks.
- Adapting to the evolving landscape of viral threats is essential for the resilience of ambulatory surgical services.
Abstract:
During the spring of 2020, as Coronavirus Disease 2019 (COVID-19) infections rapidly spread across the globe, all sectors of healthcare, everywhere, would change in ways that were unimaginable. Early on, the ambulatory surgery space, being no exception, would suffer deep and impactful reductions in patient volume and revenue. Though actual care stoppages were short-lived, decreased ambulatory surgical patient volumes continued for a myriad of reasons, though in some cases, ambulatory surgery centers (ASCs) provided surgical care in limited numbers to patients who were "offloaded" from inpatient lists. Released on March 24, 2020, herein, we address the key perioperative issues as they relate to COVID-19 and ambulatory surgery including the many complexities and challenges of a new and rapidly changing virus, the impact of viral infection and vaccine development on perioperative outcomes, key ambulatory surgical approaches to COVID-19-related patient and staff safety, and finally, managing issues related to both supply chain (personal protective equipment (PPE) and other necessary equipment) and facility staffing.
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