Planning the Comeback: Checklist Considerations When Restarting Elective Surgeries

Thoughtware Article Published: May 19, 2020
Stethoscope and laptop

As states, counties and municipalities begin easing stay-in-place restrictions, many hospitals and health systems are carefully considering options to restart elective surgeries and medical care. Unfortunately, reopening the operating rooms won’t be as simple as continuing where we left off before the SARS-CoV-2 virus and the incidence of COVID-19 occurred. There are many factors for leadership to consider while keeping the safety of patients and staff at the forefront of operations. With COVID-19 still looming and safety concerns heightened, below are areas to consider as your organization begins to plan a path forward to reopening:

1.    Timing for Reopening of Elective Surgery

  • Review and monitor clinical census, availability of ICU and non-ICU beds, personal protective equipment (PPE) and medical supplies
  • Coordinate with local, state and/or federal health departments 
  • Continually update COVID-19 safety protocols and policies 
  • Create and provide informational guidelines for patient-facing materials
  • Review BKD’s “Hospital Use of Incident Command System During & After the COVID-19 Pandemic
  • Begin evaluating diagnostic and ancillary service levels for increase in utilization
  • Evaluate labor needs, e.g., technicians, RNs, physicians and administrative staff

2.    COVID-19 Testing Within a Facility

  • Be prepared with available testing kits and/or rapid testing when available
  • Establish a process flow that screens patients by survey to alleviate testing constraints 
  • Continue to support staff and patients by implementing daily temperature checks at entrance, complimentary masks and testing support for needed staff

3.    Case Prioritization & Scheduling

  • Gather a list of all previously canceled/postponed and new cases
  • Create a clinically led task force to review elective cases and surgical plans to move forward
  • Develop a strategy for phased opening of operating rooms, including capacity goals, outpatient versus inpatient case composition and prioritization 
  • Ensure adequate availability of inpatient and ICU beds and supplies for postoperative care
  • Ensure supply chain reliability, with emphasis on surgical supplies, implants and anesthesia support. This includes verification of expiry products and incoming shipment tracking for COVID-19-related delays
  • Determine a policy and guidelines for COVID-19 positive procedural candidates that include treatment, postponement of procedure and further timelines

4.    Post-COVID-19 Issues for the Five Phases of Surgical Care

  • Phase 1: Preoperative
  • Phase 2: Immediate Preoperative
  • Phase 3: Intraoperative
  • Phase 4: Postoperative
  • Phase 5: Post-Discharge Care Planning

5.    Collection & Management of Data

  • Continue to track financial data related to COVID-19 and not related to COVID-19 cost; recommend daily input and review
  • Keep incident action plan updated; recommend daily input and review
  • Collect data and monitor COVID-19 volumes and testing across sites of care
  • Continuous inventory of bed availability, PPE supply, ICU capacity and ventilator availability
  • Quality of care metrics

6.    COVID-19-Related Safety & Risk Mitigation Surround Second Wave

  • Update and implement social distancing, mask wearing and other safety policies for staff, patients and visitors
  • Restrict number of persons that can accompany the procedural patient to the facility

7.    Additional COVID-19-Related Issues

  • Develop guidelines and procedures for potential second wave
  • Increase personnel support for overall well-being, with emphasis on both mental and physical health
  • Increase EVS and cleaning efforts for all areas of the hospital

Elective surgeries and medical care are engines that financially power and sustain many hospitals. While the term “elective” is frequently used, many of these surgeries and clinical services are essential for the safety and well-being of patients and the community. Reopening will be a challenge, but with a carefully devised plan and decision-making agility (multiphase approach), hospitals and health systems can efficiently handle the utilization bounce back without jeopardizing patient and staff safety. 

As with most topics related to COVID-19, changes are being made rapidly. Please note that this information is current as of the date of publication. If your leadership team has questions or would like to discuss potential strategies, reach out to your BKD Trusted Advisor or use the Contact Us form below for additional information.      

Additional Resources

Related Thoughtware

Kate & Ben — How can we help you? Contact Us!

How can we help you?