Scheduling Delayed Treatment and Surgeries Post-Pandemic: A Stakeholder Analysis

Abstract

Many are interested in how to safely ramp up elective surgeries after national, state, and voluntary shutdowns of operating rooms to minimize the spread of COVID-19 infections to patients and providers. We conducted an analysis of diverse perspectives from stakeholders regarding how to trade off risks and benefits to patients, healthcare providers, and the local community. Our findings indicate that there are a large number of different categories of stakeholders impacted by the post-pandemic decisions to reschedule delayed treatments and surgeries. For a delayed surgery, the primary stakeholders are the surgeon with expertise about the clinical benefits of undergoing an operation and the patient’s willingness to tolerate uncertainty and the increased risk of infection. For decisions about how much capacity in the operating rooms and in the inpatient setting after the surgery, the primary considerations are minimizing staff infections, preventing patients from getting COVID-19 during operations and during post-surgical recovery at the hospital, conserving critical resources such as PPE, and meeting the needs of hospital staff for quality of life, such as child care needs and avoiding infecting members of their household. The timing and selection of elective surgery cases has an impact on the ability of hospitals to steward finances, which in turns affects decisions about maintaining employment of staff when operating rooms and inpatient rooms are not being used.

Developing an Outpatient Pediatric Pre-Procedure COVID-19 Testing Model

“…COVID-19 has forced healthcare providers and institutions to make complex decisions regarding the provision of surgical care during the pandemic, including weighing the risk and benefits of proceeding versus postponing essential surgeries. 5 Research to date has demonstrated that delayed care during the pandemic has had detrimental effects on the health of children. 6-12 More children are presenting to the emergency room with acute illness as a result of delayed care due to fear of exposure to COVID-19 in the healthcare setting.…”