Surgical Re-entry Strategy Following COVID-19 Pandemic

Abstract

Following the Presidential declaration of a national emergency, many health care organizations adhered to recommendations from the Centers for Medicare and Medicaid (CMS) as well as the American College of Surgeons (ACS) to postpone elective surgical cases. The transition to only emergent and essential urgent surgical cases raises the question, how and when will hospitals and surgery centers resume elective cases? As a large health care system providing multispecialty tertiary/quaternary care with across the Southeast United States, a collaborative approach to resuming elective surgery is critical. Numerous surgical societies have outlined a tiered approach to resuming elective surgery. The majority of these guidelines are suggestions which place the responsibility of making decisions about re-entry strategy on individual health care systems and practitioners, taking into account the local case burden, projected case surge, and availability of resources and personnel. This paper reviews challenges and solutions related to the resumption of elective surgeries and returning to the pre-COVID-19 surgical volume within an integrated health care system that actively manages 18 facilities, 111 operating rooms, and an annual operative volume exceeding 123,000 cases. We define the impact of COVID-19 across our surgical departments and outline the staged re-entry approach that is being taken to resume surgery within the health care system.

Hospital transfusion service operations during the SARS‐CoV‐2 pandemic: Lessons learned from the AABB hospital survey in preparation for the next infectious disease outbreak

“…ICU bed availability and COVID‐19 caseload, not blood availability, were the most relevant considerations for canceling surgeries; PPE availability was a close fourth. Remarkably, blood supplier notification was closely associated with reduced wastage throughout the course of the pandemic despite the resumption of ESP 30–32 and despite the increasing number of COVID‐19 cases. Wastage remained at or below 10% even as notifications reached their lowest levels in mid‐August, by which time blood suppliers were able to increase their donor pools in response to blood donor eligibility criteria modifications made by the Food and Drug Administration 33…”

COVID-19 mRNA vaccination, reactogenicity, work-related absences and the impact on operating room staffing: A cross-sectional study

“… 5 , 6 Wohler et al stated, “Resuming elective surgical cases in the face of a global pandemic is a complex issue with unanticipated complicating factors”. 7 Operating room services at the authors’ hospital were reestablished pre-vaccination in the summer of 2020 using a gradual and tiered approach, but this approach did not initially consider provisions for team member absences due to vaccination reactogenicity.…”