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Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19

INTRODUCTION: The COVID-19 pandemic has compelled a majority of hospital systems to reduce surgical and procedural volumes in an attempt to preserve resources. Elective surgery and procedures resumption has proven to be a calculated risk between COVID-19 exposure and resource depletion and patient m...

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Autores principales: Serrano, Oscar K., Orlando, Rocco, Papasavas, Pavlos, McClure, Mitchell H., Kumar, Ajay, Steinberg, Adam C., Cohen, Jeffrey L., Shichman, Steven J., Singh, Rekhinder K., Sardella, William V., Schipper, Bret M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578777/
https://www.ncbi.nlm.nih.gov/pubmed/33106786
http://dx.doi.org/10.1016/j.sopen.2020.09.001
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author Serrano, Oscar K.
Orlando, Rocco
Papasavas, Pavlos
McClure, Mitchell H.
Kumar, Ajay
Steinberg, Adam C.
Cohen, Jeffrey L.
Shichman, Steven J.
Singh, Rekhinder K.
Sardella, William V.
Schipper, Bret M.
author_facet Serrano, Oscar K.
Orlando, Rocco
Papasavas, Pavlos
McClure, Mitchell H.
Kumar, Ajay
Steinberg, Adam C.
Cohen, Jeffrey L.
Shichman, Steven J.
Singh, Rekhinder K.
Sardella, William V.
Schipper, Bret M.
author_sort Serrano, Oscar K.
collection PubMed
description INTRODUCTION: The COVID-19 pandemic has compelled a majority of hospital systems to reduce surgical and procedural volumes in an attempt to preserve resources. Elective surgery and procedures resumption has proven to be a calculated risk between COVID-19 exposure and resource depletion and patient morbidity and mortality from surgical deferral. METHODS: Within a few days of halting elective surgery and procedures, our 7-hospital (2427 in-patient beds, 26,647 inpatient surgeries) healthcare system developed a multidisciplinary Pivot Plan with the primary outcome of a phased resumption of elective surgery and procedures. The plan entailed the integration of our electronic medical record, order entry automatization, perioperative staff utilization, partnering with primary care providers, and a stepwise COVID-19 testing algorithm based on a predetermined hierarchy of case acuity and timeliness of patient care. RESULTS: The Pivot Plan was instituted on May 10, 2020. Since then, 22,624 patients have been tested for COVID-19 in anticipation of an elective surgery and procedures; 140 (0.62%) tested positive for COVID-19 and had their procedure deferred. As our testing capability has increased, we have been able to increase our added elective surgery and procedures capacity from 13 cases per day to 531 cases per day. In turn, we have seen the case volume increase by 52%. CONCLUSION: Our academic healthcare system located in one of the initial COVID-19 hotspots in the United States has successfully resumed elective surgery and procedures in part due to a receptive and supportive culture based upon nimbleness, agility, and rapid integration of multiple resources from a cohort of diverse disciplines applied to the perioperative services workflow.
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spelling pubmed-75787772020-10-22 Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19 Serrano, Oscar K. Orlando, Rocco Papasavas, Pavlos McClure, Mitchell H. Kumar, Ajay Steinberg, Adam C. Cohen, Jeffrey L. Shichman, Steven J. Singh, Rekhinder K. Sardella, William V. Schipper, Bret M. Surg Open Sci Article INTRODUCTION: The COVID-19 pandemic has compelled a majority of hospital systems to reduce surgical and procedural volumes in an attempt to preserve resources. Elective surgery and procedures resumption has proven to be a calculated risk between COVID-19 exposure and resource depletion and patient morbidity and mortality from surgical deferral. METHODS: Within a few days of halting elective surgery and procedures, our 7-hospital (2427 in-patient beds, 26,647 inpatient surgeries) healthcare system developed a multidisciplinary Pivot Plan with the primary outcome of a phased resumption of elective surgery and procedures. The plan entailed the integration of our electronic medical record, order entry automatization, perioperative staff utilization, partnering with primary care providers, and a stepwise COVID-19 testing algorithm based on a predetermined hierarchy of case acuity and timeliness of patient care. RESULTS: The Pivot Plan was instituted on May 10, 2020. Since then, 22,624 patients have been tested for COVID-19 in anticipation of an elective surgery and procedures; 140 (0.62%) tested positive for COVID-19 and had their procedure deferred. As our testing capability has increased, we have been able to increase our added elective surgery and procedures capacity from 13 cases per day to 531 cases per day. In turn, we have seen the case volume increase by 52%. CONCLUSION: Our academic healthcare system located in one of the initial COVID-19 hotspots in the United States has successfully resumed elective surgery and procedures in part due to a receptive and supportive culture based upon nimbleness, agility, and rapid integration of multiple resources from a cohort of diverse disciplines applied to the perioperative services workflow. Elsevier 2020-10-22 /pmc/articles/PMC7578777/ /pubmed/33106786 http://dx.doi.org/10.1016/j.sopen.2020.09.001 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Serrano, Oscar K.
Orlando, Rocco
Papasavas, Pavlos
McClure, Mitchell H.
Kumar, Ajay
Steinberg, Adam C.
Cohen, Jeffrey L.
Shichman, Steven J.
Singh, Rekhinder K.
Sardella, William V.
Schipper, Bret M.
Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19
title Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19
title_full Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19
title_fullStr Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19
title_full_unstemmed Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19
title_short Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19
title_sort getting back to work: a framework and pivot plan to resume elective surgery and procedures after covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578777/
https://www.ncbi.nlm.nih.gov/pubmed/33106786
http://dx.doi.org/10.1016/j.sopen.2020.09.001
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