Multidisciplinary Approach to Reduce OR Delay and Cancellations Due to Covid-19 Testing

BACKGROUND INFORMATION: The COVID-19 pandemic has influenced the global health care system. The institutional guidelines indicate that all surgical procedures require a negative COVID test within four days of surgery. Operating room (OR) delays/cancellations related to pending COVID results can lead to unnecessary waste of PPE resources. Additionally, it can cause undue emotional distress for the patient and family, which affects the patient experience. OBJECTIVES OF PROJECT: The objective of this project was to reduce OR delays/cancellations related to COVID-19 testing. PROCESS OF IMPLEMENTATION: Perioperative guidelines and workflow on testing for COVID-19 prior to surgery was developed utilizing the institutional guidelines, based on Centers for Disease Control and Prevention (CDC) recommendations. A tracking tool was created to enter COVID-19 test information, starting from 6/15/2020. This data included information regarding test status, delays and cancellations. Testing appointments and pending results were reviewed throughout the day to ensure timely identification and interventions if the patients fell outside the COVID testing criteria. Communication to surgical and leadership teams were also completed to ensure proper follow up and escalation of processes. STATEMENT OF SUCCESSFUL PRACTICE: The development of a COVID-19 test tracking tool data indicates significant reduction of OR delay or cancellation. The overall data from June to August 2020 shows that COVID-19 pending tests have improved significantly from 6.8% to 0.2%. Of the pending results, the delay of surgical cases improved from 2.9% to 0.2%; and the cancellations of cases improved from 0.7% to 0.07%. IMPLICATIONS FOR PERIANESTHESIA NURSES AND FUTURE RESEARCH: Having a tracking tool provides perianesthesia nurses an opportunity to quickly identify COVID testing needs. This can have a positive impact on the patient experience during a pandemic and eliminate the waste of PPE, helping the organization to be financially responsible. The development of the perioperative guidelines is important in managing practice changes during a global pandemic.