What to Consider When Reopening Your Surgery Center

April 28, 2020 | Article

By Laurie McKee

The COVID-19 pandemic has impacted hospital surgery departments significantly. Many have postponed all elective cases, following recommendations from CMS and the American College of Surgeons. Because of this, some hospitals are reporting as much as a 70% decline in case volume—with an equally sharp decline in operating income.

Facilities hope to recoup this lost volume once the Public Health Emergency is over, but the reality is that patients may look elsewhere for care or have already received care at another facility. To avoid a permanent loss of market share, it’s important to develop an effective recovery plan.

We’ve broken down essential components for healthcare organizations to consider when it comes to COVID-19.

What to Consider When It Comes to Reopening Your Surgery Center
Communicate Infection Control Efforts
Patients may not be comfortable entering the hospital environment for elective procedures if they know you’ve cared for COVID patients. Patients may feel more comfortable in the ambulatory surgery center environment for their elective procedures. Therefore, hospitals should consider how they’re going to market their infection control efforts post COVID-19.

Consider How to Approach Out-of-Pocket Payments
Patients may put off elective procedures if they’ve been impacted by the economic downturn, including loss of a job or decrease in hours. They may not want to take time off or perhaps they no longer have insurance. It’s going to be important for organizations to evaluate how they’re going to approach out-of-pocket payments.

Involve Key Healthcare Stakeholders & Prioritize
Engage key stakeholders including surgeons, anesthesia, and schedulers. Evaluate your case backlog to anticipate your future case load.

Discussion should also include prioritization of cases. Patients whose health may be compromised if the case is postponed further should be scheduled first. Block schedules may need to change temporarily based on surgeon backlogs and patient needs. As organizations develop prioritization plans, they will need to include a process for managing patients who are recovering or have recovered from COVID-19.

Evaluate the capacity of your surgery department. Is there opportunity to adjust the hours of operation temporarily with longer days or adding Saturday to the work week? It’s important to include staff in these discussions. Some staff may be looking for extra hours if hours decreased during the pandemic and others who were displaced may just want things back to normal. It’s important to be sensitive to their needs. Another option may be to add additional rooms temporarily. Perhaps space in the PACU or pre-op area could temporarily be converted to perform elective procedures.

In addition to evaluating space capacity, hospitals need to ensure they have enough PPE and other supplies to handle the additional surgery volume.

Overestimate the Amount of Time Things Will Take
The pre-admission testing process will be challenging as schedulers determine if history and physical examinations and diagnostic testing are still within the appropriate time frames. It’s going to be important to carefully evaluate each patient to determine what is still valid and what needs repeating.

Case times will need to be evaluated with new regulations post COVID-19. Turnover times may need to be increased by as much as 30 minutes due to new regulations regarding intubation.

Review Policies
Don’t overlook your policies as many of these may be affected by the aftermath of COVID-19.

  • What will your policy look like regarding family or significant other accompaniment to their surgical procedure? How many should be allowed? Should you just allow drop off and pick up?
  • What will your waiting room look like? How many will be allowed in the waiting room at one time? How will they be seated to allow for social distancing?
  • How will you ensure cleaning between families?
  • What process will be in place for screening of staff, patients, and visitors coming into the facility?

Understand the Impact of COVID-19
It’s clear things are going to be very different post COVID-19. To be successful, organizations need to develop plans to reopen their surgery departments now. By thinking through these scenarios carefully and cautiously, you’ll be better prepared to move forward.

Healthcare organizations are facing a critical moment with COVID-19. You need a business advisor to help you sort through the impacts.

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