Elective surgeries, prohibited in Pennsylvania in March in an attempt to slow the COVID-19 pandemic and not burden hospital vacancy, now have the go-ahead to resume in the state.
On April 27, the Pennsylvania Department of Health released additional guidance for hospitals and ambulatory surgical facilities that provides elective surgeries may be resumed at the discretion of the hospital or facility.
Specifically, the department announced that hospitals may “begin to allow elective admissions and may begin performing elective surgeries and procedures if the hospital makes an affirmative decision that it is able to do so without jeopardizing the safety of patients and staff of the hospital ability to respond to the COVID-19 emergency.” The department provided nearly identical guidance for ambulatory surgical facilities.
For further guidance as to the appropriateness of resuming elective surgeries, the Department of Health referred hospitals to the joint statement issued by the American College of Surgeons, American Society of Anesthesiologists, Association of Perioperative Registered Nurses and the American Hospital Association. Where applicable, the guidance offered by the Children’s Hospital Association of the United States should be consulted. The joint statement provides a number of benchmarks hospitals should consider before resuming elective surgery and processes to maintain when reopening that segment of the surgical program, such as:
- There is a sustained reduction in the rate of COVID-19 cases in the relevant geographic area for at least 14 days.
- The facility has adequate beds, medical equipment, ventilators and trained staff to treat all non-elective patients.
- The facility has available testing to protect staff and patient safety.
- The facility has adequate personal protective equipment and medical supplies.
Additionally, the joint statement provides guidance as to case prioritization and creating the appropriate polices and structures for all stages of surgical care. The Children’s Hospital Association’s guidance provides similar benchmarks and additional recommendations for conducting case-by-case evaluations to stratify particular surgeries during this crisis.
While further government approval is not needed to resume elective surgery, hospitals must update their emergency preparedness plans, and all facilities must update the Pennsylvania Patient Safety Reporting System to indicate what procedures are no longer suspended.
Now that the Pennsylvania Department of Health has authorized resuming the performance of elective surgeries, hospitals and ambulatory surgical facilities must engage in a thoughtful analysis and evaluation of whether – and to what extent – they are positioned to safely resume elective cases.
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