Updated May 1, 2020: Restarting elective procedures or surgeries during the COVID-19 pandemic will require additional assessments to optimize your patients’ health for the best possible outcome. In today’s crisis, doctors must follow the standard of care when known, and customize and innovate when it is not.
We encourage you to assess not only the patients’ medical needs for surgery but also their potential for becoming infected with the COVID-19 virus during the perioperative period. We recommend that you inform patients why additional questions are necessary by using phrasing similar to the following:
“COVID-19 is an extremely contagious virus believed to be spread by person-to-person contact. For your safety as well as the safety of our own team members and other patients, we will be gathering additional information to better assess your risk of becoming infected by COVID-19 during your surgical episode.”
Consider offering the following pre-procedural instructions:
- Continue to shelter in place to protect yourself from potential exposure to COVID-19 prior to the procedure. If you have not sheltered in place, or if you or your family members work or volunteer in high-risk areas such as a medical facility or an occupation where you interact with a large number of individuals in close proximity, please contact us so we can determine your risk of exposure.
- Continue to follow physical distancing and handwashing guidelines. This applies to the person who will be bringing you to and from our facility as well.
- Check for the following symptoms each day until your procedure and notify us immediately if they occur:
- Fever above 100.5 F that lasts 24 hours.
- New respiratory symptoms such as cough, shortness of breath, sore throat, etc.
- Loss of smell.
- If you have had COVID-19 and were tested, please bring those results with you the day of your procedure. We may retest you on the day of surgery. If you have never been tested, you will be tested prior to your procedure. Should you test positive your procedure will be postponed until you have fully recovered and have a negative test result.
An important part of patients’ recovery is their emotional and mental health, which often involves maintaining close physical relationships with their family members. Consider the following inquiries to determine the patients’ risk for exposure to COVID-19 post discharge.
- Obtain the name and contact information of the adult who will be in attendance during surgery and will drive the patient home. Advise the patient’s contact of the screening protocols that will be required to remain in attendance.
- Discuss the discharge plan with the patient. Consider asking these questions to ensure that appropriate shelter in place and social distancing requirements can be followed:
- Will you be recovering in your home or at another location (family member or friend)?
- How many individual(s) will be assisting you with your recovery at home?
- Are any of the individuals who are assisting with your recovery working or volunteering in a high-risk area such as a medical facility, or as a police officer, fireman, or an occupation or volunteer position with close proximity to a large number of people?
- How many individuals currently live there?
- How many visitors do you anticipate having?
- Will you have someone who is able to pick up prescriptions and groceries? (If not, have the patient provide a local pharmacy who can deliver medications.)
- Remind the patient to visit the grocery store before surgery so they will not need to shop in the week after surgery.
- Ask the patient if they have the technology at home (e.g., computer or cell phone) to perform a telehealth post-op visit. If so, as part of pre-op preparations, test the application after downloading so your staff can ensure it is available for post-op communication.
History is a limited guide to COVID-19. There is insufficient uniformity and rational benchmarking, so the process is challenging. Through it all, we are slowly winning the first part of the battle—we see this clearly because of the great work our doctors and hospitals are doing under crisis conditions. The Doctors Company is providing this assessment to support you and respond to your needs—and those of your patients.
Ambulatory/Outpatient Care Facilities,
Large Group Physician Practice,
Oral and Maxillofacial Surgery,
Otolaryngology-Head and Neck,
Solo or Small Group Physician Practice