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Resources for Resuming Elective Procedures During COVID-19

Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, and Julie Ritzman, MBA, CPHRM, Vice President, Department of Patient Safety and Risk Management

Updated May 1, 2020: As states and local governments begin allowing businesses to reopen under “Opening Up America Again” guidelines, patients who have had to delay elective surgeries and procedures are contacting healthcare facilities to ask about scheduling.

Your patients most likely want to know about the safety of surgery during the pandemic and what occurs if they contract COVID-19 post-procedure. You may have questions about keeping your staff and patients safe, informing patients about new risks the pandemic has created, and potential liability risks you may be facing.

To provide guidance during this crisis, we offer the following resources and recommendations for resuming your practice while enhancing safety and reducing liability risks. Although the following address surgical care, they apply to medical procedures as well:

  1. Check with your state medical board and local authorities to understand those conditions that must exist to safely resume surgeries and if you are meeting those directives. This should include all clinical settings in which you practice (i.e., hospital, ambulatory surgery center, clinic, or office).
  2. Recognize the situation is fluid, and based on the data related to the virus, the situation can change. Stay connected with local authorities and be flexible to meet those directives.
  3. Consult with the organizations where you practice to review the policies and protocols in place and determine whether there is sufficient capacity, supplies, and personal protective equipment (PPE) to safely resume elective procedures. 
  4. Contact your specialty organization for recommendations and guidance. The American College of Surgeons (ACS) has general surgical information and links to the major subspecialties available at COVID-19: Elective Case Triage Guidelines for Surgical Care
  5. Check the elective surgical guidance that has jointly been provided by the ACS, American Society of Anesthesiologists (ASA), Association of periOperative Registered Nurses (AORN), and American Hospital Association (AHA).
  6. Review the ACS guidance on surgical case prioritization, utilizing the Medically Necessary Time-Sensitive (MeNTS) worksheet.
  7. When discussing the traditional risks and benefits of the procedure with your patients, be sure to also review pertinent items related to COVID-19 as discussed in Elective Surgery Informed Consent and Shared Decision Making During COVID-19.

We offer these recommendations as part of our mission to advance the practice of good medicine. During these unprecedented times, medicine requires fortitude, resilience, and judgment. Continue to be diligent and proceed with caution. Stay abreast of community incidence of disease and restructure your approach when needed.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.


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