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Restarting Elective Procedures During COVID-19

For the past several months, addressing immediate issues related to the COVID-19 pandemic has been the dominant focus of the healthcare field. While medical professionals are still working to understand and mitigate the impact of this virus, many of the day-to-day operations of their organizations have been put on hold.

One staple of the healthcare system that has been paused due to these unprecedented events is elective surgical procedures. This April, a joint statement from numerous medical organizations, including the Centers for Disease Control and Prevention, U.S. Surgeon General and American Society of Anesthesiologists, recommended an interim cancellation of elective surgical procedures until certain safety thresholds are met. The principle requirements include the following:

  • There should be a sustained reduction in the rate of new COVID-19 cases in the relevant geographic area for at least 14 days.
  • The facility shall have appropriate number of ICU and non-ICU beds, personal protective equipment, ventilators and trained staff to treat all non-elective patients without resorting to a crisis standard of care.

According to Mary Dale Peterson, MD, FACHE, president, American Society for Anesthesiology, ensuring there are enough resources to address the needs of COVID-19 and elective surgery patients is an essential element of restarting these procedures. Due to the variables unique to each healthcare organization or system, leaders must routinely evaluate their capacity to adequately provide a safe standard of care, which includes leaving room for potential spikes in COVID-19 infections.

“Most hospitals are being asked by states to reserve a certain amount of capacity,” she says, which will provide them with the option to resume elective surgical procedures while maintaining readiness for COVID-19 surges. Once the capacity standards have been met, they can turn their attention to beginning these procedures once more. However, getting started presents its own set of challenges.

“I think we are starting to see patients suffer undue harm from waiting to have their procedures done,” says Peterson. Some patients are holding off on elective procedures, or even emergency room visits, due to COVID-19 fears. There are, however, several ways for healthcare professionals to assuage the fears of their patients through clear communication about their COVID-19 practices.

Peterson sees several opportunities for leaders to mitigate the concerns of their patients, including opening up ambulatory surgical centers which, outside of overwhelmed areas like New York City, likely have not seen any COVID-19 patients during the pandemic. Another option would be to designate specific areas of the hospital for COVID-19 patients to reduce the risk of exposure for others. While these may seem obvious to those in healthcare, sharing this information with patients could help them overcome their fears so they can receive the medical care they need.

By helping patients understand the significant measures organizations are putting into place to keep them protected from this pandemic, the hope is that these elective procedures can begin again and bring back many of the furloughed healthcare workers who are eager to return from the sidelines, according to Peterson.

“I know many of my colleagues are glad to be back at work, glad to be back in the OR doing what we love every day: taking care of patients,” she says. If the healthcare organizations and systems maintain the principle standards of restarting through rigorous observation and reevaluation, patients should once again be able to receive the care they need through elective surgical procedures.


Editor’s Note: If you’re interested in learning more about restarting elective surgical procedures from Peterson, we encourage you to watch this recording of the recent “Special ASA/ACHE Joint Webinar – Challenges and Strategies in Restarting and Expanding Elective Surgery after COVID-19” from our ACHE COVID-19 Resource Center.

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