OR Manager - June 2020 - 10

COVID-19
Continued from page 9
asked if they have had any contact with
anyone who has had COVID-19. Their
temperatures are taken at the door before
they come into the center.
Patients are not being tested for
COVID-19 before being admitted to the
center at this time, but they may be if
and when the center is able to obtain
one of the fast testing machines that
can detect the coronavirus in 5 minutes,
like the Abbott molecular point-ofcare
test.
Steps taken to redeploy and
protect staff
Some of the center's staff have been
furloughed, and some have been redeployed.
Staff with critical care skills
were deployed to work in urgent care
centers affiliated with the main hospital,
and some have been deployed to work
in the family care center, which is in the
same building as the center.
Other staff work at the center on an
as-needed basis, such as sterile processing
staff, who come in to run tests
on the sterilizers and to make sure the
equipment is all in order.
Furloughed staff are being paid.
" We were anticipating and prepared
for a spike in patients in the beginning,
but it didn't come, " says Ibragimov.
" There has been a low volume in the
inpatient and outpatient settings both
because people are avoiding going to
the hospital unless they absolutely have
to. "
The center tries to do several cases
on one day, so staff don't have to come
in every day for one case.
At the same time, they are making
sure to space out cases. " We are spacing
and restricting people because visitors
cannot stay in the waiting room, "
he says. " Only one person can come
into the center with a patient. Then they
have to leave, and come back when the
patient is ready for discharge. "
" We have a universal masking pol10
OR
Manager | June 2020
ASCA guidance on necessary
surgical procedures for ASCs
during the COVID-19 pandemic
On March 18, the Ambulatory Surgery
Center Association (ASCA) released a
statement on how ambulatory surgery
facilities should proceed with cases that
should not be postponed.
Included in the statement:
➤ A surgical procedure may be considered
urgent and necessary if the
physician decides that a months-long
delay would increase the risk of significantly
worse morbidity or prognosis
for the patient.
➤ If a procedure can be safely postponed
without significant risk to the
patient, it should be delayed until
after the pandemic.
➤ Physicians should consider the potential
for postoperative complications
that could place stress on nearby
hospitals that may lack capacity for
transfers.
➤ ASCs should develop explicit controls
on how to manage infection risks of
nonpatient visitors (eg, patient caregivers,
vendors, contractors).
➤ ASCs should be prepared for the possibility
that hospitals may need to shift
icy, " says Ibragimov. " All staff wear
masks at all times. Patients are given
the option of wearing one or not, but
many of them are wearing some sort of
a mask when they arrive at the center. "
Ibragimov says the staff are using
regular personal protective equipment
(PPE) that would be used for non-aerosolizing
procedures, per the center's
guidelines. All staff wear face shields,
which were donated by the community.
If the procedure is aerosolizing, surgeons
wear N95 masks and anesthesia
personnel have their own guidelines,
which say they should wear N95 masks
for all cases because intubation and
necessary surgical procedures to ASCs
and/or that their resources will be
required to serve their community and
healthcare system in a different capacity.
➤ ASCs need to recognized that the
pandemic may create situations when
they need to shut down, such as when
a patient, staff member, or physician
who has been in the ASC is suspected
or diagnosed with COVID-19 or when
there is a significant shortage of
personal protective equipment (eg,
masks, gowns, gloves) that prevents
safe practice of surgical cases.
https://www.ascassociation.org/asca/
resourcecenter/latestnewsresourcecenter/covid-19/covid-19-guidance?utm_
term=the%20statement&utm_
campaign=COVID-19%3A%20
Guidance%20for%20ASCs%20
on%20Necessary%20Surgeries&utm_
content=email&utm_source=ActOn+Software&utm_medium=email&cm_
mmc=Act-On%20Software-_-email-_COVID-19%3A%20Guidance%20for%20
ASCs%20on%20Necessary%20Surgeries_-the%20statement
extubation
induce coughing and can produce
aerosols.
When the center's status changed to
doing only emergent and urgent cases
in March, Ibragimov says they also did
an inventory of the center's PPE and
anesthesia machines, in case they were
needed elsewhere, and they made a
skills checklist of all staff members in
case they had to be redeployed.
Communication is key
In these uncertain times, it is important
to communicate with staff, says Ibragimov.
" I have been holding a weekly
conference call with all of the staff every
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OR Manager - June 2020

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