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Outpatient ORs Reopening for Business
Surgical professionals begin preparing for the gradual return of elective cases canceled during the coronavirus outbreak.
OSD Staff
Publish Date: April 18, 2020   |  Tags:   COVID-19
GO TIME GO TIME Same-day surgeries can be scheduled in states where COVID-19 infection rates are on the decline.

Finally, some welcome news about the COVID-19 crisis. Elective surgeries are included in the first phase of the federal government's three-step approach to reopen the country after a month-long shutdown designed to slow the spread of the coronavirus. Surgeries performed in outpatient operating rooms can begin in states that demonstrate a downward trajectory of confirmed COVID-19 cases within a 14-day period, according to the reopening plan.

The Association of periOperative Nurses has teamed up with the American College of Surgeons, American Society of Anesthesiologists and the American Hospital Association to develop a roadmap for resuming elective surgeries as soon as safely possible. The joint statement provides guidance for testing staff and patients for COVID-19, prioritizing the rescheduling of previously canceled cases, stocking adequate personal protective equipment and developing a strategy for phased openings of operating rooms.

"Getting back up to speed is going to be very chaotic," says AORN CEO and Executive Director Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN. "The roadmap will help alleviate fears about how it will be accomplished."

Ms. Groah believes the difficulties surgical professionals face in the coming months will be multifaceted and emphasizes the importance of a coordinated effort to restart the stalled surgical industry. "Every surgical team member and all healthcare leaders must be on board with the plan to reenter the operating room in an organized manner," she says.

Importantly, the roadmap outlines ways to proactively plan for a possible second wave of the virus. "We need to maintain adequate levels of PPE, medications and supplies that are ready to go," says Ms. Groah. "We were caught behind the eight ball during this peak. That can't happen again."

The gradual return of elective surgeries is a much-needed boost for the outpatient surgery industry, which has seen operating rooms across the county shutter for all but emergent cases. In some facilities, employees have been furloughed as administrators struggle to keep staff on the payroll while revenue streams have slowed to a trickle.

"It's nice to have a framework for reopening," says Greg DeConciliis, PA-C, CASC, administrator of Boston Out-Patient Surgical Suites in Waltham, Mass. "Our discussions about ramp-up plans for re-opening have been academic. Starting now, they become concrete."

Ambulatory Surgery Center Association CEO William Prentice was also happy to hear the news. "The guidelines on elective surgery, when combined with clinical and operational guidelines to protect patients and healthcare workers, provide a framework for facilities to safely resume providing care to appropriate patients," says Mr. Prentice. "I expect ASCs to work with federal and state policymakers to use this guidance in states that meet the gating criteria to provide needed care as soon as practicable."

Ms. Groah is certain surgical nurses, many of whom volunteered to help along the frontlines of COVID-19 response efforts, are up to the challenge of facing a new normal in the operating room. "They're very resilient and critical thinkers who want to create safe environments for patients," she says. "When they come back, they'll be ready. The patient they're taking care of will be the most important person to them in that moment."

Adam Taylor and Daniel Cook