With the state mandate to stop all non-life-sustaining businesses in an effort to flatten the curve of COVID-19 cases, many elective surgeries had to be postponed. While patients and physicians understand the need for limiting unnecessary social interaction at this time, many people wonder how the postponement decisions were made and when restrictions will be lifted.

Kimberly Wheeland BSN, MSN, RN, CMSRN, CCHM, Associate Vice President, Surgical Services at Evangelical Community Hospital, in Lewisburg, took the time to answer some questions and share insight on the situation.

- Talk a little bit about the decision to suspend elective surgeries as a facility. What is considered an elective surgery and what goes into that decision?

The decision to temporarily stop performing elective surgeries and procedures was driven by a state mandate to do so.

Procedures are looked at in three categories:

Elective procedures are defined as any procedure that could be delayed 4-6 weeks and not change functional outcome or cause patient harm.

Urgent, time-sensitive procedures are defined as procedures that can be slightly delayed but not 4-6 weeks or the patient could have their function or outcome altered in a negative way.

Emergent procedures are defined as any condition requiring surgery in a more immediate state that could result in loss of life, loss of limb, or loss of function if not done.

How is the decision made to move forward with a surgery right now?

Each day during the COVID-19 response, a team meets to discuss the surgeries that are scheduled within the next 48 hours. Each case is evaluated with a thorough review of the patient’s medical chart and feedback from the surgeon as well as a representative from Anesthesiology.

For Evangelical, the review team consists of the Chief of Surgery, Associate Vice President of Surgical Services, Associate Vice President of the Surgical Group, Chief Medical Officer of the Evangelical Medical Services Organization, and the Medical Director of Anesthesia.

If the patient is deemed to be a candidate for surgery, the surgeon has a discussion with the patient about the risks involved with any surgery, but particularly a surgery happening during a pandemic. The patient then has the option as to whether they choose to move forward with the procedure.

What is Evangelical doing for the surgeries that do have to move forward to assure patient safety?

We are carefully segregating positive or suspected positive COVID-19 patients from patients who don’t meet any of the Centers for Disease Control (CDC) guidelines for testing in all phases of our care.

All patients are screened for symptoms and risk according to current screening guidelines.

If a patient is positive or suspected positive with COVID-19 and has an emergent surgical need, the procedure is performed in an operating room specifically allocated for only those procedures. Once their surgical procedure is completed, they recover in that same room until their post-anesthesia care is complete and are moved to the special COVID-19 unit within the Hospital for the remainder of their care.

While all operating rooms are cleaned and sterilized, the designated COVID-19 operating room undergoes even more specialized cleaning processes to ensure patient and staff safety.

Right now, how are decisions made about when elective surgeries might start again? Once the crisis has passed, how long will it take to get elective surgeries back on schedule?

Elective surgeries and procedures will not begin again until the state lifts the mandate preventing them. We do not know when that will occur.

We are actively planning how we will address delayed elective surgeries and procedures when we are permitted to move forward with them. In all cases, the rescheduling will be clearly communicated with patients.

Will there be a long wait for those who were postponed being rescheduled? Talk about the impact this may have on staff as surgeries ramp back up.

Again, we are actively planning the process for resuming elective surgeries and procedures when it is permissible to do so. We will be extending the hours the operating rooms are running each day as well as considering scheduling surgeries for the weekends to expand our ability to meet the needs of patients whose procedures have been delayed.

Evangelical has always been committed to meeting patient needs and we are equally committed to transitioning surgical care back to normal processes as quickly as possible.

Patients who graciously accepted a delay in their procedure will find themselves in the care of exceptional surgeons and staff who are ready and able to improve their health and function.

We want more than anything for our patients to be reassured their care is a priority and though we had to make some difficult decisions, all were made with our patients and staff as the driving forces.

Cindy O. Herman lives in Snyder County. Send e-mail comments to her at CindyOHerman@gmail.com.

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