Five spine and orthopedic surgeons discuss where the biggest safety concerns lie for patients and staff during the return to elective surgeries.
Question: What is the biggest safety challenge for patients and staff with the return to elective surgery?
Jeffrey Wang, MD. Keck Medicine of USC (Los Angeles): Our biggest challenge will be to resume operations in a careful and cautious manner, preserving social distancing and changing our processes to protect patients and our healthcare workers. The entire flow of operations will need to be examined, from parking, getting to the clinics and ORs, being able to maintain social distancing and altering our processes to preserve safety. This will require changing everything from the check-in process, drop-off process, waiting areas and how we move patients. Changing processes to accommodate the new social norms will be the largest hurdle.
Brian Cole, MD. Midwest Orthopaedics at Rush (Chicago): The challenge is that we will have ongoing processes in place that create extra layers of work to keep patients and employees safe, and ultimately that will reduce throughput and efficiency. We have to be nimble and adapt to that. To address the pent-up demand and ongoing needs, we have many strategies in place, including extended hours, working in shifts, operating and seeing patients on Saturdays. We are going to work harder for longer to manage the pent up demand and existing demand so patients are not inconvenienced and we can maximize procedures that we know to be effective.
Jason Scalise, MD, The CORE Institute (Phoenix): The safety of our patients and staff is our highest priority. As the restrictions in elective surgery are beginning to be lifted and the demand to address the backlog of care increases, a measured approach will be needed to ensure appropriate screening remains, as we suspect it will continue to be recommended for the foreseeable future. We have implemented a robust screening infrastructure that includes antibody testing. By remaining true to our protocols and guidelines, I am confident we can mitigate any safety challenges that could otherwise occur.
Isador Lieberman, MD. Texas Back Institute (Plano): The biggest challenge, and what consumed the majority of our strategy time, was exactly how to implement a socially distanced check-in process, a screening and personal protective equipment strategy for patients and staff, and a sanitation strategy after each patient encounter. We are concerned about manpower issues, as this new strategy is labor-intensive. In addition, we are concerned about the availability of PPE and sanitation resources.
Owen O'Neill, MD. Twin Cities Orthopedics (Minneapolis): It has been creating a safe environment for them to work. The testing protocols have alleviated these concerns.