Health systems nationwide are examining policies and procedures related to their resources, staffing, and scheduling to prepare for anticipated patient surges due to COVID-19. In late March, I talked with perioperative physicians and administrators from two health systems with rapid increases in COVID-positive cases, which have prompted significant changes in…

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When the coronavirus pandemic begins to subside, hospital leaders will be sorting out the repercussions and trying to resume normal operations. The main impact on ORs has been the widespread cancellation of non-essential procedures. Case cancellations in March and April have reduced elective procedure volumes as much as 90%. Most…

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Editor' Note The American College of Surgeons (ACS) on April 17 released a new document, “Local Resumption of Elective Surgery Guidance,” to help healthcare facilities prepare to resume elective surgery once COVID-19 has peaked in their area. The document includes four categories: COVID Awareness—addresses the community’s COVID-19 numbers, including prevalence,…

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Editor's Note The Joint Commission, in its April 8 online newsletter, announced the creation of a web portal with resources to assist healthcare workers create capacity for surge patients with COVID-19. Included are: Use of Ambulatory Surgery Centers (ASC) as Alternative Care Sites for Hospitals Emergency Management Healthcare Environment Checklist…

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Editor's Note The American College of Surgeons (ACS), Association of perioperative Registered Nurses (AORN), and the American Society of Anesthesiologists (ASA) on March 24 released a joint statement regarding decision making on elective surgeries. The statement includes that: "A Surgical Review Committee, composed of surgery, anesthesiology, and nursing personnel is…

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Editor's Note The Centers for Medicare & Medicaid Services (CMS) on March 18 released recommendations that all elective surgeries and nonessential medical, surgical, and dental procedures be delayed during the COVID-19 outbreak. As more healthcare providers are asked to assist with the COVID-19 response, it is important that they consider…

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Editor's Note In consultation with clinical experts and in response to government guidance that hospitals and ambulatory surgery centers (ASCs) postpone elective surgical procedures during the COVID-19 pandemic, the Ambulatory Surgery Center Association (ASCA) released a statement March 18 on how and when facilities should proceed with cases that should…

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Hospitals have long dominated the realms of infection control and antibiotic overuse. Ambulatory surgery centers (ASCs), which typically release patients the same day of a procedure, use antibiotics less frequently than other facilities, and most do not have an antimicrobial stewardship program. However, some ASC leaders and organizations are encouraging…

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Surgical errors and emergencies can happen at any time, at any facility. For ambulatory surgery centers (ASCs), a major challenge is finding official guidance on the topic. For the most part, it’s up to the individual facility to craft its own policies, competencies, and drills for OR emergencies. “The Association…

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Editor's Note In this study, an outpatient fracture pathway greatly improved the efficiency and timeliness of care, and it reduced costs. A total of 187 patients during the preintervention period and 308 patients during the intervention period were eligible for the ambulatory pathway. Those managed as outpatients increased from 1.6%…

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