Industry guidance: ASCs in prepared counties should resume elective cases in 'step-wise' manner, anticipate lower volumes


ASCs should prepare for drug shortages and expect lower volumes when resuming elective procedures, according to joint guidance from the California Society of Anesthesiologists and the California Ambulatory Surgery Association.

Five additional highlights:

1. The guidance follows California Gov. Gavin Newsom's announcement that hospitals and health systems may resume scheduled and elective procedures that were deferred as facilities prepared for high volumes of COVID-19 patients. CSA and CASA endorsed CMS guidance on how and when to resume elective procedures, as well as guidance from other industry groups.

"We endorse the concept of step-wise resumption of cases, which provides adequate evaluation of the effectiveness of both facility and community efforts to mitigate infection," CSA and CASA said in their joint guidance.

2. ASCs should only reintroduce elective procedures in counties where health departments have indicated there is sufficient capacity, equipment and personnel to manage COVID-19 patients, and cases that have become urgent should be prioritized. In the event that there is an "unanticipated or unmanageable rise in COVID-19 cases in their community," surgery centers may need to again pause elective cases. Data on local declines in COVID-19 cases should inform any decisions to increase volumes or reintroduce more complex procedures.

3. Surgery centers are encouraged to stagger patient arrivals, modify case turnover times to accommodate social distancing, and allow for adequate postoperative room sanitation and air exchanges. The CDC has outlined guidance for environmental infection control in healthcare facilities.

4. CASA and CSA asked facilities to implement "common sense" testing and screening protocols, including polymerase chain reaction lab testing between 48 and 72 hours in advance of a patient's scheduled surgery. Patients who test positive should likely either be rescheduled or moved to an inpatient facility, depending on the urgency of their medical needs.

5. Centers should have enough personal protective equipment for 14 days of anticipated procedures on hand before restarting elective cases, and they should be able "to readily replenish the supply of PPE without relying on state or county departments," CASA and CSA said. They cautioned centers to plan for potential drug shortages in the coming weeks and months.

More articles on surgery centers:
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