15 ASC administrators on patient volumes, effects of a 2nd wave

ASC patient volumes are recovering as centers resume full operations across the U.S.

Here, Becker's ASC Review surveyed 15 administrators to hear best practices around restarting elective procedures and solicit predictions on the effects of a potential second wave.

Note: Responses were edited for style and content, and were presented alphabetically.

How ASC patient volumes have recovered:
Central Kentucky Surgery Center in Danville, Ky.: 100 percent of volume
Covenant High Plains Surgery Center in Lubbock, Texas: 94 percent
Elite Surgical Center in Wayne, N.J.: 100 percent
Executive Surgery Center of Little Rock (Ark.): 85 percent
Hastings (Neb.) Surgical Center: 100 percent
Jefferson Surgery Center Blue Bell (Pa.): 75 percent
Kerlan-Jobe Surgery Center in Los Angeles: 80 percent
Memorial Ambulatory Surgery Center, in Mount Holly, N.J.: 70 percent, restarted elective procedures in June
Millennium Surgery Center in Meridian, Idaho: 100 percent
Northern Wyoming Surgical Center in Cody: 90 percent
OrthoArizona Surgery Center Gilbert: 100 percent
Pacific Surgery Center in Poulsbo, Wash.: 80 percent
Southwest Lincoln (Neb.) Surgery Center: 90 percent
Triangle Orthopaedics Surgery Center in Raleigh, N.C.: 90 percent
Wayne (N.J.) Surgical Center: 75 percent, expects volume to recover fully by July

Question: What is one best practice that has been successful in helping your center resume elective surgery?

Kaycee Clary, administrator at OrthoArizona Surgery Center Gilbert: Electronic communication with patients, and early and constant communication with scheduling offices as well as patients.

Todd Currier, administrator at Northern Wyoming Surgical Center: We have kept open communication with our surgeons' clinical offices, and we have also kept the public abreast of our reopening process.

Brooke Day, administrator at Hastings Surgical Center: We are screening all of our patients prior with a standard questionnaire and any concerns are brought to the physician to decide how to proceed. Our staff and physicians are happy with the processes in place. There are potential patients that are naturally more apprehensive than others, but some may also be planning ahead in the event that we experience an increase in COVID-19 cases in the fall/winter.

Alfonso del Granado, administrator at Covenant High Plains Surgery Center: Working as a team to prioritize safety has given staff, physicians and patients much-needed peace of mind.

Carla Lauenstein, administrator at Southwest Lincoln Surgery Center: COVID-19 testing patients 48 to 72 hours prior to date of surgery, access to personal protective equipment (N95 masks, PAPRs), communication with the Lincoln/Lancaster County Health Department.

John Paoni, administrator at Physicians Care Surgery Center: Our clinical operations committee met and set up phases to resume operations. We tested all staff, including surgeons, for COVID-19. We limited visitors to our facility. All patients scheduled for surgery are tested and given instructions for quarantining until their procedure. Any positive patient had their procedure canceled. Everyone is screened upon entry to our facility.

Catherine Retzbach, BSN, RN, administrator at Memorial Ambulatory Surgery Center: The guidelines for the New Jersey Department of Health require a negative COVID-19 test before surgery. So maintaining social distancing, screening patients before coming to the center and once at the center, having appropriate PPE and a negative COVID-19 test has made staff, surgeons and patients comfortable with coming for surgery.

Dennis Simmons, CEO of Wayne Surgery Center and Elite Surgical Center: Practicing social distancing with PPE during the pandemic, so when the state resumed elective surgeries, all we had to do is add the testing component.

Q: Do you expect an uptick in COVID-19 cases will cause your center to stop elective procedures again? Why or why not?

Kaycee Clary: No. If there is a surge, I anticipate surgery centers will be needed to continue essential care for patients, particularly in orthopedics, to help with allowing additional capacity in the hospitals.

Todd Currier: As the community, state and nation continue to reopen and restrictions are lifted, we expect to see an increase of cases within our region. We do not anticipate stopping elective procedures, unless there is a health concern within our facility. If we have a concern within our community, we plan to work the reopen phases backward by limiting cases, requiring quarantining and determining necessity of specific cases. [We're doing this] all with the intention of not having to close down the facility again.

Brooke Day: No, there are patients we serve that cannot experience a delay in being treated in a timely manner.

Alfonso del Granado: No. We test all patients no more than 72 hours prior to surgery, preferably within 24 hours, and are well stocked with PPE.

Jamie Fowler, administrator at Pacific Surgery Center: No, we are implementing good policies that are ensuring COVID-negative patients are only being seen in our ASC. Staff are complying with PPE use to protect themselves and the patients. While I think that a surge is likely, I feel that our ASC is better prepared to deal with continuing surgical cases throughout the duration of the surge.

Philomena Glowka, administrator at Jefferson Surgery Center Blue Bell: No, due to patient testing parameters.

Carla Lauenstein: No, I do not believe that an increase in cases will cease operations; I believe that the healthcare systems and providers in the state of Nebraska have proven that we can safely provide services to our patients and reduce the spread of the virus. Our healthcare system has not been overwhelmed so far at any point during the pandemic, and I believe that has been due to a proactive, safe approach.

John Paoni: I don't anticipate that any increase will cause us to stop elective procedures. We are taking every precaution to limit exposure to our staff and patients. We continue to monitor all entries into our facility to limit exposure. Everyone is required to wear a mask at all times. Everyone entering, including staff, receives a temperature and pulse ox test prior to entry. Proper protection equipment is provided and everyone in our facility has undergone PPE training.

Kim Price, administrator at Central Kentucky Surgery Center: I am not sure how the increase in cases will affect our area. The governor has always acted quickly with the best intentions for everyone's safety. I could see a potential in reduction of cases, but I do not feel that they will be suspended again.

Shane Ricks, administrator at Millennium Surgery Center: No, Idaho does not have a high incidence of COVID-19. We are currently experiencing an increase in cases. It has not reached the level of concern to postpone elective cases. There is a remote possibility we would stop doing our plastic surgery cases.

Karen Reiter, COO at DISC Sports and Spine Center in Marina Del Ray, Calif.: No, we are very safe.

Catherine Retzbach: The center and the New Jersey Department of Health are keeping a close eye on all the metrics regarding new cases, new hospitalizations and rate of transmission. If there is an uptick in COVID-19, I feel the guidelines will change and we will be returning to urgent cases only.

Dennis Simmons: We believe the virus has run its course here in New Jersey. Of course as you increase testing, you have more positive test results. Most of the patients that we have received positive test results are asymptomatic.

Britney Smith, administrator of Executive Surgery Center of Little Rock: Yes, we would have to shut-down due to state and federal directives on elective surgeries

Christine Washick, RN, administrator at Triangle Orthopaedics Surgery Center: Unless there is a mandated halt at the state or federal level, we are in a unique position to fulfill a community need and provide orthopedic elective cases that although are not "urgent" in nature, are impeding a patient's quality of life. Dealing with immobility and chronic pain can negatively impact a patient's physical as well as emotional health. Enhanced cleaning, availability of testing, and securing necessary supplies and PPE should ensure our ability to remain open to provide a safe environment for patients to be treated outside of the hospital setting, helping to ensure hospital capacity for community surge in COVID-19 cases.

Trudy Wiig, RN, administrator at Kerlan-Jobe Surgery Center in Los Angeles: Not by choice unless, as was the case the first time we stopped elective cases, it's the socially responsible thing to do. This decision was further buoyed by city, county and state mandates stipulating no elective cases be performed. There is the possibility that patients will be slow to seek medical options for their pain or loss of function out of fear of entering a medical or healthcare facility for treatment.

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