It could take 3-6 months for Missouri ASC to resume normal operating volumes, admin says

Matthew Ewasko, administrator of Physicians Alliance Surgery Center in Cape Girardeau, Mo., outlines how his center is resuming elective procedures and key considerations for ramping back up to full volume.

Question: What is your plan for resuming elective procedures in the future? What will be different at the center?

Matthew Ewasko: Physicians Alliance Surgery Center has created a list of criteria that must be met for elective procedures to be scheduled; urgent cases have been allowed at the center so long as the procedure is acceptable. This list was created in collaboration with my physician ownership group, and insight from our anesthesia providers. Our screening process will allow for the backlog of cases to be seen, while at the same time provide a level of protection for our staff.

The PAT process is followed up with another screening and temperature reading when the patients arrive at the center for their surgery. If the patient has developed any signs/symptoms of COVID-19, or they have a fever, they are asked to return to their vehicle and we will work with them to reschedule their surgical procedure.

Additional measures currently in place at the facility include, screening (including temperature reading) each employee and rep that enters the building; no family or guests allowed in the waiting room (they are waiting in their vehicles); surgical procedures are only being done three days per week instead of five; all staff members are wearing masks while in the building and we are providing masks for the patients if they do not have one already; and we re-routed all deliveries and sales reps to our front door so they can be checked in with our registration desk.

Q: How has the pandemic affected your plan for growth in the next 6 to 12 months?

ME: We anticipate it taking around three to six months before all of our specialties resume normal operating levels. With physicians' offices being closed, or having reduced hours for the past two months, the referral base is very low. The backlogs of each surgeon will be done first, but once that volume is reduced it will take some time for patients to be seen in their respective offices. Another factor we are looking at is the number of people who continue to put their procedure off until they feel safe to do so. Even though our facility is open and is scheduling cases, we have heard from several patients who are choosing to wait another few weeks before they consider moving forward.

Q: What does the "new normal" look like for ASCs?

ME: We are looking at keeping some of the processes that we currently have in place, and looking at what steps can be taken to improve should we experience something like this again. One of the items we are going to keep is our check-in process for sales reps at the facility. This will allow us to track who is in our building with greater efficiency, and allow us to limit the amount of personnel in our surgical suites.

One process that we will start focusing more on is the utilization of available technology. Using some of the available tools and resources out in the market will enable our processes to streamline and reduce the amount of direct patient contacts. We are looking at paperless registration processes, integrated scheduling with our physicians' offices, and improving upon our billing procedures.

Another key aspect that we have learned during these past few weeks is that we need to improve our preparedness in regards to supply items. While we were, and are, well stocked on normal use items, we did not have a plan for increased protection PPE items since those items weren't historically used at our facility. A list of needed items will be developed, and a new stock area will be created for these items to be stored in case of future need.

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