Texas ASCs brace for hospital spillover, but another PPE shortage could spell disaster

Many Texas hospitals are pausing elective surgeries as nursing staff and beds run critically low amid a fourth COVID-19 surge, and ASCs are gearing up for what might come next.

Gov. Greg Abbott on Aug. 9 asked hospitals to temporarily pause elective procedures and announced that Texas is recruiting out-of-state healthcare workers to help Texas hospitals with staffing.

ASC administrators are closely monitoring the coronavirus infection rates and hospitalizations in their areas, and preparing themselves from what may come next.

"In our area, there are very few hospital beds available, especially COVID beds," said Tammy Stanfield, RN, administrator and director of nursing of North Pines Surgery Center in Conroe, Texas. "Next door to us is a major Houston hospital's freestanding ER. We came in [earlier this week] to find all their signs covered and a sign on the door to go to the nearest ER. Since there are very few beds, we figure there is overflow backup in the ER. If patients are to be admitted, they have consolidated all of their staff to take care of those admissions."

As for ASCs in Texas, Ms. Stanfield said they will stop performing elective surgeries like they did in spring 2020, but hopes that financial relief similar to the Paycheck Protection Program will be discussed.

Celia Smith, BSN, RN, administrator of Houston Premier Surgery Center in The Villages, said maintaining close communication with physicians and other healthcare leaders in the area has been key to staying informed about decisions hospitals are making on elective procedures.

"Most of the hospitals in our area have available beds, adequate supplies and staffing; therefore, are continuing to allow some elective procedure," Ms. Smith told Becker's. "I appreciate that the governor is leaving it to the hospitals to gauge what their capacity is to perform elective procedures instead of mandating they all be paused."

Some ASCs in areas with particularly high hospitalizations are preparing to take on added elective procedures or divert resources to hospitals.

"We are gearing up as we did before when our hospitals postponed elective surgeries," said Debbie Smith, administrator of Heart of Texas Surgery Center in Woodway. "We have onboarded at least one physician due to the announcement to perform some podiatry cases here at the center."

Other ASC leaders are more optimistic about continuing to perform elective procedures — highlighting their improved safety protocols — to support hospitals, but fear that a supply chain shortage for vital equipment could spell disaster.

"ASCs are in a position to take spillover cases from hospitals, which can help hospitals free up space to treat COVID-19 patients," according to Susan Cheek, administrator of Dallas Endoscopy Center. "If there becomes a [personal protective equipment] shortage, then this could affect ASCs' abilities to perform these very important procedures."

One thing is for certain: The postponement of elective surgeries over the past year has had serious ramifications not just for ASCs and hospitals, but also for patients, and all healthcare stakeholders are hoping to avoid a repeat of 2020.

"Last year we had an unacceptable number of patients who delayed necessary treatment and ended up needing more invasive, riskier procedures, and I would not want to repeat the cycle," according to Alfonso Del Granado, administrator of Covenant High Plains Surgery Center in Lubbock. "While hospitals should take reasonable steps to protect their populations, the overwhelming weight of the responsibility must fall on the governor's shoulders, and I would hope he will also take reasonable steps to protect those same populations."

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