We are in this together.

The ORDx team realizes that everyone has been impacted in different ways by COVID-19, and we stand ready to collaborate with hospitals and health care organizations to assist in delivering safe care during critical procedural encounters.

As doctors and nurses, the patient is always our highest priority. Providing safe and effective patient care continues to be our primary objective, and while like many we have been impacted by the current crisis (for example, in our ability to travel) we are committed to working with our clients and all healthcare providers to find a way forward.

In these difficult moments we have the opportunity to reflect on the way we comport ourselves. The hardships are countered by the good in people as we watch heroes emerge, communities take action, and more consideration shared in everyday encounters. We have tried to play our part in working closely with our clients to overcome the challenges that have been placed upon us all. While much of what is being experienced by healthcare organizations is unprecedented, most challenges are ones that our team have faced in various contexts, and we encourage you to get in touch with us to take advantage of our experience and guidance.

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We Can Help During this Crisis:

  • We are virtual meeting ready to work with your team to facilitate effective short-and long-term recovery plans to deal with current issues around restart, and to prepare for optimal future responses.

  • We can help mediate discussions around collaboration, communication and teamwork, which may have been problematic for the organization prior to COVID-19.

  • We can facilitate surgical scheduling priorities and procedures, and recommend other key departmental imperatives to manage variable elective and COVID-19 demand curves.

  • Our experienced team can support current key hospital leaders in administration, quality, infectious disease, surgery, anesthesia, and nursing, and also fill temporary gaps in hospital leadership teams during planning sessions centered on re-entry.

  • With our medical, nursing and hospital leadership experience, we can assist in optimizing financial opportunities and recovery for hospitals via strategic allocation of surgical schedules.

Resurgence

Are You Ready for the Post COVID-19 Reality?

As the world hopes for a flattening of the COVID-19 outbreak curve, healthcare organizations and caregivers must quickly reflect on their capacity to deal with a new surge – the surge of delayed treatments. Operating rooms and the entire perioperative process will be stressed to meet the demand for immediate interventions. The same organizations must be mindful that a reemergence of significant numbers of COVID-19 patients could again stress their system’s ability to deal with the myriad of other illnesses that seek their attention each day.

To help prepare your organization for post COVID-19 surge patient care, consider:

  1. What dismantling did your organization undergo to manage surge capacity?
  2. Did you deploy anesthesia machines as ventilators?
  3. Was your perioperative staff redeployed elsewhere and were they ready to function effectively?
  4. Was your staff impacted emotionally? How fatigued is leadership (this may impact initial reopening)?
  5. Did repurposing of your PACU into an ICU delay restarting your surgical schedule? (Many PACUs had to have walls built for air handling purposes that ICUs require.)
  6. How prepared were and are you for the risks to surgical staff from a nosocomial transmission of coronavirus ? How clear is it now what precautions you should take to prevent this as you prepare to restart your elective surgical schedule?
  7. What should you do if an elective surgical patient or a member of your surgical/perioperative staff develops COVID-19? How can you prevent this from shutting down your re-start?

These are some of the questions that must be addressed as you plan for restarting your system. Perhaps even more importantly, they must be answered as plans are put in place to be certain that such national and local emergencies never again so negatively impact healthcare delivery.

Perhaps we must also address how you dealt with the usual surgical emergencies and semi-emergencies during the pandemic. Did your morbidity and mortality increase? If so, how do you plan to deal with that going forward?

As you plan for the near-term resumption of more “normal” operations what elements of longer-term planning should be addressed? SARS-CoV-2 is almost certain to reappear in the fall (even assuming it is less prevalent in coming months) coincident with seasonal influenza. What approaches should you take to deal with this likelihood – in terms of policies and procedures, testing approaches and engineering/structural controls?

These are all questions that ORDx+Rx can help answer. We can also provide the expertise to help you develop plans for your future responses. Call us today to help you prepare to face the next healthcare crisis, and to deal with those crises your organization faces every day. Together, we can be ready!

Helpful COVID-19 and Post-COVID-19 Links

The articles and information shared here focus on the issues we see our clients and other healthcare organizations and hospitals facing as they work to meet the challenges presented by the current COVID-19 pandemic.  From recommendations regarding anesthesia, to helping your team stay mentally healthy during the pandemic, to resuming your organization’s normal surgical routines and schedules, these articles provide insight and guidance.

This pointed assessment of how we managed common disease during the COVID-19 crisis points to the need for a rational, carefully designed plan as we move forward.

Hospitals will need a plan to resume a comprehensive surgical schedule to meet the needs of routine surgical care. There is a suggested plan available designed to help your institution. The American Society of Anesthesiologists (ASA), The American College of Surgeons (ACS), The Association of periOperative Registered Nurses (AORN) and the American Hospital Association (AHA) have issued a Joint Statement Roadmap for Elective Surgery.

A road map for navigating through the current COVID-19 pandemic in the United States will be useful to healthcare organizations. Specific directions for adapting public-health strategy to limit the epidemic spread of COVID-19 is outlined.

The management of surgical cancer patients will be a critical process to meet their needs as we resume a more rational system of care.

Psychological stress has emerged as a critical factor for many hospitals. Dealing with this and planning for the future are critical for your successful recovery.

There are stark lessons to be learned from how hospitals responded to the present pandemic.

 Two recent Wall Street Journal Opinion pieces share viewpoints on the importance of “elective” surgery, and the difficulties hospitals are facing.

Anesthesia machines are equipped with sophisticated mechanical ventilators that can maintain patients with COVID-19 respiratory failure.  They are not typically used for the extended periods of time required for critical care ventilation and this report addresses special considerations for this adaptation of use to supplement a facility’s supply of standard critical care ventilators.

The potential shortage of critical care ventilators for a surge of COVID-19 patients with respiratory failure has prompted interest in using a single ventilator for more than one patient.  This statement from multiple critical care organizations discourage such practice.

Multiple authors from settings with experience in managing anesthesia care of large numbers of COVID-19 patients report lessons learned in this compendium of published papers:

In a time of surge crisis our hospitals will need to set parameters for “elective” surgery:

This document from the Centers for Disease Control offers interim guidance for the prevention of nosocomial transmission of novel coronavirus to patients and staff. Although it requires adaptation to the elective surgical environment it offers some useful information related to the hospital environment.

A recent editorial from Anesthesiology offers some ideas for prevention of cross-transmission in the operative setting from the dual perspectives of anesthesiology and infectious diseases.

Another set of suggestions for prevention of peri-operative transmission by authors from the fields of both anesthesiology and healthcare quality and safety.

Surgeons working in the head & neck region can be at higher risk. The suggestions and precautions linked here can be useful to all the perioperative team.

Supplies are frequently an issue for some institutions. There are some useful resources available. Massachusetts has set up such a resource.

Immunity testing can be problematic and thus hospitals must be vigilant as to validity before imposing mandatory testing in the “reentry” process.

The Council on Surgical and Perioperative Safety (CSPS) offers some useful resources to the Perioperative team on restart.

Dr. Atul Gawande outlines his views on COVID-19 in the New Yorker.