Hospitals prepare to restart elective procedures

Hospitals and health systems across Illinois are preparing to restart elective procedures.

Hospitals halted the procedures last month to clear up space for a potential surge of COVID-19 patients, and to prevent the spread of the virus.

But as hospital bed and ICU capacity have stabilized across most of the state, many are looking at reopening their doors.

The Illinois Department of Public Health said the procedures can restart on May 11 if hospitals and outpatient surgery centers meet certain guidelines.

That includes forming a review committee to determine how to prioritize elective inpatient cases. Facilities must also test patients before each procedure and acquire an adequate amount of personal protective equipment. Also, cleaning policies in all areas along the continuum of care must follow established infection control procedures and, when possible, facilities should establish non-COVID care zones for screening, temperature checks and waiting areas. They should also have the ability to routinely screen all staff.

The department may suspend elective procedures if there is a rapid resurgence or second wave of COVID-19 or a decrease in statewide hospital COVID-19 testing levels.

And hospitals can’t perform the procedures if their hospital bed, ICU bed or ventilator availability drops below 20 percent.

The guidelines consider both the state’s public health goals related to COVID-19 with the providers’ goal of ensuring that patients can get surgeries and procedures they need for their health and well-being, said Illinois Health and Hospital Association spokesman Danny Chun.

“It strikes a reasonable balance between those two important goals,” he said.

IHA CEO A.J. Wilhelmi previously told Health News Illinois that Illinois hospitals and health systems were losing $1.4 billion a month in revenue from responding to the coronavirus crisis, in part because of the cancellation of such procedures.

Not clarified in the guidance is whether facilities will need state approval before they can go forward with elective surgeries and procedures. When asked, a spokesperson for the governor’s office told Health News Illinois the “guidance for elective surgeries are being updated and will be available soon.”

Health systems across the state are taking different approaches on when to restart.

NorthShore University HealthSystem said its planning to ramp up surgical and elective procedures beginning May 11.

“We have robust screening processes and infection prevention protocols to ensure our patients receive safe, high quality care that they expect from NorthShore,” the system said in a statement.

BJC HealthCare said it also plans to start phasing in procedures and visits by next month.

“As long as COVID-19 continues to slow, BJC could start phasing in procedures and visits in early to mid-May for certain services at some facilities.”

Other health systems told Health News Illinois that they have not yet set a time for when such procedures can start again.

“While we have not identified a specific date to resume elective surgeries and procedures, we are working on a process and a timeline to ensure that we meet or exceed the Illinois Department of Public Health guidelines to ensure the health and safety of our patients and staff,” said University of Illinois Hospital and Clinics CEO Michael Zenn.

UnityPoint Health, which operates facilities in the Quad Cities and Peoria regions, said it has “begun planning for resuming elective procedures that prioritize the health and safety of our team members, patients and communities.”

OSF HealthCare, which operates 14 hospitals in Illinois, said they are working on a “comprehensive pathway” to safely resume services.

Carle Health, which operates three hospitals, said it will continue to evaluate individual health needs, including those for surgeries and procedures.

“We are following updated guidance closely and ensuring we have the appropriate protective equipment, testing supplies and other important resources and processes in place to ensure that our patients receive a high quality experience,” said Dr. Blair Rowitz, associate chief medical officer of Carle’s surgical services.

Hospital Sisters Health System, which operates nine hospitals in central and southern Illinois, said it is working on a plan for when it can start such services again.

“HSHS hospitals are currently working on processes to bring those services back online and will be communicating with patients soon on what they should be prepared for, including having a negative COVID-19 test on file within a certain time period before the procedure and enforcing current visitor restrictions.”

Advocate Aurora Health, which operates 28 hospitals in Illinois and Wisconsin, said it is extending restrictions on elective surgeries and procedures through May 15 while “evaluating communities with low prevalence of COVID-19 to explore lifting restrictions.”

AMITA Health, which operates 19 hospitals in the Chicago region, said it has assembled an “interdisciplinary team” to begin reemergence planning, including when to restart such procedures.

“We’re still taking into consideration all factors that will allow us to safely restart non-emergent procedures, such as availability of PPE and COVID-19 tests,” the system said in a statement. “We will not restart these procedures until we know we can best protect our patients, physicians and associates.”

Cook County Health spokeswoman Deb Song said they are working on “plans to phase in elective procedures and surgeries.”

Pipeline Health said it was currently reviewing the state guidelines so it could “proceed with a plan that is optimal for providing a safe environment of care and in our patients’ best interests.”

While pediatric care does not have the same amount of elective procedures, there have been “significantly” fewer surgeries in recent months at Lurie Children’s Hospital, said Dr. Marleta Reynolds, head of the hospital’s surgery department. The worrisome trend, she said, is that children are not coming in for care because families are concerned about coming to the hospital.

She said a system-wide team is meeting several times a week to determine what it would need for the hospital to ramp up such procedures as early as this summer, when pediatric procedures are most common.

 

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