During the moratorium, hospitals in New York still had authority to perform emergent and urgent procedures. The definition of urgent was murky, however, and in some instances, delaying procedures by more than a few weeks can cause serious complications or exacerbate a patient’s condition.
In the weeks leading up to the resumption of elective procedures, Bratko said, a group of Catholic Health clinical leaders met to go through every specialty and separate urgent cases from legitimately elective procedures. The former received priority by several days during the restart.
Account for costs
Grants from the CARES Act Provider Relief Fund help cover lost revenue from the cancellation of elective procedures but don’t address the cost of adding components such as preoperative COVID-19 screening, not to mention the vast expenses related to treating COVID-19 cases, Catholic Health’s Edwards said.
“We're going to require some type of additional funding or budget balancing to make up for that gap, on top of the funding received from the CARES Act,” Edwards said. “Obviously, we know we're going to be short of budget, but really there's still a lot of unknowns and uncertainties throughout the summer and the fall in terms of how much of this volume are we able to recoup versus what is lost forever, as well as the likelihood of a second wave or spike of COVID cases.”
Communicate with patients
A challenge in implementing preoperative COVID-19 screening is the obligation for patients to make at least two appointments before their procedure: one for the standard set of tests a week or two ahead of time, and a second for coronavirus testing.
“We've worked with our PR team to put flyers in place … to just over-communicate everything that we're doing,” Bratko said.
Catholic Health also compiled FAQs for its surgeon practices to help patients “understand all of the work that the perioperative response team did to go through policies and procedures,” Bratko said. Patients also can use a link on the system’s website to get information.
Social media has been a valuable channel, especially for reaching the set of patients who may be reluctant to visit the hospital but urgently need care. Some of the messaging simply boils down to “We’re here. Don’t wait.”
Putnam Hospital Center’s Kelly echoed the importance of ensuring that surgeons know how to communicate the new protocols to patients.
“When you’re sick, you say, ‘I have to trust my doctor,’” Kelly said. “We have to make sure surgeons are comfortable in reassuring their patients that we have done everything possible to make this a safe environment.”
The pandemic may be slowing in New York, but it will be top of mind for hospital leaders in the foreseeable future. New processes must be sustainable.
"We wanted to hardwire [them]," Bratko said.
At Putnam Hospital Center, Kelly said, “We’re not looking at a post-COVID era. We’re looking at a post-pandemic era right now. COVID will be with us for a long time.”