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The Post-COVID Future of Outpatient Surgery

Surgical leaders discuss how patient care will change in the months and years ahead.

Joe Paone

Joe Paone

BIO

Finally, thankfully, ORs have begun to reopen for elective procedures in communities where COVID-19 cases are on the decline. The coronavirus pandemic that temporarily shuttered outpatient surgical facilities continues to hit pockets of the country hard, but healthcare leaders are beginning to look forward, quite literally, to the gradual return to some semblance of normalcy. There are plenty of unknowns moving forward, but one thing’s for certain — surgery will never be the same.

Advanced screenings

COVID-19 has changed the calculus of pre-op screenings. “We’ve learned more about the disease,” says David Shapiro, MD, an anesthesiologist with extensive ASC management experience who’s based in Tallahassee, Fla. “We were probably a bit naive in our ability to protect our patients.”

During the pandemic, surgical leaders leaned on response guidelines coming from everywhere — the CDC, state governments and specialty and professional societies. “All those things came hard and fast in a situation that was as dynamic as it could possibly be,” says Dr. Shapiro.

Now is the time to reassess and rethink the testing patients must go through before setting foot in your facility. Jay Horowitz, CRNA, of Quality Anesthesia Care in Sarasota, Fla., hopes evidence of additional COVID-19 symptoms will move patient and staff screenings beyond temperature readings and questions about recent travel. “Maybe we should place a pulse oximeter on them, looking for abnormally low readings,” he says. “Or ask if they’ve had a loss of sense of smell or taste.”

He thinks point-of-care, rapid-result COVID-19 tests could be a game-changer. “We can test patients and staff right there in the parking lot before they even enter the building,” he says. “If everybody comes in the morning and gets a negative test, we’re good.”

Mr. Horowitz, who primarily works ophthalmic cases, says providers will need to reorient procedurally to account for COVID-19. “We have a plastic drape, for instance, that covers the patient’s face and has a little hole so you can see the eye,” he says. “If a patient had the virus, where would it most likely be piling up during the case? Under that drape, so we must be a little more careful pulling it off. That’s the type of thing we’ve never had to think about before.”

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