Restarting Elective Surgery After COVID-19: 4 Key Policies You Need

Your practice’s financial stability means you have to quickly scale your elective surgeries back to pre-coronavirus days while complying with new safety guidelines. Two of the top policies you need to iron out and then communicate are your pre-surgical COVID-19 screening processes and surgery visitation allowances.

As you create and implement your new COVID-19 surgical policies, be sure to include the following points.

Develop COVID-19 Testing Policy

You should implement a diagnostic testing policy to protect staff and patients. Because the same quick, accurate diagnostic testing isn’t available in all areas, tailor your policy requirements specific to your resources. The American College of Surgeons recommends including these diagnostic testing points in your policy:

Patients

Symptom screening: Verbally screen all patients for COVID-19 symptoms including fever, cough, and respiratory symptoms.
Conduct testing: Require patients to take a rapid COVID-19 test as part of their pre-op workup. Keep in mind availability may decrease as more surgical centers are testing. In the absence of mass testing capabilities, follow the guidance of your local public health officials. If you can’t verify a patient’s COVID-19 status, you should supply proper PPE for physicians and nurses.
Determine plan: Decide your tactic for when a patient tests positive.
Require retesting: Institute a retest policy, keeping in mind that fever and respiratory complications are common after surgeries, and false negative tests have been reported as high as 30 percent.

Staff

Require testing: Test all healthcare workers.
Determine contingency: Plan what you will do if a staff member tests positive.

Communicate New Visitor Restrictions

The Centers for Disease Control and Prevention (CDC) recommends you prohibit additional visitors from accompanying your elective surgery patients. If your patient requires an additional person for some reason, the patient’s visitor should also be pre-screened

It is important that you clearly communicate to your patients in both verbal and written formats your visitation policy post pandemic Here are several recommended items to include in your policy:

Visitor allowances: Indicate if the patient has to come alone. Many centers allow one provider for a pediatric or disabled individual but otherwise the patient may have to come alone.
Transportation details: If you don’t allow visitors, explain where you want the patient dropped off and how you assist patients from curbside drop off to pre op registration. Make sure to give the patient clear instructions and directions.
Discharge education: Provide extensive written post-surgical and discharge instructions to provide the primary care person or visitor if they aren’t allowed in with the patient. Explain how and when you will provide the information such as will send home with patient at pick up.
Contact information: Include a phone number to call with any follow-up questions.

Explain Levels of Required Personal Protective Equipment

For the safety of both your patients and staff, continue implementing mask and social distancing policies. . The only way to ensure compliance is to provide your patients and staff with these policies so they can cooperate and feel confident in your added precautions.

CMS offers these recommendations for reopening facilities during Phase 1:

Always require masks: Healthcare providers and staff should wear surgical face masks at all times. Patients should wear a cloth face covering that can be bought or made at home if they do not already possess surgical masks. If they don’t have a mask, provide one for them.
Increase protection for high-risk procedures: Procedures on the mucous membranes including the respiratory tract that carry a high risk of aerosol transmission, should be done with great caution, and staff should utilize appropriate respiratory protection such as N95 masks and face shields.

Sources: The American College of Surgeons has a checklist to help you plan what patients and surgeries to prioritize. The American Hospital Association, American College of Surgeons, American Society of Anesthesiologists, and the Association of periOperative Registered Nurses published a detailed road map to resuming elective surgeries

For more strategies to improve your reimbursement as you scale your practice revenue back to pre-Coronavirus days, national consultant and coding expert, Penny Osmon Bahr, CPC, CHC, CPC-I, can help. By attending the online training “Return Your Practice Revenue to Pre-Coronavirus Days Safely & Firmly,” you’ll learn steps to take now to recapture volume, optimize visit mix and recover revenue so you can reach your new normal before you know it.