AACS Statement on the Return of Elective Surgery and Treatment
Wednesday, April 22, 2020
On March 18, 2020 the Centers for Medicare & Medicaid Services (CMS) released guidance to limit "non-essential adult elective surgery and medical and surgical procedures." The guidance additionally notes that while "decisions remain the responsibility of local healthcare delivery systems...and those surgeons who have direct responsibility to their patients," when determining the risks and benefits of any planned procedures "...not only must the clinical situation be evaluated, but resource conservation must also be considered."
Currently, 36 states and Washington, DC, have released official statements or their state officials have made statements to media addressing the issue of elective procedures during the ongoing COVID-19 outbreak.
Three states (Alaska, Oklahoma, and Texas) have issued orders rolling back their restrictions on elective procedures. AACS recommends that all members follow their state’s applicable laws and regulations regarding elective surgery. A summary of these statements and orders can be found here.
For members in a state when the return to elective surgery is pending AACSrecommends all members engage in the following core practices:
Social Distancing: Maintenance of strict social distancing in patient scheduling, positioning and movement within a facility, and continued maximal possible use of telemedicine/telehealth capabilities for the duration of the crisis.
Family and Friends: Minimum group size for patients’ visits. Visitors present for transportation only will wait off-site until contacted at conclusion of the visit.
Screening Prior to Visit: Use of on-site fever and self-report of COVID-19 symptom screening for all patients and staff immediately prior to or upon entering a facility.
Hand Sanitizing: Hand sanitation procedures required of all patients and providers upon entering the facility. Hand sanitation required for providers throughout the day. Regular sanitizing of hard surfaces, patient-care equipment, and workstations by care personnel.
PPE Use: PPE use by providers and patients. If PPE is unavailable, personal cloth face coverings by patients is recommended.
PPE Supply: Maintenance of operational levels of PPE appropriate to continue both elective patient care AND to respond to the potential for a resurgence in COVID-19 cases.
Also, be advised that if resurgence occurs, members will likely be forced to either limit or halt elective care again.
AACS encourages all members to adhere to, when applicable,Roadmap for Resuming Elective Surgery after COVID-19 Pandemic issued by the American College of Surgeons, American Society of Anesthesiologists, Association of periOperative Registered Nurses and the American Hospital Association.