On Monday, May 25, Augusta Health moved to Phase II of its plan to resume and re-open outpatient services in three phases. Phase II services include elective Outpatient Surgery, Endoscopy, Cath Lab, Sleep Lab and Inpatient/Outpatient Invasive Radiology. All of these services require pre-procedure COVID-19 testing of the patient.
A quick check of the Augusta Health COVID-19 Dashboard
|Bed Availability||Very Good|
|Prevalence of COVID-19 in the community|
An increase in positive cases in the Central Shenandoah Valley district
|PPE Supply||Very Good|
|Confidence in safely moving to Phase II||Very High|
"Our dashboard indicators, which we monitor daily, were signaling that we could now safely move to Phase II," says Shawn Craddock, DNP, RN, CNOR, NE-BC, Administrative Director of Surgical Services, who is leading the Task Force on the resuming of outpatient services. "Most of our indicators were a solid green and the system did not have signs of being stressed, and so it was time to move forward. Many of our patients have been postponing surgeries over the past months, and while not emergencies, their situations were becoming urgent. We're confident we can safely provide the healthcare services they need."
Safety is the primary reason that patients receiving services during Phase II will be tested for COVID-19 before their procedures. "Knowing whether or not a patient is positive for COVID-19 has a great impact on the flow of the case," explains Craddock. "We need to have full knowledge of the situation to keep the patient, other patients, and the staff safe. A positive test affects the PPE we need to use and the movement of the patient through the hospital. It also triggers the question, 'Should this procedure continue?' Recent studies have shown that COVID-19 positive patients have a higher risk for poorer surgical outcomes. So perhaps we should delay to have both greater safety and a better outcome for the patient."
Patients who need pre-procedure COVID-19 testing are scheduled for a test at the Waynesboro Assessment Center about three to four days before the scheduled procedure. The test is given by a 'Drive Thru' method to eliminate any time in the waiting room of the Assessment Center. Craddock reports that, on average, test results are known in about 36 hours. A case manager calls the patient if the result is negative; a physician calls if the result is positive.
If the result is negative, the procedure proceeds as scheduled. "It's very important that the patient quarantine until the procedure," explains Craddock. "Once we know the test is negative and we began planning accordingly, it's crucial that the patient does not risk exposure to the virus before the procedure."
Craddock indicates that both pre-procedure COVID-19 testing and the first procedures have gone well. "As it happened, it was good to start on the Memorial Day holiday. It's traditionally a lighter day, and that was helpful. It was great to see how quickly everything gelled and how well the staff worked together again," says Craddock.
Physicians and surgeons are contacting patients whose procedures were postponed during the pandemic response to reschedule. Most are scheduling the most urgent cases first, so not all patients may have received a rescheduling call yet. Patients with concerns or a change in their condition should contact their provider's office.
As Phase II continues, Craddock emphasizes these points:
- "We follow the CDC guidelines and do everything we can to keep you safe while in our care," he says.
- The pre-procedure COVID-19 test is important to protect everyone—patient, staff and other patients. The post-test quarantine is equally important to prevent an unknown exposure and perhaps infection.
- "Keep masking! Keep washing your hands! It works," adds Craddock. "Now that things are opening up, some are assuming it's safe to stop those preventive actions, but the opposite is true. As things start opening up, it's time to be even more vigilant about masking, social distancing and washing your hands."