How to Prepare Your Surgical Practice for COVID-19

While it feels like we are starring in a Hollywood horror movie (you know the one), there’s no getting away from the fact that – for the moment at least – there is the new “normal.” 

And in this new normal, conferences, including biggies such as HIMSS and AAOS, have been canceled, schools are shuttered, university classes are being moved online and nothing is what it was just a short time ago.

The new normal

Few sectors will emerge from this situation unscathed – barring face mask and toilet paper manufacturers – and that includes elective surgery.

So, what can your practice do to be as prepared as possible to get through the coming tough days, weeks and possibly months?

Have a clear workflow in place for cancellations 

Having a workflow and systems in place to manage all eventualities is crucial to maintain optimal efficiency and that includes cancellations. 

If your practice already has a cancellation system in place, now is the time to review and optimize it in case you need to tweak it a bit for the potential high volume of cancellations on the horizon. 

If your practice has never had a formal workflow in place, this is what we suggest: 

1. Record the reason the patient canceled. It might be because of COVID-19, but it could be because of something else entirely. Remember, even in eventful times, regular things still happen.
2. File any cancellations into an electronic list for proactive follow up in a specified window of time. This could mean a month, perhaps two months or even “when things are back to normal” ie TBD. The actual time frame is less important than making sure there is a system in place to make sure these patients don’t fall through the cracks, leading to permanently lost revenue. 
3. Decide on rescheduling parameters. This could depend on age or whether the procedure can be performed at an ASC rather than at a hospital. Any cases that can be rescheduled should be clearly tagged to ensure effective follow-up and rescheduling at the appropriate time.
4. Don’t forget to maintain an active list of “move up” patients. These are patients who have all their clearances and authorizations in place and want to have their surgery done sooner rather than later. Make a note to regularly check this list to move up cases to fill any unused surgical blocks.

Rethink how you treat the elderly

Older adults (those 60+) are the demographic most at risk for COVID-19. They also make up the biggest segment of the population getting elective surgery so they will make up the majority of patients asking to cancel their surgery. 

People need to stop & remember the most vulnerable group

The reasoning is clear. No one wants to be in a hospital right now. Since ASCs offer less exposure than a hospital, maintain a list of older patients who could undergo their procedure at an ASC. If these patients want to cancel no matter where the surgery takes place – and assume that some will – move up younger patients, who are less at risk and are willing to undergo surgery. 

Once again, it comes down to having effective systems in place and ensuring you maintain your “move up” list of younger patients who have the need for their procedure and are ready to roll.

Address anxiety with your patients

Anxiety is a large factor in canceled surgeries when circumstances are normal. With the 24-hour news cycle, alarmist social media posts and empty supermarket shelves we’ve witnessed in the last week alone, anxiety is high for many people right now. Throw in going to a hospital for surgery and that anxiety could skyrocket.

Don’t ignore the situation; this is the time to show heightened empathy with your patients. Send out an email, newsletter or other forms of communication clearly stating your practice’s policies, methods or precautions for ensuring the safety and health of patients and staff. Let patients know it’s still safe to come into the clinic and, if possible, have a helpline or email set up so patients can ask their questions and voice any concerns they might have with your practice directly. 

At times like this, going that extra mile for patients and showing them some love will go a long way to helping reassure them, even if they opt to cancel their surgery for the foreseeable future. 

Make the office a safe space

While surgical practices are, by nature, more sanitary work-spaces, taking things to the next level of cleanliness will give staff and patients peace of mind. There are several steps that can be taken:

1. Have hand sanitizer readily available. Some practices already have these in the bathrooms or entrances of their practice. However, for those who don’t have, now is the time to stock up. Place them strategically around the waiting room and hang signs encouraging patients to wash their hands frequently.
2. Wipe down surfaces in heavy foot traffic areas frequently. This could include the waiting room, examination rooms, and bathrooms. Cleaning these surfaces multiple times a day can give patients a greater sense that you are doing everything in the practice’s control to keep patients safe and healthy. The current law only requires daily cleaning of medical offices. However, with the World Health Organization declaring this a pandemic, taking greater precautions is the name of the game now.
3. Discourage patients with fever or any symptoms of a cold/flu from coming into the clinic. This information can be communicated via phone, text, or email. This is a difficult yet necessary step in keeping social distance from those who may be at risk of carrying the virus.

Keeping your staff safe must also be a top priority

Institute remote working

Given the shutdowns being rolled-out around the world, the government could start instituting restrictions on large workplaces. Practices could also be forced to deal with the issue of staff who are in self isolation and not allowed into the office for 14 days or even longer. Given these likely scenarios, now’s the time to think about how to prepare your practice to ensure staff can work remotely. 

Make sure all mission critical systems are accessible if staff are physically outside the office.  If they are cloud based, it’s easy. If they are not, request that your IT team set up a remote desktop using HIPAA compliant technology. You will need access to your Practice Management, EHR system and Surgical Coordination Platform. Some offices have begun stress testing their systems in the event that many staff need to work from home. Create a series of procedures and guidelines as preparation for different scenarios.

Working from home requires self-discipline & always being connected

And again, even in an “emergency” climate, it’s critical to ensure all data is processed in a HIPAA-compliant way to avoid jeopardizing patient information.

 Prepare a disaster recovery plan

No one knows how this situation will end and how much it will worsen. Rather than getting frantic and thinking about the unknown, focus on the things you can do to protect your practice. 

That includes putting a disaster recovery plan in place. Don’t put off setting this up. Work on documenting processes and mapping out scenarios across the entire workflow. This documentation MUST be part of every practice. Remember, this too will pass, but other situations could arise and knowing you have a recovery plan in place for every scenario should be very reassuring.

Prepare for the day after

Right now, it’s hard to see the positive in the current situation, but staying positive is important. While no one wants to see a slowdown in surgery, it is going to happen. And practices can view this “free time” as an opportunity to focus on strategic initiatives and to tackle any projects – both physical and digital – you might have been putting off. 

Waiting rooms may start to look like this very soon

Ultimately, the more prepared you are, the better equipped your staff will be to handle the unknown and the unforeseen events hitting us. 

Above all, stay safe and healthy and may the normal, “boring” times return as soon as possible.