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Elective Surgeries are back on the schedule after Governor lifts restriction.

empty operating room in hospital. Stock Photo.

On May 1 the Governor announced hospitals could once again begin scheduling elective surgeries. Elective surgeries shouldn’t be considered optional – they’re vital to the health of both individuals and hospitals across the state. 

The initial order in Mid-March suspended non-essential or elective surgeries which the Governor’s office broadly defined as surgeries that “could be delayed without undue risk to the current or future health of a patient.” 

But those surgeries represent a significant portion of revenue for all hospitals across the state, including Cobre Valley Regional Medical Center. 

This sentiment was echoed by Evelyn Vargas, Public Relations Director for the hospital, who says that the revenue from their elective surgeries is one reason they’ve been able to bring in a cath lab and add new equipment for both radiation and mammography.

Overall, the suspension of elective surgeries in hospitals across Arizona has meant a loss of 30% to 40% in revenues, which equates to a revenue reduction between $430 million and $575 million per month, according to an azcentral report. 

The suspension also created a significant backlog of cases, says CEO Neal Jensen.

The hospital is now in the process of sorting out hundreds of elective surgeries that had been scheduled during March, April, and May, working with local doctors and patients to get them rescheduled. 

Prioritizing which cases go first is really up to the doctors, says Vargas. 

Although the word “elective” can make it sound as though these surgeries are optional, that is not the case. Repairing a hernia or replacing a knee count as elective surgeries, but both are necessary. However, both are procedures that doctors may have chosen to delay when weighing them against the risks of a surgery amid heightened concerns over COVID-19 and PPE supplies. 

In some cases, deferring those elective surgeries too long can create an urgency where there was none initially. These cases will be some of the first to be identified and prioritized as elective surgeries resume.

Vargas acknowledges that the fear of COVID-19 may prevent patients from going to the hospital and addressing issues that should be looked at immediately. Yet, even during the lockdown, CVRMC continued to treat patients with immediate needs. 

“There has been little to no interruptions in those services,” Jensen said. “We continue to treat those patients, first and foremost ensuring their safety as well as minimizing their exposure to other patients.” 

 

Scheduling elective surgeries at CVRMC

 

Although elective surgeries are allowed again, COVID-19 is still here, so the hospital is strictly following a screening protocol which includes new rules prior to scheduling these procedures.

Patients are questioned as to symptoms and possible exposure to COVID-19. An operation may be deferred for a minimum of 14 days after the last known exposure. 

For patients showing COVID-19 symptoms – a fever of 100.4F or greater, a cough, shortness of breath, and/or malaise – the surgery will be deferred and COVID-19 PCR testing will be done. Whether the test results are negative or positive, surgery will be deferred until at least 14 days after symptoms improve.

After clearing these hurdles, the patient will be scheduled for the elective surgery. Seven days prior to the surgery, COVID-19 testing will again be performed. If the results are negative, the patient will have the surgery. If positive, the surgery will be deferred until at least 14 days after the patient’s last known exposure to the virus.

CVRMC currently provides PCR COVID-19 testing in house. However, because rural hospitals have been hampered by a lack of tests, the hospital’s COVID Response Team is reviewing the inventory of PPE and test collection kits on a regular basis. Jensen points out that the hospital is also required to leave 20 percent of its beds available in case of a surge in COVID-19 patients, and this could affect the scheduling of elective surgeries. 

 

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