As the nation continues to take unprecedented action to manage the COVID-19 pandemic, we want to provide some critically important reminders to the ASC community.
First, strictly adhere to federal and state guidance to immediately postpone all surgeries that can be delayed for 6 to 8 weeks. This is a critical step in slowing the transmission of the virus. Second, as you are well aware, the healthcare system is facing a critical shortage of certain medical supplies and personal protective equipment. Use these resources sparely and wisely.
Finally, the increasing stresses of the pandemic on traditional hospital services may soon lead to federal and state government decisions to use ambulatory surgery centers to support the healthcare system in expanded surgical use and new ways during the pandemic. You must be prepared for your ASCs to work in coordination with local hospitals to manage care and patients not currently contemplated, most of which will require regulatory waivers and other guidance that could be forthcoming in the very near future. We encourage all ASCs that have not already done so to communicate with your local hospitals to ensure a coordinated response in the best interest of your communities. We recognize that all of this is unprecedented but be assured that ASCA will continue to be a trusted advocate and resource for you as we all work together to meet these challenges.
Bill Prentice Chief Executive Officer Ambulatory Surgery Center Association
Larry Taylor, CASC President Ambulatory Surgery Center Association
P.S. For those ASCs that are continuing to offer emergent surgical care, we are providing some expanded safety guidelines designed to help you keep your patients and staff safe.
Please note that events and recommendations surrounding COVID-19 are evolving rapidly. This material is provided for informational purposes only and does not constitute medical or legal advice. It should not be construed as representing ASCA policy or substituting for the judgment of a physician and consultation with independent legal counsel.
To help ASCs protect patients and families, their surgical staff and the US population from COVID-19, ASCA is sharing the following recommendations:
Pre-screen all patients for symptoms or high-risk exposure prior to their visit, beginning at the physician’s office and during any pre-admission phone calls or other remote methods. Inform the patient to call ahead and discuss the need to reschedule their appointment if they develop symptoms of a respiratory infection (e.g., cough, sore throat, fever).
Upon arrival, but prior to admission, patients should again be asked about a personal history of fever, sore throat, cough or other respiratory symptoms, and about similar symptoms in family members or close contacts. The body temperature of the patient should be checked upon arrival. Ask also about contact with a confirmed case of COVID-19 or recent travel to a high-risk area.
Prohibit individuals (including patients) from entering the facility if they are experiencing elevated temperature or symptoms suggestive of COVID-19.,/p>
All visitors, including vendors, should be actively assessed for fever and respiratory symptoms upon entry to the facility. If fever or respiratory symptoms are present, visitors should not be allowed entry into the facility. Determine the threshold at which screening of visitors entering the facility will be initiated and at what point screening will escalate from passive (e.g., signs at the entrance) to active (e.g., direct questioning) to restricting all visitors to the facility. If visitors are limited, encourage use of alternative mechanisms for patient and visitor interactions such as video-call applications on cell phones or tablets.
Make sure appropriate personal protective equipment (PPE) (gloves, mask, eye shield/goggles, face shields and gown) is available and worn by healthcare providers based on their job description. Ensure the healthcare provider is educated and trained and has practiced the appropriate and correct use of PPE including the removal of such equipment.
Conservation and strategies for optimizing the supply of PPE is critical. Only essential personnel should be present in cases. Strategies and options to optimize supplies of PPE can be found at www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html
Consider phone follow-up for all patients 7–14 days post procedure to ask about the development of symptoms or a diagnosis of COVID-19 and have contingency plans in place (including public health authority reporting) when a positive result is confirmed. The facility should follow the advice of the public health authority on notifying other patients and families who may have been exposed to a patient or family member who subsequently is diagnosed with COVID-19.
Conduct frequent educational meetings, including refresher training, for staff regarding infection prevention and related precautionary practices.
Staff should be screened per ASC policies that are consistent with public health guidance for symptoms of COVID-19. They should not come to work with symptoms and should contact their personal physician.
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