ASC Association provides guidance on necessary surgeries during COVID-19 pandemic

ByCasey Tingle

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In light of the COVID-19 pandemic, the Ambulatory Surgery Center Association released recommendations on how and when facilities should proceed with cases that should not be postponed due to the likely increase of significantly worse morbidity or prognosis for the patient.

According to a press release, the Ambulatory Surgery Center Association (ASCA) recommends physicians make care decisions with patients and families that minimize potential risks to patients while ensuring they receive necessary care that cannot be safely delayed. To reduce potential stress from post-surgical complications that may require a transfer, the release noted facilities should establish a line of communication with local hospitals to ensure coordination in managing care during the pandemic.

“In addition, ASCs should develop explicit controls on how to manage the infection risks of all non-patient visitors (patient caregivers, vendors, contractors, etc.) who present themselves inside the facility and should strictly prohibit all non-essential visitors,” the ASCA noted in the statement. “Additional social distancing policies should be employed.”

If the pandemic proceeds to a point that strains the health care system, the ASCA noted hospitals may need to shift necessary surgeries to ASCs, or ASCs and their resources will be required to serve the communities and the health care system in a different capacity. In these situations, ASCs and hospitals would receive additional guidance from regulatory agencies, according to the ASCA.

Finally, the ASCA noted the COVID-19 pandemic and its impact could create situations in when ASCs may need to shut down. According to the release, these could include when a patient, staff or physician who has been in the ASC is suspected or subsequently diagnosed with COVID-19 or when there is a significant shortage of personal protective equipment that prevents safe practice of surgical cases.

At this time, the ASCA noted cases that may still need to proceed with surgery include:

- acute infection;

- acute trauma that would significantly worsen without surgery;

- potential malignancy;

- uncontrollable pain that would otherwise require a hospital admission; and

- a condition in which prognosis would significantly worsen with a delay in treatment.

However, procedures that can be safely postponed without additional significant risk to the patient should be delayed until after the COVID-19 pandemic, according to the ASCA.

“The current and ongoing efforts to isolate our population and create social distancing are essential steps in saving lives by shortening and ultimately ending the COVID-19 pandemic,” according to the statement. “The health and safety of patients, along with preventing the spread of COVID-19, must be our highest priority. We concur with the American College of Surgeons that ‘the risk to the patient should include an aggregate assessment of the real risk of proceeding and the real risk of delay, including the expectation that a delay of 6 to 8 weeks or more may be required to emerge from an environment in which COVID-19 is less prevalent.’”

Reference:

www.ascassociation.org/asca/resourcecenter/latestnewsresourcecenter/covid-19/covid-19-guidance