AAOS updates guidelines amid COVID-19 pandemic, including resuming elective surgery

In response to recommendations by CMS for re-opening American health care systems, the American Academy of Orthopaedic Surgeons has released five clinical considerations for orthopedic surgeons and allied health professionals during the COVID-19 pandemic, according to an AAOS press release.

“CMS has once again offered a helpful, nationwide framework for entering this new phase of the pandemic, and we applaud the agency for recognizing the significant differences in disease incidence and prevalence in each state and locale,” AAOS President Joseph A. Bosco III, MD, FAAOS, said in the release. “Now as individuals across the country begin evaluating these recommendations and implementing them in their practices, the AAOS is offering additional detail for prioritizing the safety of our patients and members.”

The following five AAOS guiding principles cover COVID-19 testing, telehealth procedures, resuming in-person care and elective surgeries, and risk stratification:

1.  Patient safety must be the highest priority when considering the provision of health care services, items and procedures during the COVID-19 pandemic;

2. The safety of health care personnel and staff should be of next highest priority, after accounting for patient safety, when considering the provision of health care services, items and procedures;

3. Adhere to CDC, and relevant federal, state and local public health guidance and recommendations; the safety of patients and staff members is paramount;

4. Decisions should be locally based, as factors vary by locale; this includes incidence, prevalence, patient and staff risk factors, community needs and resource availability (to include ICU beds, hospital beds, ventilators and personal protective equipment ). It is imperative to accurately determine if the disease burden curve trajectory in the physician’s local community is increasing, flattening or decreasing, as well as the reproductive number; greater than, equal to or less than one; and

5. Follow legal restrictions. Many states and locales have mandated shutdowns and stay-at-home orders; it is important to adhere to these legal requirements.

 

Reference:

https://www.aaos.org/globalassets/about/covid-19/aaos-clinical-considerations-during-covid-19.pdf