Everywhere you turn, you see the phrase ‘a new normal’, but what does it really mean for busy healthcare organizations on the front lines of responding to COVID-19? The answer is – no one really knows, but it’s time to start planning for it. In all likelihood, the new normal will be different for just about every health system in America based on each community’s response to COVID-19 and how rampant the virus is at any given time.
For the past six weeks, hospitals have been almost exclusively immersed in survival mode. Changing PPE policies every few days, opening and staffing the incident command center, setting up testing sites, triage tents, monitoring restricted visitation policies, dealing with staffing challenges, employee fears and anxieties, and supply shortages – just to name a few.
Today, if not sooner – it’s time for hospitals to shift gears. Maintaining COVID-19 response efforts remains critical, but a dedicated team needs to be established to plan for the future. With so many unknowns about this virus, immunity, and the future of testing – and another surge of cases anticipated for the fall/winter of 2020-2021 and a vaccine more than a year off, hospitals face perilous financial ruin if business continuity plans are not put into place as soon as possible. Already, several large and prominent health systems are among countless others that have been forced to make extremely difficult decisions by announcing layoffs, furloughs, and reductions in staff hours to help trim millions in expenses in order to offset the effects of lost revenue.
Phase 1: Resuming Non-Emergency Procedures
Just last week, CMS issued guidance which includes recommendations to healthcare facilities on how to begin opening back up for non-emergency procedures. This guidance issued on April 16 comes after the agency’s March 18 recommendation that facilities should limit non-essential care to expand surge capacity and preserve PPE. While CMS is still encouraging telehealth whenever possible, they recognize that not all care can be delivered virtually. A brief overview of their guidance includes:
- Coordinate with local and state public health officials to evaluate COVID-19 trends prior to moving forward.
- Offer care based on necessity – prioritizing surgical and procedural care, and chronic disease management for highly complex patient populations, followed by certain preventive services.
- Establish routine COVID-19 screening checks for patients and staff, including temperature checks.
- Ensure resources such as PPE, healthy staff, facilities, testing, and post-acute care options are available without hindering surge capacity.
The Advisory Board, a best practices healthcare firm, recommends making decisions about when and how to phase-in elective procedures based on a broader range of factors, such as: clinical urgency; alignment with system strategic goals; profitability; market share; competitive advantage for introducing early; backlogged case volumes; expected length of stay; duration of procedure (i.e., OR time needed); surgeon/anesthesiologist availability; availability of staffing and facility for post-op care; and PPE required/availability. Working to evaluate each procedure/service against this broader list of considerations will help organizations introduce the services patients need, while also focusing on key factors such as financial metrics, market share and operational feasibility.
Getting back to the ‘new normal’ will not come without its challenges – but developing a comprehensive, strategic plan for moving forward will allow health systems to regain some percentage of lost revenue while helping keep their patients and staff healthy and safe.
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Helpful Resources for Healthcare Providers Evaluating the Introduction of Elective Procedures:
- CMS Recommendations for Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare – Phase 1
- Modern Healthcare – How Hospitals Can Reopen Once COVID-19 Surge Passes
- The Advisory Board – Weighing When to Reopen the Health System
- The Advisory Board – Is it Time to Restart Elective Procedures?
- The Advisory Board – 3 Steps to Prioritize Services Post-COVID-19 Surge