Elective surgeries back on the table

Elective surgeries back on the table


Central Illinoisans who have been waiting since March for non-urgent but, in many cases, medically necessary surgeries and procedures, will experience relief effective this Monday.

But, patients must be tested and free of COVID-19 before their procedure can go forward.

At Decatur Memorial Hospital (DMH), for example, the surgical backlog is 500 cases. At Advocate BroMenn Medical Center in Normal, its 300 cases and at Advocate Eureka Hospital in Eureka, it's 40. At Bloomington-based OSF St. Joseph Medical Center, it's more than 100 cases. At OSF HealthCare Saint James-John W. Albrecht Medical Center in Pontiac, nearly 100 surgical patients are waiting.

It will be weeks before all those patients are treated — a month and a half at DMH, guessed Dr. Ted Clark, their chief medical officer and affiliate vice president for the Memorial Health System, which includes Abraham Lincoln Memorial Hospital in Lincoln — as hospitals continue to treat other patients.

It will be longer if social distancing lets up too quickly and there's another wave of COVID cases.

"I am not expecting clear sailing," commented Dr, James Nevin, Eureka’s chief medical officer. "It'll take time to slowly ramp up in a safe and prescriptive manner."

He added the order of surgical patients is determined by a complex formula that includes the severity of the patient's condition, their medical history and the anticipated length of surgery and hospital stay. How long patients have been waiting will also be considered, Hospitals said they are doing OK for now with supplies of personal protective equipment and medication.

"We are beginning with the cases that were canceled in March with the determining factors: the patient can go home following the procedure/surgery, patient has a driver and patient can have a COVID-19 test performed with a negative result," said Patty Peterson, public relations director for Sarah Bush Lincoln Health Center of Mattoon.

Staff and surgeons want patients to know that they are anxious to treat them. Hospitals and surgeons have taken a financial hit with the delays, and some surgical services staff were deployed elsewhere in hospitals or, in some cases, furloughed.

"We want to take care of our patients. We want to take care of our community," said Clark. "We're ready to get back to work in the safest way possible."

According to Paul Skowron, the Chief Executive Officer (CEO) of Warner Hospital & Health Services in Clinton, the surgical staff is, "ready to resume surgical activities."

"In a rural community such as Clinton, the lack of elective surgery has been tough mentally on the staff and community because the service provides a vibrancy that a small hospital needs and a convenience close to home that the community appreciates," he said.

When the COVID-19 pandemic hit Illinois in March, surgeries continued when they addressed life-threatening conditions such as open-heart and neuro-surgeries and orthopedic and other procedures that, if not performed immediately, would have caused permanent disability.

But, procedures that could be delayed were deferred to conserve resources for COVID-19 patients and to reduce infection risk. Illinois Department of Public Health is allowing elective surgeries to resume as the spread of COVID-19 slows.

Examples of surgeries and procedures that have been postponed include non-urgent joint replacement, gallbladder and prostate surgery; hernia repair; gynecological procedures such as hysterectomies; cancer biopsies; endoscopies and colonoscopies; removal of moles and skin lesions; and pain management, ophthalmological, podiatric and ear, nose and throat procedures.

"For most hospitals, the bulk of what we do is elective surgeries," OSF St. Joseph President Lynn Fulton said. "The patient needs it but not immediately. There is only so long you can put off elective procedures before it affects the health and well-being of the patient."

According to Clark, delays in cancer screening biopsies may delay treatment and postponing orthopedic procedures may result in pain.

"We think the benefit of elective surgeries outweighs the risk at this point because of the aggressive steps we're taking to protect the patients," Clark said.

Hospitals are not yet moving to 100 percent elective surgical capacity because non-COVID patients must be kept separate from COVID patients, because hospitals must be prepared for a possible second COVID surge and because hospitals must be ready for any medical emergency.

"HSHS St. Mary's Hospital (in Decatur) is working on a process to bring those (elective) services back online and will be communicating with patients soon on what they should be prepared for, including having a negative COVID-19 test on file ... before the procedure and enforcing current visitor restrictions," said marketing specialist Andrew Dilbeck. "We will continue to maintain a safe hospital environment for all patients we serve."

Skowron noted the Clinton hospital "will scale in the volume" to maintain enhanced infection control and allow for COVID testing turnaround time.

"We will be easing in," Fulton said. "We will not be flipping the switch on Monday and filling our operating rooms (ORs)."

"The most important aspect of all of this is protection of the patient," Clark said.

"There is a cautious optimism going forward," Nevin said.

Fulton added she's relieved to welcome non-COVID patients back to St. Joseph and wants to assure them that steps have been taken to reduce infection risk.

"If anybody knows how to manage infection, it's the hospital," Clark said.


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