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Starting next week, Minnesota hospitals will again be able to perform elective procedures, which can include surgeries and procedures like endoscopies. Here, Jena Rohlik, R.N., and Josh Lugar, surgery director at Avera Marshall Regional Medical Center, discuss processes in an endoscopy room.
MARSHALL — Weeks ago, as Minnesota’s health care providers worked to build up a response to the COVID-19 pandemic, there were some services that got put on hold. In a move to help protect patients and health care workers and conserve needed equipment, Gov. Tim Walz ordered a temporary stop to procedures like elective surgeries.
Now, providers are getting ready to reopen clinics and hospitals for more non-emergency procedures.
“We want to offer this care to patients,” said Dr. Curtis Louwagie, an ophthalmologist at Avera Marshall Regional Medical Center, and one of the physicians planning for the return of elective surgeries. “I’m excited to start surgeries again, too.”
Louwagie said Avera Marshall anticipates doing some elective procedures next week — however, it’s taken a lot of planning work to get to that point.
Starting Monday, Walz ordered that health care providers like hospitals, surgical centers, clinics and dental practices can start doing elective procedures again. However, providers need to have a plan in place to help protect patients and health care workers. At Avera Marshall, Louwagie has been part of the planning efforts to restart elective surgeries and other procedures.
When it comes to medical procedures, the word “elective” can be a little misleading, Louwagie said. While they’re not as urgent as a heart attack or a life-threatening injury, elective procedures are still important for people’s health and wellness. For example, he said, cataract surgeries and joint replacements are two common elective surgeries that make a big difference in patients’ lives. The governor’s order had also put a hold on medical procedures and screenings like colonoscopies, mammograms and eye exams.
But balancing needed elective procedures with COVID-19 response isn’t simple.
“It’s taken a tremendous amount of work to get this going again,” Louwagie said. The Minnesota Department of Health gave providers “a pretty detailed document” with the requirements to resume elective surgeries.
For hospitals like Avera Marshall, it will be important to make sure they keep beds and protective equipment available in case there’s a surge of COVID-19 patients.
“We can’t fill all the beds with knee replacement patients,” Louwagie said. Hospitals also need to make sure that they can help protect staff and patients from possible spread of COVID-19.
Louwagie said Avera Marshall has been taking all those factors into account as it prepares to resume elective procedures. To start with, he said, “We won’t be able to do as many surgeries a day as we used to.” They will also likely start with procedures that don’t require a hospital stay.
Avera Marshall is currently working with the Minnesota Department of Health and the Minnesota Hospital Association to clarify some of the guidelines that will affect how more complex procedures, like hip replacements, are handled, Louwagie said.
Other considerations for scheduling elective surgeries include supply levels at the hospital, and whether there are COVID-19 patients who need treatment.
“The whole plan really depends on what happens with the community and COVID-19,” Louwagie said.
Avera Marshall has also developed criteria to help determine which procedures to schedule first. Surgeries with a bigger impact on the patient’s health outcomes are a higher priority. Other important considerations include whether a patient might be at a higher risk from COVID-19, whether due to age or chronic health conditions like heart disease or diabetes.
“We’ll have to be doing a lot of pre-screening work,” Louwagie said, to help make sure that patients don’t have the coronavirus themselves, and pose a risk to health care workers.
Precautions against COVID-19 will mean the process of getting an elective surgery will be a little different now, Louwagie said. All same-day surgeries will be done at Avera Marshall’s Bruce Street campus. Patients will only be able to bring one person with them for an outpatient surgery, to make sure they can get home safely. Both the patient and their driver will be screened at the hospital entrance, and they both will have to wear masks at all times.
Louwagie cautioned that the guidelines for elective procedures could change, depending on the latest guidance from the MDH and the Centers for Disease Control. Eventually, he said, “The opening of the economy is going to change how all this looks as well.”
Louwagie said Avera Marshall will be contacting patients who had procedures previously scheduled. People who have questions about getting an elective procedure can call their health care provider’s office, he said.