Surgical Case Deferment During a Global Pandemic

Excerpt

In March of 2020, hospitals across the United States began deferring elective surgical procedures in response to the rapidly escalating SARS-CoV2 pandemic. On March 15, 2020, the Massachusetts Department of Public Health (DPH) issued a directive that all non-essential surgery be deferred [1]. Massachusetts General Hospital (MGH) needed to quickly evolve surgical scheduling guidelines that were clear, reasonable and fair to meet the needs of our patients and balance the evolving needs of our hospital and healthcare system. On March 17, 2020, the American College of Surgery (ACS) published guidance for triage of non-emergent surgery [2]. A method was needed to quickly draw-down our operating room (OR) schedule to be in line with the ACS guidelines and more detailed guidelines that we developed. This was necessary given the rising need to conserve space, staffing and PPE resources. We describe a method for case deferment that empowers a large swath of surgical specialties to make safe and quick decisions that result in a dramatic reduction of the OR schedule and hospital census. The following rules and methodology have applicability for our current pandemic as well as during other emergency situations such as blizzards, hurricanes or massive power outage. …