8 Helpful tips for Effectively Managing Cancelled Surgical Cases and COVID-19

At CaseCtrl, we are committed to helping our partners get through these challenging times. We are grateful for all the healthcare administrators and workers caring for our communities. As one of my peers, Dr. Dave Levin, noted, “There is no way around this. The only way is through, and the best way through is together.” It goes without saying that unprecedented events like this are disruptive to all. To help protect our employees, the CaseCtrl office has been closed indefinitely, and our employees are now operating from the safety of their homes. In spite of the difficult times, I am happy to report that everyone has been working hard to deliver the best surgical scheduling experience possible for our partners.

As many of you are experiencing first hand, COVID-19 is forcing the cancellation of many elective surgeries. Take advantage of this downtime to come up with a disaster recovery plan for how you will ramp up when the time comes. Here are some tips to consider as we navigate these uncharted waters- 

1. Create a master list of all your cancelled cases to make it easy to prioritize and organize action items for cancelled cases. Don't assume all cases though are cancelled due to COVID-19 closures. Economic considerations may represent a significant proportion of cancellations too and these cancelled cases should be handled differently than ones that were simply cancelled due to closure of the facilities. Make sure your record the reason for cancellation and recognize that the usual reasons of cancellation may still apply too. If you don't have an existing software solution to manage your surgical candidates, and you use posting sheets or a paper calendar, now is a good time to organize the cancelled cases in a list. Consider using a shared online spreadsheet like google sheets, but we would recommend de-identifying personal health information and using a password to protect it to avoid HIPAA violations.  
2. Curate a list of 'standy' surgical candidates. Identify patients who are ready for surgery with no roadblocks to scheduling. Inevitably, with the number of disruptions COVID-19 has created, not everyone will necessarily be immediately ready to reschedule their surgeries. Having a clear understanding of who your standy by surgical candidates are that are flexible and want to get done as soon as possible, will help you prioritize which patients to use to fill in the inevitable gaps in your schedule. You want to ensure your practice is humming on all cylinders when the restrictions are lifted. 
3. Reassure patients that they will not be forgotten and that their surgery will take place eventually. Do not promise when it may happen, but promise to communicate and update as the situation evolves. Make reminders to follow up with patients if restrictions are extended. Patient's will appreciate your concern for their well-being. Don’t ignore the situation and demonstrate heightened empathy with your patients. When the clinic is open again be sure to inform them, and clearly state precautions your practice is taking to ensure a healthy environment. Unfortunately, due to personal circumstances surgical candidates may end up cancelling their surgeries altogether, however, going the extra mile will leave a lasting impression on them. Clear lines of communication are key, and we recommend designating a point person for your surgical candidates to remain in contact with.
4. Recognize the reality that cash flow will be constrained in the near term, and that there will be long lasting economic implications of idle ORs and ASCs. If you own your ASC act now and reach out to your commercial lender to inquire about any COVID-19 related aide. Consider reaching out to your vendors to see if payments can be deferred. Disaster loans are available through the coronavirus stimulus package that are first-come first-serve to help small business retain employees. I have shared some attachments here and here with information on those options if your interested.  
5. If you operate out of a large hospital, plan for high demand for limited resources when restrictions are lifted. Many elective surgeries may play second fiddle to backlog of cancer surgeries for example. Reach out to leadership to get an advanced understanding of how these conflicts will be resolved. Expect policies to be fluid given the unprecedented nature of the crises. 
6. Expect supplies such as personal protective equipment or ventilators may remain in short supply for the foreseeable future and constrain how fast operating rooms can ramp up. Take inventory of your ASC's stockpiles and forecast ahead what you might need. The last thing you want is restrictions lifted and a lack of supplies preventing you from moving forward. 
7. Revisit your patient's expectations and potential outcome from surgery as the delay is extended. Unfortunately, with a lack of access to medical services such as physical therapy, a protracted delay in surgery can have a negative impact on the ultimate outcome of some elective procedures. Be sure to formally address such concerns with patients before surgeries are rescheduled. 
8. Consider who your essential personnel are. Unfortunately downturns like this force us to evaluate the resources available and get more lean in operations. This is a good time to reassess your processes and see where efficiencies can be realized. Perhaps now is the time to consider sharing personnel resources with a partner. Some practices we work with are leveraging our multi-surgeon workspaces on CaseCtrl to facilitate sharing of schedulers. One of the first practices we deployed in saw a 50% increase in scheduler efficiency/productivity and consequently is considering downsizing and sharing more scheduling responsibility with the MAs using the features that facilitate easy collaboration in CaseCtrl.     

Finally, it is easy to get caught up in the doom and gloom of the moment, but as immunity in the community grows, eventually the pandemic will end, and patients will need to have their surgeries rescheduled. In these trying times, I wanted to spotlight one herculean effort in particular by our engineers Saachi Roye & Keming Zhang. They have risen to the challenge and have been working in overdrive to develop, test, and deploy innovative new features our clients are requesting. One of our clients requested a mechanism to keep their surgical candidates in the loop. Working hand in hand with our partner, a new targeted mass messaging feature we call "announcements" was launched. This feature allows real-time communications based on the case, surgeon, & patient-specific criteria, affording unprecedented levels of "CaseCtrl" for updates and reassuring anxious surgical candidates. This is saving furloughed staff hours of time and allowing them to focus on what matters most- patient care. Most importantly they are effortlessly able to keep tabs on the patients pending surgery without the risk of anyone getting lost as a result of the disruption in services. Necessity is indeed the mother of invention!