Einstein doctors perform urology surgery.

Elective Surgeries Resume With Enhanced Safety Protocols

By on 08/07/2020

After being postponed during the peak COVID-19 outbreak, elective surgery is happening now at all hospitals and outpatient-procedure units in the Einstein system. Safety protocols are in place to protect both patients and staff.

Surgeries are being done at the following locations, says Radi Zaki, MD, Interim Chair of Surgery for the Einstein Healthcare Network:

  • Einstein Medical Center Philadelphia
  • Einstein Medical Center Montgomery
  • Einstein Medical Center Elkins Park
  • Outpatient surgery centers at Center One in the Northeast section of Philadelphia and on the campus of Einstein Montgomery

Screening colonoscopies are being performed at Einstein’s outpatient location in Blue Bell, as well as at the hospitals and surgery centers. Services started in early to mid-June, depending on the facility.

In early March, Einstein hospitals, like so many others around the country, shut down elective surgeries – procedures for which a delay would not threaten life or damage organ function.

“All the hospital services needed to be dedicated towards the care of patients that have been suffering from this pandemic,” says Jay Simhan, MD, Vice-Chairman of Einstein’s Department of Urology.

Resuming elective procedures became possible because of “a dramatic reduction in the total number of hospitalized patients in the city of Philadelphia,” Dr. Zaki says. As a result, “we could go into the yellow phase in our recovery,” which allowed elective surgery.

Dr. Zaki says all of this took “a tremendous amount of planning and preparation to keep our patients safe, as well as our employees – plus we added in-house testing for COVID, which was a huge component.”

“We implemented processes for every step of the patient experience to protect both patients and staff,” says Richard Fine, MD, Network Chair of Anesthesiology and Medical Director of the Operating Rooms at Einstein Medical Center Philadelphia.

“The goal was to establish separate pathways for COVID and non-COVID patients in the hospitals to ensure that our staff felt safe and in turn could convey that to our patients.”

Processes to Protect Patients and Staff

All processes are  based on the most recent medical literature and guidelines from the U.S. Centers for Disease Control and Prevention (CDC) and the Philadelphia Department of Public Health, Dr. Fine says.

 According to Dr. Fine, here are some of the safety measures in place:

  • People planning to have any procedure must undergo telephone screening, answering questions to indicate whether they might have COVID-19 or have  been exposed to it.
  • After their screening and before they enter the hospital, patients are encouraged to quarantine to maintain social distance from others.  
  • Patients who are scheduled for an overnight stay in the hospital or will receive general anesthesia are required to have  a COVID-19 test ahead of time. Tests are done in-house, with results in 24 hours or less.
  • Patients scheduled for elective surgery who test positive for COVID will have their surgeries postponed.
  • Patients who test positive for COVID and require urgent or emergency surgery will be isolated in the hospital to protect both staff and other patients.
  • Both patients and caregivers are required to wear appropriate masks and other personal protective equipment at all times in the hospital, based upon CDC guidelines.

Although elective surgeries were postponed during the height of the pandemic, those considered more urgent did receive care.

“Emergency care and hospital care never stopped,” Dr. Simhan says. “When patients were sick and came to the emergency room or came to their primary doctor or their specialist, we took care of them.”

Throughout the pandemic, Einstein continued to support the needs of its underserved population, Dr. Fine says.

Urgent Procedures Never Stopped

The surgeries that continued included urgent heart procedures, liver transplants, cancer surgery and any procedures for which postponement could have resulted in further complications for the patient..

“Since the pandemic started in March, we have performed over 50 successful open-heart surgeries, with no patients acquiring COVID-19 – or any other infection – during their hospital stay,” says Raymond Singer, MD, Chief of Cardiac Surgery at Einstein Medical Center Montgomery.

Dr. Singer urged people not to hesitate to seek treatment for heart problems. “Sadly, we have also seen patients who stayed at home despite having heart symptoms, resulting in complications that could have been prevented if they had sought their care in a more timely fashion.”

The focus was on stopping truly elective surgeries, Dr. Simhan says. “Those patients for whom delaying surgery might result in deterioration of an organ function were taken care of.”

Of course, cesarean and nonsurgical births never stopped. Most types of gynecological surgery continued as well, says David Jaspan, DO, Chairman of Obstetrics and Gynecology for Einstein Healthcare Network.

During the last three months, departments maintained lists of patients whose procedures had been canceled or postponed, as well as patients with new concerns, Dr. Simhan says.

Now doctors are reaching out to patients on their lists and letting them know when they can be rescheduled, he says.  “We’ve communicated to all of our patients that we would reschedule only in an environment that’s very safe for them.”

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