Becker's Hospital Review

64 CMO / CARE DELIVERY PPE requirements. We would not want to stop doing surgeries aer we started because we do not have enough PPE. Tony Slonim, President and CEO, Renown Health (Reno, Nev.) For Renown Health, this is all about risk assessment. We need to bal- ance the ongoing health risks from further delaying important but elec- tive surgeries with the ongoing limitations in PPE, COVID-19-related exposure to those who may be carriers and a lack of population-based testing that prevents us from knowing who may have the virus but be asymptomatic. Matt Walker, PharmD, CEO, William Bee Ririe Hospital (Ely, Nev.) Most challenging is the potential risk to patients given that you are bringing them out of their homes to a healthcare facility. Where does one begin in rescheduling elective procedures that were canceled in March? How are you collaborating with local/state health officials? Kathy Bailey, President and CEO, Carolinas HealthCare System Blue Ridge (Morganton, N.C.) As we did with canceling procedures, we will rely on our providers to help determine which cases need to be scheduled first. ey will look at patients who have urgent issues, and based on condition and COVID test results, determine when to do their procedures. We've had a seat at the county unified incident command table since the pandemic was first identified and will be a part of the unified col- laboration and discussion in determining when and how to begin to open businesses again. We are also part of the chamber of commerce discussions with businesses in our community on when and how to begin opening again. Peter Banko, President and CEO, Centura Health (Centennial, Colo.) We started with a 22-member multidisciplinary physician- and clini- cian-driven team across our 17 ministries for Centura, like we have for testing, PPE and other aspects of managing this efficiently effective vi- rus. is "return to normal" group has provided standard recommenda- tions and considerations in four key areas — resources, patient selection, critical nature of the patient and capacity. ey also directed the forma- tion of individual hospital committees to make the final determination of the prioritization of patients based on their unique needs, impact of COVID-19, geography, acuity and availability of support. Ralph Castillo, CEO, Morgan Medical Center (Madison, Ga.) As with most things, this begins with the surgeon and the patient. ose two entities have to agree that these items are necessary going forward, and they both are comfortable with the hospital. e key first step is the surgeon, followed by the patient, and then the regulatory restriction satisfactions. Rick Davis, President and CEO, Central Peninsula Hospital (Soldotna, Alaska) Protecting our employees is our No. 1 objective as we bring elective cases back into the OR. To help achieve that goal, we've converted four of our pre-op bays into negative pressure intubation/extubation rooms so we can keep everyone safe during the most dangerous parts of the surgical case. We also formed a cross-specialty surgeon com- mittee to help triage the schedule to make sure that the more urgent cases don't get delayed and pushed out because the ORs are backed up with less urgent cases. We are working alongside the local borough within their incident command structure to help guide them as they look toward develop- ing alternative care locations. We provide some guidance to the state through our state association. Michael Dorsey, CEO, Johnson Regional Medical Center (Clarks- ville, Ark.) Our hospital used the surgery section meeting, made up of surgeons, anesthetists and nursing, to cease performing elective surgeries and monitor emergency surgeries during the active COVID-19 phase. is group has decided what cases to begin aer certain criteria at the hospital and county level have been met. We are in constant contact with local, regional and state representa- tives regarding the opportunity to safely begin elective surgery. Steve Edwards, President and CEO, CoxHealth (Springfield, Mo.) We have appointed a group of highly regarded informal and formal phy- sician leaders to establish the criteria to guide the prioritization of cases. ey are evaluating cases in a new category that we call "time-sensitive medically necessary." ese are cases that might have been elective one month ago, but have or will likely grow more acute. Due to the degree of subjectivity, the final decisions are made by this physician panel. We have a three-stage revamping, which may be stepped back or advanced based upon readiness metrics and risks of outbreaks. Each stage is based upon completing two cycles with a flat number of new cases per day. Each stage is liberalizing qualifying criteria. Will Ferniany, PhD, CEO, UAB Medicine (Birmingham, Ala.) e first step is sufficient testing of surgery patients and OR staff. Kiley Floyd, CEO, Nemaha Valley Community Hospital (Seneca, Kan.) We will begin with our most urgent needs and add from there. We have weekly calls within our county with our peer hospital, as well as county health. Statewide calls are under two different entities — our hospital association and the department of health. Ken Johnson, President and CEO, Hutchinson (Kan.) Regional Medical Center As you know, Kansas has not been nearly as hard hit as many other states with a more dense population, especially in larger urban settings. We are working closely with local and state health officials. We are cur- rently following the CMS guideline for elective procedures and asking our medical staff to consider the procedure and its necessity during this time. e hospital leadership team sponsored a community medical collaborative before much was being discussed in Kansas. is weekly call is attended by about 40-50 or so physicians, APPs, nursing, ancillary technicians and administrative colleagues representing many organiza- tions within the community. We have found this to be very effective in discussing strategies and tactics as we continue to address the changing patient needs in our community. We have a favorable relationship with our state health department and are well represented by state and na- tional legislative colleagues. Michael Layfield, Interim CEO, Carlinville (Ill.) Area Hospital e key first steps: Access physician availability, schedule the patient via online preregistration (helpful to reflect the absence of the human touch) and ask the COVID-19 screening questions. Once the patient arrives at hospital, we will need to rescreen the patient in person, then have them wait in their parked car in the parking lot. We'll place a call to the patient's cellphone while they wait in their car (no waiting in the lobby) to go straight to the surgery department. We'll also coordinate with family to pick up patient and return back home. Robb Linafelter, CEO, Lincoln (Neb.) Surgical Hospital

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