Becker's Hospital Review

103 FINANCE CMO / CARE DELIVERY "All of these things are exceedingly complex. … It takes a remarkable amount of work to spin surgery back up just from the logistics of long delays like this. Plus, many of them have seen extensions of their pa- thology, which means that the care they require is more complicated than it would have been if we had gotten to them in a timely manner," Dr. Calkins said. Strategies to close the gap At Seattle-based UW Medicine, where 18,000 procedures were post- poned during the pandemic between April 2020 and December 2021, the system is trying to analyze how far into their backlog they've gotten so far. By prioritizing the most time-sensitive cases using expert opin- ion and expanding operating hours, the system is working through the backlog. Salt Lake City-based University of Utah Hospital is working through 500 of its backlogged procedures, according to the Salt Lake Tribune. To speed up the process, the hospital brought in a U.S Navy medical team of 20, including physicians, nurses, respiratory therapists and administrators. e Navy team will stay for 30 days, probably too short a time to clear the entire backlog, but enough to make a dent in the list. Cleveland Clinic could not provide a firm number regarding the health system's backlog. However, "we are already scheduling and doing some of the proce- dures we delayed," spokesperson Alicia Reale Cooney told Becker's. "Wait times depend on the type of surgery and medical condition of the patient," she added. "Our teams are working to ensure we resched- ule patients who had their procedures delayed in a timely way." Rochester, Minn.-based Mayo Clinic is working through its backlog as well. "Over the course of the pandemic, Mayo Clinic has actively managed the volume of scheduled services across ambulatory, procedural and surgical care," spokesperson Kelley Luckstein said. "We have also worked closely with physicians and patients to ensure care occurred in a timely manner and that patients continued to receive the high- est-quality care and outcomes." Financial effects of delayed surgeries en there's the financial effects. Healthcare organizations saw rev- enue from elective surgeries decline, particularly earlier in the pan- demic and during subsequent surges, as they held off on these proce- dures. One study published in May 2021 in Annals of Surgery found that hospitals lost an estimated $20.3 billion in revenue from March to May 2020. Hospitals received federal relief aid to help cover expenses or lost rev- enues tied to the public health crisis. Still, "this has not been a good year for healthcare from a financial aspect or most other aspects," Dr. Calkins said. He said IU Health has had a steady and consistent effort since 2008 to ensure they are insulated against economic shock, and that planning has helped the health system from a financial perspective over the last two years. And IU Health continues planning today, while working through the backlog of delayed surgeries. "We have every intention to plan for another surge of COVID cases in the fall," Dr. Calkins said. "Assuming that when it gets cold, we'll probably see COVID come back at least to some degree. at could significantly affect our recovery plans. If we made it to the fall with our backlog completely cleared, I think we'd be doing well and going into the fall and seeing another surge would just set us back again. We're keeping that contingency planning in mind." "Our priority is the health and welfare of our patients, but the reality is when any hospital encounters a significant reduction in surgical volumes over a 22-month period, there is a financial consequence," said Susan Gregg, a spokesperson for UW Medicine. "We had six COVID-19 surges over the past 22 months." n Why some hospitals ask patients, visitors to ditch N95s By Mackenzie Bean H ospitals across the country of- ten ask patients and visitors to swap out their N95s with sur- gical masks in line with CDC guide- lines, which public health experts say are outdated, according to Politico. Many health systems — such as North- western Medicine in Chicago and Munson Healthcare in Traverse City, Mich. — ask patients to replace or cov- er their masks with a surgical mask supplied by the facility for quality con- trol, according to the report. Most cli- nicians in hospitals also wear surgical masks when interacting with patients, per CDC recommendations. Studies show N95 masks offer better protection against airborne viruses, as they create a tighter seal around the face. Health experts have ex- pressed concern that broad use of surgical masks in hospitals are putting vulnerable people at higher risk of contracting COVID-19. "It's baffling," Ezekiel Emanuel, MD, PhD, a bioethicist at the University of Pennsylvania in Philadelphia, told Politico. "This is something where the CDC has been on the wrong side for a long time." Dr. Emanuel, who has advised Presi- dent Joe Biden's administration on its pandemic response, said his daugh- ter was asked to replace her N95 with a surgical mask at Boston-based Massachusetts General Hospital. The hospital told Politico it follows CDC guidance and updated its policy in late January to allow patients to keep N95s on if they wear surgical masks over them. The CDC and the White House's COVID-19 response team declined Politico's request for comment. How- ever, the entities have previously said surgical masks offer sufficient protec- tion against the virus in many situa- tions within hospitals. n

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