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like this updated process and feel it has improved our customer service in addition to increasing our efficiency.” The staff take their own tempera- ture, as well, when they arrive and must wear PPE at all times, she says. “There was a debate about wearing a surgical mask over the N95, so the N95 could be reused. Most employees and physicians are choosing to double- mask to preserve the N95,” Craig says. Some members of the staff are fear- ful of performing procedures that have to do with the airway, such as anesthe- sia, ENT, EGDs, she says. “There has been a lot of anxiety because they are in the direct line of fire. They wear full facial shields or helmets along with all other PPE during all EGDs, intuba- tions and extubations.”


Rolling with the Changes “This has been a long and chal- lenging road, and it appears that we may be facing continued regulations that change frequently going for- ward,” says Chris D. Skagen, execu- tive director of the Colorado Ambu- latory Surgery Center Association in Denver, Colorado, and the Oregon Ambulatory Surgery Center Associa- tion in Salida, Colorado. “ASCs will have to have resiliency and mobility going forward.” Colorado ASCs received an exec-


utive order (EO) from the governor’s office the day before elective surger- ies were to be resumed that clarified what facilities would need to do to resume elective surgery. “That did not give us much time to prepare,” Skagen says. “Luckily, the criteria in the EO were in line with the existing guidance, and we have been in talks with the governor’s office to keep up with the regulations.”


A lot of the protocols for re-


opening were the same as when the ASCs were closing, Skagen says. “For example, there is an intake desk for temperature screening, asking patients if they traveled, giving them


14 ASC FOCUS AUGUST 2020| ascfocus.org


hand sanitizer, etc.,” he says. “Every- one wants to see testing, but the ques- tion is where are we going to find ade- quate testing. And what can we do in lieu of a test if it is unavailable?” ASCs already do a high level of screening for patients, says Tammy Burnett, president of the Mississippi Ambulatory Surgery Center Associa- tion in Jackson, Mississippi. “Other than screening visitors and wear- ing masks at all times, much of this is already covered in what we do,” she says. “The testing is confusing for many and not especially help- ful. Thankfully, we do not expect to do a lot of testing if we are properly screening and our surgeons are dili- gent in their clinical evaluations.” Going forward, Burnett expects


to be busy “catching up and shaking off any rust that accumulated during the lockdown.” Cindy Bishop, executive director of the Louisiana Ambulatory Surgery


Center Association in Baton Rouge, Louisiana, says that the ASCs in her state resumed operation under cer- tain state guidelines. “They want us to evaluate all patients with a screen- ing instrument or test, if available; have at least five days of PPE in store; have an area hospital with ICU capacity in case we need to trans- fer; perform cases that are time-sen- sitive; ensure that we have adequate staff, including surgical, surgical support, recovery and nursing; fol- low up with patients in 10–14 days regarding COVID-19 symptoms; fol- low Centers for Medicare & Medic- aid Services’ (CMS) guidelines; and continue to postpone any procedure in which a delay would not adversely affect the patient.” For more information on states resuming elective surgeries, visit ASCA’s COVID-19 Resource Center and click on the Resources for States button.


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