Dr. Michael Gordon: 4 new hurdles contributing to orthopedic hospital delays

Practice Management

Over the past four weeks, Hoag Orthopedic Institute in Orange County, Calif., has steadily ramped up to nearly normal inpatient volumes, according to Michael Gordon, MD, a spine surgeon who shared his thoughts with Becker's Spine Review.

"This required a stepwise return of furloughed staff to the OR, including physicians, nurses and techs who had been idled," Dr. Gordon said.

For the returning staff, the ramp-up period has come with many new hurdles and protocols as a result of the COVID-19 pandemic. Dr. Gordon outlined four such hurdles and how they are contributing to delays in hospital care:

1. The need for social distancing, which decreases the ability to flow patients through the hospital.

2. Mask wear, mandatory for both patients and staff, has seemed to slow communication as patients are inexperienced in mask use.

3. Limiting family members to only one person and restricting their time in the hospital has hindered patient mobilization.

4. The need to prepare the home for postoperative care as opposed to a skilled nursing facility.

Additionally, Hoag has dramatically altered its processes to deal with the pent-up demands of patients waiting for reconstructive procedures, according to Dr. Gordon.

"This has included everything from simple outpatient extremity cases to complex revision total joint and spine surgery," Dr. Gordon said, "Not surprisingly, 'elective' spine surgery patients who have been in pain for several months are clamoring to be treated."

Heightened safety protocols have been implemented to protect the virus from spreading to patients and staff, including patients being screened three to five days prior to surgery and placed in quarantine after the result has been received. Positive COVID-19 tests require a two-week quarantine as well as retesting.

"Despite all of these hurdles, the staff and physicians at our hospital have demonstrated resilience, adaptability and great professionalism," Dr. Gordon said. "As the pandemic wanes, hopefully over the next six months, without too-significant a 'second peak,' we hope to return to a form of normalcy in a stepwise fashion."

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