Safely Reopen Your Operating Room Using Epic

As hospitals continue to reschedule the backlog of elective surgeries cancelled due to COVID-19, guidelines and best practices continue to evolve. Increasing urgency due to the cumulative effect of delays on patient health and hospital revenues has pushed hospitals to quickly implement new workflows using the best information available.
Whether your organization is in the early stages of reopening or midway through rescheduling your backlog of cases, assessing challenging areas with an eye toward optimizing your system can help ease the process.
In this article, we highlight three key challenge areas hospitals are tackling and identify methods to address them within Epic .
Risk Assessment and Pre-Surgical Screening
Patient and staff safety is a chief concern while reopening operating rooms (ORs). In addition to isolation and safety precautions on the day of surgery, quickly updating pre-surgery workflows to include COVID-19 and antibody testing can be challenging. Updating pre-operative planning tools can help ensure patients are properly tested and provide data to ensure proper adherence.
Here are a few recommendations for risk assessment and pre-surgery screening.

Consider updating pre-surgical screening workflows to include lower-risk options such as e-visits and off-site testing.
Create Procedure Pass tasks for COVID-related protocols such as COVID-19 and antibody tests.
Create a dashboard to track testing tasks for upcoming cases to get a high-level view of the completion rate for upcoming cases. Include metrics on order placed, completed, positive patients, results pending
Update Order Sets and consider creating a to alert the provider to place the correct COVID-19 orders.

Triaging and Scheduling Backlog
Case prioritization and scheduling is perhaps the biggest challenge during the reopening process. Identifying key stakeholders and developing a prioritization process requires a multidisciplinary team and the correct tools for success. To improve efficacy, this should also be an iterative process.
First, ensure all backlogged cases have a COVID-specific cancellation code. You’ll want to assess the reliability of this data to determine whether cases were properly identified at time of cancellation.
Next, identify and assess your strategy for prioritization. Key factors here include case acuity, case , risk, and revenue/margin. Organizations using generalized criteria should consider a rule-based prioritization score such as MeNTS , from the University of Chicago Medicine and Biological Sciences. Use discrete questions in the Case Request and Scheduling forms, such as the effect of a delay on the patient, the availability of alternative treatments, the potential need for ICU bed, the potential for the procedure to be done at an ambulatory surgery center (ASC), and the procedure’s overall priority.