STHS Procedure Scheduling Update

As Louisiana Department of Health and the Governor's Office of Homeland Security and Preparedness work to manage the COVID-19 coronavirus outbreak in our state, St. Tammany Health System will work closely with state and local authorities to ensure the health and safety of our patients, families and community.

We are instituting a tiered system to determine which procedures may proceed as the Stay-At-Home order is adjusted and time-sensitive medical procedures that may have been delayed in the early days of the pandemic response now require attention.

Urgent and emergency cases will continue to be addressed emergently. Tier One cases will be those already delayed that now need attention within the next two weeks; Tier Two will need attention within 30 days and Tier Three within 60 days.

Time Sensitive Criteria for Surgical Procedures

• STHS will follow all conditions and requirements set forth in LDH Notice #2020-COVID19-ALL-010 Section I.A.(3)(a) i-vi and the April 24, 2020 update.
• STHS Surgery Department to schedule cases at Main OR, Covington Surgery Center, Endo, Cath Lab and Interventional Radiology as follows:
  • All Tier 1, Tier 2 and Tier 3 cases can be scheduled effective now.
  • Pre-Procedure COVID-19 PCR test result required within 72-hours of procedure and test to be ordered by proceduralist.  A positive test result requires re-evaluation of timing of procedure.
    • Exception: Pre-Procedure testing in Endo and Interventional Radiology only required for procedures with high-risk of COVID-19 transmission including surgery/endoscopy of the upper GI tract; nasopharynx; oropharynx; trachea and; lung.
    • Providers required to document presence of a time sensitive medical condition in patient chart.
    • Checklists for COVID-19 specific issues are incorporated in all phases of care.
    • STHS Main OR, CSC and inpatient capacity to be monitored by STHS Surgery Department.
    • STHS current visitation policy and infection control screenings will be maintained.
    • STHS will contact patients within 10 to 14 days after invasive procedures to determine whether the patient has symptoms signs/symptoms of COVID-19 or has tested positive for COVID-19 since the procedure.
    • Development and oversight of this guideline is by ad hoc Surgical Prioritization Committee that includes representatives from STHS Medical Staff, Administration, Infection Control and Surgery Department.

References:

1. LDH Healthcare Facility Notice/Order Notice #2020-COVID19-ALL-010: http://ldh.la.gov/assets/oph/Coronavirus/resources/providers/LDH-MEMO-UPDATE-RESTORE-MED-SURG-Procedures.pdf
2. LDH Available Medical, Surgical and Dental Procedures: Update 04/24/2020:  http://ldh.la.gov/assets/medicaid/hss/docs/Coronavirus_2019/Clarification_MedSurgDentalProcedures_04242020.pdf