Local healthcare facilities are preparing to restart elective procedures, but they’ll have at least more than two weeks before state restrictions are lifted.
Gov. Jay Inslee announced Wednesday that his March 19 order restricting non-urgent procedures will continue through May 18. However, he also updated guidance on what procedures are allowed after calls for clarification from hospitals, doctors and healthcare organizations.
The restrictions have been a financial blow and limited patients at hospitals, clinics and ambulatory surgical facilities, but healthcare facilities and organizations agree that ramping up procedures has to be done safely.
“The requirements set forth are reasonable for when a hospital or clinic has the supplies and capacity to perform procedures,” Cassie Sauer, CEO of the Washington State Hospital Association, said in a statement.
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The association said Inslee’s Wednesday clarification was “much-needed” to ensure patients are getting access to care, said Tim Pfarr, association spokesman. Providers have been conservative in interpreting the order because of the potential criminal penalties, leaving many patients without needed care, he said.
The governor’s March 19 order limits healthcare services, procedures, and surgeries that, if delayed, are not anticipated to cause harm to the patient within the next three months. The order doesn’t define harm, and the governor clarified Wednesday the determination is up to individual clinicians.
Healthcare providers should consider if a patient’s illness or injury is causing significant pain, significant dysfunction in their daily life, or is progressing, Inslee’s Wednesday clarifying statement said. But clinicians should also assess the risk of harm as a result of performing the surgery or procedure during the pandemic.
Some patients are putting off urgent care when they need it, Pfarr said, and hospitals are seeing a “concerning trend” that non-COVID patients have become severely ill due to delays.
“Hospitals continue to be a safe place to receive medical care, and we want to remind Washingtonians to seek medical care for new or chronic conditions before they become an emergency,” Sauer said in a statement.
PeaceHealth St. John Medical Center officials reported a 30% drop in emergency department visits, and it urged patients to come in if they need care. The hospital has protections in place to make sure those coming in for care aren’t exposed to COVID-19, said Randy Querin, hospital spokesman.
According to the Washington State Nurses Association (WSNA), healthcare facilities must resolve the problem of inadequate personal protection equipment before restarting non-urgent procedures.
“Reopening elective procedure areas and surgical centers must happen responsibly,” said a WSNA press release. “We must have adequate protective equipment and accessible testing for nurses and health care workers on the front lines of the COVID-19 crisis first.”
St. John officials said last week the hospital has adequate stores of personal protective equipment and haven’t experienced shortages.
Inslee’s statement Wednesday said before providing any kind of care allowed under his order, health facilities must provide healthcare workers with appropriate and sufficient personal protective equipment; follow state protective gear guidelines; allow healthcare workers access to COVID-19 testing and timely notification of exposure; and report COVID-19 positive healthcare workers to the state.
Pfarr said the hospital association’s position is that Washington facilities are ready to start doing more procedures.
“As we prepare for a potential COVID-19 surge this fall, we hope to begin offering additional medical services soon, such as cancer screenings. Patients rely on this care for their well being, and we want to be there for our communities.”
The restrictions have also been a financial blow to Washington hospitals, Pfarr said. Statewide, hospitals are only about 50-70% full right now, which is unusually low, he said.
PeaceHealth St. John has seen a decline in patients but has not laid off employees because of the COVID-19 response, Querin said.
St. John officials said last week they are discussing how to reopen procedures safely. More details were unavailable Thursday evening. The hospital is “being thoughtful with its communication” and wants to be fully coordinated with other PeaceHealth facilities and government agencies, Querin said.
Kaiser Permanente also has not laid off staff in Longview or elsewhere, said Michael Foley, director of integrated communications. The group temporarily closed some medical offices in March to preserve personal protective equipment and staff, he said.
Physicians have been following up with patients whose procedures were delayed to keep up on their conditions, Foley said. Kaiser is “re-assessing and re-triaging patients to prioritize among those whose procedures have been delayed,” he said.
“We know that every procedure that has been considered non-urgent or elective during this pandemic is of great importance to the patient waiting for it,” Foley said in an email. “We look forward to resuming these services as soon as feasible while assuring the safety of all of our patients and staff.”
