(Article repurposed with permission from The News & Sentinel)
PARKERSBURG –WVU Medicine Camden Clark Medical Center will be restarting elective surgeries this coming week with new procedures in place as the hospital deals with the pandemic.
Since many elective operations were suspended in March as the COVID-19 coronavirus pandemic grew and impacted West Virginia, Camden Clark has only been doing urgent procedures.
“We will be moving into more of the true elective outpatient procedures,” said Candace White, director of OR Services at Camden Clark. “On Monday, we will be integrating patients coming in as outpatients for surgery.”
Other procedures include hip and knee replacements, joint replacements and more.
The hospital will engage in a phased approach with a gradual increase in volume as it is deemed safe. The hospital has a committee which meets weekly to evaluate the incidents of COVID-19 in the area.
The hospital will slowly increase the number of elective surgeries as long as the number of COVID-19 cases continues to decrease.
“If there is an increase in COVID-19, we will have to reevaluate our plan,” White said.
The medical center has made great efforts to make sure it is safe for patients to return to the hospital for emergent and routine care, said Dr. David Gnegy, Cardiologist and CCMC Medical Officer.
“We have determined that it is OK to come back and have your knee replacement,” he said.
In the coming weeks, people will be able to schedule things like colonoscopies and other same-day procedures, screenings and more.
“It is very safe now to resume routine care of our patients,” Gnegy said. “If you have been planning to have your knee replacement surgery done since February and you haven’t been able to get it done you can get in line starting on Monday.”
As patients return they will see more hospital personnel in Personal Protective Equipment, the patients themselves will be masked while in the facility and there will be a limit on the number of visitors as family will be asked to wait in their cars or elsewhere until the patient is ready to be picked up.
“The safety of our patients and our staff are of the utmost importance and that is what will guide us through the next several months,” Gnegy said.
The hospital has instituted a number of measures to practice social distancing between people, doing more extensive cleaning practices and other new procedures.
” There is going to be a new normal,” Gnegy said. “I anticipate that we will be doing masking and social distancing and avoiding large groups for the unforeseen future.
“This virus isn’t going away. We are going to have to manage it and manage the healthcare of our patients and community.”
The goal will be to develop a new normal that lets the hospital staff take care of the patients in an efficient and safe manner.
“This will be an evolving process,” Gnegy said.
Since the pandemic began, the medical center has continued to do open-heart procedures, cardiovascular surgeries and heart catheterizations.
“The Cath Lab and open-heart program have continued to take care of the patients through all of this,” Gnegy said. “The open heart program did not miss a beat through all of this.
“We continued to operate on our patients as we have needed to.”
As part of the new way of doing things, hospital personnel will be wearing more personal protection equipment based on their potential for exposure, social distancing measures will be in place in both the medical center and in individual doctor’s offices that will be seeing patients and thorough cleaning and sanitizing measures will be taken.
As a result, last week patients began getting scheduled for routine appointments and clinic appointments.
When the patients come in for a surgical procedure there will be a series of questions they will be asked, via phone, the day prior to their surgery, White said.
“They are asked to keep a temperature log and bring it with them the day of surgery, along with basic questions regarding COVID 19 — temperature, cough, travel and other things,” she said. “Vitals, temperature and more are checked.
“It validates and shows they are ready to be here for an elective procedure.”
Patients are brought and dropped off at the South Tower entrance and escorted to the Same Day Care Room and immediately taken to an individual room before surgery.
Currently no one is waiting in the waiting room. Families can wait in their car or go elsewhere while the procedure is being performed.
Once the surgeon is done, they will call the family member afterwards.
“The exception is for pediatric patients where one parent can accompany the patient and they stay in that patient waiting room in the Same Day Care Room,” White said. “They receive a call after the procedure is completed.”
With outpatient surgery, the patient will still go home the same day. The discharge instructions will be reinforced over the phone with a family member as well as given to the patient in writing, White said.
Many of the same measures are in place for people coming in for doctor appointments.
Camden Clark Chief Operating Officer Sean Smith before patients come in for scheduled appointments, they will be called by someone from Camden Clark and provided directions on things like masking requirements, limited visitor policy, registration practices and more.
“In some cases, based on the floor plan of the practice, we may ask patients to call ahead and register them in the parking lots if needed,” Smith said.
The changes in procedure adhere to Centers of Disease Control guidelines that protect both the patients and the hospital’s staff.
Primary Care Physician Dr. Gabriella Olson said some of the differences people will see in coming in for appointments is they have increased distance in all of the waiting rooms and the staff will be wearing PPE, appropriate for their level of possible exposure, just like the employees in the hospital do.
“We ask that all patients also wear masks,” Olson said.
Telemedicine and video visits were utilized a lot over the last eight weeks to help doctors and patients stay in contact over any concerns they may have. Olson said those will continue as some people may not be comfortable yet coming into a doctor’s office for an appointment.
“This whole event taught us what we are capable of doing,” Olson said of utilizing technology.
For those who do come in for an appointment they are asking that only patient come into the office and family members wait in their vehicle.
The exception to that are kids who can be accompanied by a parent and adults who need the help of a caretaker.
“That is to reduce the congestion in our waiting rooms and reduce the exposure to other patients and staff,” Olson said.
The Emergency Department has also evolved through this whole process, said Camden Clark Emergency Department Director Dr. Brian Richardson..
“Obviously we have continued to have care in the emergency department through all of this as knowledge has increased through this disease process,” he said. “We have changed the flow in the emergency department at this point, more so than we ever have up to this point.
“I would say our emergency department is more sectionalized.”
The emergency department was originally built with the idea of having to handle hazardous situations.
“We are lucky that a section of our emergency department has a completely separate entrance than the main department,” Richardson said.
“We are lucky to have an emergency department with separate rooms with solid doors on it for every patient care area.”
They have increased the negative flow capacity for some of the examination rooms to prevent potentially harmful particles from spreading out.
“We have negative flow capacity which has been increased by our engineering department,” Richardson said. “We have a flow pattern that is slightly different than it was pre-COVID 19.”
As people come into the emergency department from this point on, they will likely be masked.” If someone has a respiratory issue, they will be separated from the rest of the clientele.
“You will likely be placed in one of the negative airflow rooms if you have any symptoms that sound concerning to our frontline staff and you may be greeted by people with different levels of protective equipment,” Richardson said.
“That is just part of us protecting our patients and our staff in a manner that is better than we have ever done in the past.”
The emergency room is also following the same waiting room procedures and having families waiting in their vehicles and utilizing the nurses to do the direct follow-up contact with those families and keep them updated throughout that process.
There are exceptions, too, dealing with children where a parent can accompany them and in end of life situations, Richardson said.
The hospital is continually monitoring the COVID-19 situation.
“The benefit of being part of a large health care system is we have experts who are watching the data daily who are giving us directions daily so we can have a concerted effort throughout the whole system to do the right thing for our patients and our staff,” Olson said.
Smith said it is something they are continually monitoring, especially as more people will be coming back to the hospital.
“We are also prepared for another surge at some point,” he said. “It is something that we monitor regularly.”
Smith said they will also be looking at their travel policies for employees and monitoring where people are vacationing and making sure that employees haven’t been exposed when they come back.
“We have to be very mindful of those things,” he said.
If they see an increase, the hospital may have to pull back on its elective procedures, officials said.
There is a concerted effort to clean and sanitize the whole hospital and the areas where patients are.
“We have spent a lot of time with making sure we have disinfected, cleaned and sanitized the hospital,” Gnegy said. “We are spending more time cleaning ‘high touch surfaces’ like doorknobs, elevator buttons, bathrooms and more.
“After a patient is in a room, that room is thoroughly cleaned and sanitized.”
They are utilizing UV light robots that are used to sanitize the rooms. The UV light kills the COVID-19 virus along with a lot of other viruses, Gnegy said.
“We are increasing our use of those,” he said. “We will have five of those robots to sanitize our operating rooms to make sure the environment is safe for our patients.”
The goal would eventually be to let patients have more family members visit.
“That will be decided on through the prevalence of the disease through the community,” Gnegy said.
The medical center has had tremendous support from the community with different people, businesses and groups stepping up and providing protective masks, face shields and other protective equipment.
Also, being in an area with a number of chemical plants, the hospital already had a lot of equipment in place to help with respiratory and chemical issues. Being part of a large healthcare system they were able to start securing PPE early on.
“Part of us opening for elective procedures and opening our offices back up is the fact that we are adequately protected and we have enough PPE at this time,” Gnegy said.
Many at the hospital are eager to get back into the routine of treating patients.
“The staff is eager to get back to doing as much as they were before,” Richardson said. “They want to do it in a safe environment and a conscientious environment.
“They want to stay busy doing something they think is a compassionate productive thing.”
The volumes have been down and employees are eager to ramping those volumes back up and providing the same high level care they have before, Richardson said.
Because of the COVID-19 pandemic many people have been avoiding the hospital and the emergency room out of fear.
Heart attacks and strokes are still happening, Gnegy said adding they are only seeing about half of what they are use to, because people are avoiding the hospital.
“People are going to be harmed by not taking care of their health,” he said. “It is time to take care of yourself.
“We are here to take care of our community. At this point, it is safe to come back to the hospital.”