Returning to Elective Orthopedic Surgery During the COVID-19 Pandemic: A Multidisciplinary and Pragmatic Strategy for Initial Patient Selection
| Autor: | Georges Vles, Nicola Sweeney, Wouter Oosterlinck, Stijn Ghijselings, Lieven Moke, Geert Meyfroidt, Minne Casteels, Iris De Ryck |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
orthopedic surgery workflow Leadership and Management Pneumonia Viral risk stratification Betacoronavirus 03 medical and health sciences Patient safety 0302 clinical medicine Multidisciplinary approach Informed consent patient safety medicine Humans statement paper Orthopedic Procedures 030212 general & internal medicine Elective surgery Pandemics Selection (genetic algorithm) Surgical team SARS-CoV-2 business.industry pandemic Patient Selection 030503 health policy & services Public Health Environmental and Occupational Health COVID-19 Original Articles medicine.disease elective surgery Workflow Elective Surgical Procedures Orthopedic surgery Interdisciplinary Communication Medical emergency Coronavirus Infections 0305 other medical science business multidisciplinary |
| Zdroj: | Journal of Patient Safety |
| ISSN: | 1549-8425 1549-8417 |
| DOI: | 10.1097/pts.0000000000000755 |
| Popis: | Objective: The aim of the study was to design an objective, transparent, pragmatic, and flexible workflow to assist with patient selection during the initial phase of return to elective orthopedic surgery during the COVID-19 pandemic with the main purpose of enhancing patient safety. Methods: A multidisciplinary working group was formed consisting of representatives for orthopedics, epidemiology, ethics, infectious diseases, cardiovascular diseases, and intensive care medicine. Preparation for up- coming meetings consisted of reading up on literature and testing of pro- posed methodologies on our own waiting lists. Results: A workflow based on 3 domains, that is, required resources, pa- tient fitness, and time sensitivity of the procedure, was considered most useful. All domains function as standalones, in a specific order, and no sum score is used. The domain of required resources demands input from the surgical team, results in a categorical (yes or no) outcome, and gener- ates a list of potential patients who can be scheduled for surgery under these particular circumstances. The (weighted) items for the domain of pa- tient fitness are the same for every patient, are scored on a numerical scale, but are likely to change during the pandemic as more data become available. Time sensitivity of the procedure is again scored on a numerical scale and becomes increasingly important when returning to elective surgery proves to be acceptably safe. After patient selection, an augmented informed con- sent, screening, and testing according to local guidelines will take place. Conclusions: A workflow is proposed for patient selection aiming for the safest possible return to elective orthopedic surgery during the COVID-19 pandemic. Key Words: elective surgery, risk stratification, patient safety, multidisciplinary, statement paper, orthopedic surgery, COVID-19, pandemic, workflow ispartof: Journal Of Patient Safety vol:16 issue:4 pages:e292-e298 ispartof: location:United States status: Published online |
| Databáze: | OpenAIRE |
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