The Ontario government has released a framework to help hospitals get prepared to gradually resume elective surgeries and procedures while still maintaining the capacity to respond to COVID-19.
Details of the framework, which contains criteria that must be met before hospitals can resume scheduled surgeries, were announced by Premier Doug Ford and Christine Elliott, deputy premier and minister of health, on May 7. The criteria includes ensuring that the hospital and its region have a stable number of COVID-19 cases, a stable supply of personal protective equipment and a stable supply of medications. They must also ensure there is an adequate number of beds in inpatient and intensive care units, an adequate number of healthcare workers and the availability of post-acute care outside the hospital, which would be required to support patients after discharge.
“We’re taking a responsible and gradual approach to resuming scheduled surgeries, one that will keep our health care system strong, protect our frontline staff and patients, and ensure our hospitals stay prepared for any potential outbreak or surge of COVID-19,” Ford said in the announcement. “We’re asking each hospital to come up with a plan based on their community’s needs and the trends they’re seeing on the ground. Together, we can get surgeries back on track as soon as possible.”
Timelines will vary from hospital to hospital and be conditional on approval by regional oversight tables involved with coordinating Ontario’s response to COVID-19, according to the announcement. As a first step, hospitals will need to assess if there they have adequate staffing, equipment and other resources to resume scheduled care. The assessment will be performed on a weekly basis to reflect changing needs and requirements, including responding to any possible COVID-19 surges.
The framework also sets out criteria for prioritizing surgeries based on a patient’s condition, the type of procedure a patient requires and whether options for non-operative treatments exist. It takes into account the risks of delaying a patient’s surgery and the resources necessary when it comes to personal protective equipment, medications, intensive care unit beds and other care requirements following operations.
“Delaying scheduled surgeries was one of the toughest decisions we had to make as we responded to the growing threat of COVID-19,” said Minister Elliott in the announcement. “However, it was imperative to ensure our readiness to protect the health and wellbeing of Ontarians as we planned for a worst-case scenario. Due to the collective efforts of everyone to stop the spread of this virus, we are now in a position where we can begin to plan for ramping up surgeries.”
The government is encouraging hospitals to look for ways to improve care delivery for scheduled surgical and procedural care. Methods could include using services that reduce patient time spent in acute care settings, the use of virtual care, care in the community, post-op remote monitoring programs and outpatient care, as well as the use of e-consults services, virtual medical assessments and triaging.
For more information, see the framework released on May 7: A Measured Approach to Planning for Surgeries and Procedures During the COVID-19 Pandemic.