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Returning to Elective Orthopedic Surgery During the COVID-19 Pandemic: A Multidisciplinary and Pragmatic Strategy for Initial Patient Selection

Tijdschriftbijdrage - Tijdschriftartikel

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
Tijdschrift: Journal of Patient Safety
ISSN: 1549-8417
Issue: 4
Volume: 16
Pagina's: e292 - e298
Jaar van publicatie:2020
BOF-keylabel:ja
IOF-keylabel:ja
BOF-publication weight:1
CSS-citation score:1
Auteurs:International
Authors from:Higher Education
Toegankelijkheid:Open