Joining Forces Against the Pandemic
Healthcare workers nationwide are facing shortages of personal protective equipment (PPE) and other medical equipment needed to treat patients during the COVID-19 pandemic. To increase supplies, ASCs across the country have come together to help. If you have a similar story to share, please write Sahely Mukerji.
Santa Cruz Surgery Center
Updated: April 29, 2020
The ASC performed urgent surgeries and gave out care packages to its urgent-surgery patients, says Lisa Cooper, chief executive officer of Santa Cruz Surgery Center in Santa Cruz, California. "We also did COVID-19 antibody testing one day for the healthcare providers and, currently, are getting ready to set up drive-through nasal swab COVID-19 testing in our parking lot as we prepare to start elective surgeries," she says.
The surgery center participated with the incident command center for the local hospital, a joint venture partner, on daily calls, and Cooper underwent training, so she could volunteer to staff the center on weekends and give the hospital staff a break.
To help the hospital further, the ASC sent over boxes of gloves as the hospital's supply got low. "We moved all of our PPE into our medical records room to keep it secure and to easily inventory," Cooper says. "We created a checkout list to keep track of usage." Cooper's sister and friend, who has contacts in China, donated hundreds of N95 and procedure masks to the ASC, she adds.
The surgery center staff got 40 hours of PTO, assistance with unemployment claims and access to paid education time, she says. "We have been doing weekly Zoom calls to keep connected. Yesterday, we surprised the staff with one employee who was pregnant. I dropped off a reveal cake so she could cut the cake and share the news with all the staff. She already knew the baby's sex but the staff did not."
The ASC has received the stimulus funds and Medicare advance. "Our Paycheck Protection Program loan (PPPL) has been approved and we are in the process of finalizing the documents," Cooper says. "We have not heard back on our disaster loan with advance $10,000 payment. We applied for all of these on day one when they opened."
The cash projection of performing six to 10 urgent cases per week indicates the ASC would be able to remain open until the end of July, Cooper says. "We will have challenges as we open in phases, as locally, the labor needs will be great with little revenue. The PPPL will assist," Cooper says.
Mississippi Valley Endoscopy Center
Updated: April 20, 2020
“We closed our endo facility for a couple of weeks and then re-opened last week—just two days a week—to help take the burden off the hospital endo department,” says Michael J. Patterson, RN, ASCA Board member and president and chief executive officer of Mississippi Valley Endoscopy Center in Davenport, Iowa. “Our multispecialty ASC has been open the entire time but only performing surgery on Tuesday and Thursdays. We are performing ‘necessary surgeries’ only. Same thing with our endo facility.” Some of the team members have taken temporary assignments to assist with COVID-19 testing, others have decided to stay home because they have small children to care for or older family members that need assistance, he says. “We have supported each staff member in their decisions based on their individual circumstances.”
Valley View Hospital, the joint venture partner of Mississippi Valley Endoscopy Center, canceled elective surgeries at the hospital for the foreseeable future in the middle of March. When it did, the employees, headed by nurses Brady Heuer and Kristen Dirksen, started sewing masks out of the blue wrap cloth used to protect sterilized surgical tools from contaminants before surgery, according to a March 19 article in Post Independent.
Constitution Surgery Center East
Updated: April 15, 2020
The ASC in Waterford, Connecticut, made a donation of surgical masks with eye shields to the local fire and ambulance department. “Several of our talented employees are also sewing and donating cloth masks for the local community,” says Robert Taylor, clinical director and total joint coordinator.
The two area health networks, Yale New Haven Health System and Hartford Healthcare, recommended that the ASC remains open to decompress the local hospitals of emergent and urgent cases, Taylor says. “We telephone screen every patient within 24 hours of arrival, check their temperature prior to entering the building and have prohibited visitors within the ASC.” The center anticipates continuing these practices once the emergency declaration is lifted and are investigating serology and or point-of-care testing kits becoming available via the US Food and Drug Administration’s Emergency Use Authorization. “We maintain a good supply of PPE, have reviewed all infection control practices, and are following all FDA recommendations,” he says.
Kona Ambulatory Surgery Center
Updated: April 10, 2020
The Kona Ambulatory Surgery Center and Kona Community Hospital are partnering to collect donated surgical masks and N-95 masks—items desperately needed by all health facilities amid the COVID-19 pandemic.
The ASC in Kailua-Kona, Hawaii, and Kona Community Hospital partnered to collect donated surgical masks and N-95 masks.
“We have volunteered to be the donation site to collect items donated by our community,” says Nadine Calloway Reese, clinical manager and assistant director of the ASC. “My surgical team inspects the donated items and inventories them for use by our hospital. This has been rewarding for us to be able to support the hospital and our community.”
The center has temporarily suspended cases following its governor’s stay-at-home order and was working on creating a protocol for reopening. “Prior to closure, we had increased our screening process with preop and all employees. Now with the community spread of the virus, we are trying to decide if we will require lab testing prior to surgery for all patients. We are also prepared to assist the hospital as needed if there is to be an influx of patients.”
Oregon Surgical Institute
Updated: April 9, 2020
An employee of Oregon Surgical Institute in Beaverton, Oregon, read an article about repurposing sterile processing wraps, and soon after, the entire surgery center came together to make masks. “We gathered our team, doctors, physician assistants and reps, and started to sew,” says Erin McKay, administrator. “Most of us have never used a sewing machine, but together we made 175 masks to share with our families, friends and local MD offices.” The team made masks in three sizes, she says, adult, child and toddler. “Additionally, we gave 1,800 surgical masks to our two local hospitals, Legacy and Providence.
“We know we are not on the front line but we are keenly aware that we have the ability and the resources to hopefully make a difference,” McKay says.
The ASC has a group of trauma doctors and has been seeing patients in need of emergent/urgent surgeries, McKay says. “This has been good for staff and for our community, as we are still serving in a capacity that affords patients the ability to have a necessary surgery in a safe environment.”
The center also has tightened up its screening process and is following guidelines similar to hospitals, e.g., extensive screening, no visitors in the lobby, temperature screening for everyone walking through the door, including staff, and rescheduling patients if anything falls out of compliance with the guidelines, McKay says. “We are prepared if we need to act as a resource center for the hospitals as well as prepared to get back to business as usual, whenever that may be,” she says.
Mankato Surgery Center
Updated: March 27, 2020
Joleen Harrison, RN, CASC, administrative director of Mankato Surgery Center in Mankato, Minnesota, has started making masks for a Covid-19-HELP group on Facebook and is looking for people who sew. She is using sterilization wrap, or “blue wrap,” to make the masks. “This is a barrier material that we are not thinking about and has a rating for being a barrier for sterile supplies after it is sterilized,” she says. “Medline is where we are getting the supply of Gemini sterilization wrap. This is not N95 rated but similar, as a surgical mask.” Harrison says the material is easy to sew and has devised a pattern to mirror the surgical masks with ties that are in use currently. It has a twist tie or pipe cleaner for the nose bridge. The mask can also go over the N95 masks or be doubled up.
“We have reached about 40-plus sewing people in the community, and other very helpful people in the industrial cutting business have offered to help cut the mask portion for us,” Harrison says. “This makes life easier for sewing in a more productive fashion.”
So far, Harrison and her group have pre-cut enough material to make 300 masks.
Updated: March 24, 2020
On March 23, a surgery center in Fairfield County, Connecticut, transferred three ventilators to a hospital in the same county, along with personal protective equipment (PPE), including N95 masks to help protect front line providers in the hospital. The ASC has cancelled all its cases and has closed for at least two weeks. Another center in the region put together boxes of PPE for their nurses to bring back to the hospital during their shifts to share with their colleagues. A third center coordinated the pickup of PPE with another hospital in Fairfield County, including gloves, gowns, masks and shields.