Ballad Health evaluates return of elective procedures

David Floyd • Updated Apr 23, 2020 at 8:52 PM

As Tennessee prepares to reopen its economy, Ballad Health is developing plans and awaiting guidance from the state on how to restart elective procedures.

To help free up personal protective equipment for use during the novel coronavirus (COVID-19) outbreak, Gov. Bill Lee signed an executive order on March 23 that prohibited hospitals and outpatient surgery centers in Tennessee from performing elective procedures, which he later extended through April 30.

Ballad Health Chief Operating Officer Eric Deaton serves on the state's economic recovery group, which he said would be making its final recommendations to the governor on Thursday. That would include plans to resume elective and non-urgent procedures.

The health system will finalize its own plans once the governor reviews and approves the guidance for those procedures. Deaton anticipates the system’s plan should be done early next week.

"The start date of non-emergent procedures will be based on the finalization of our internal plan and also with the guidance from the governor's office," Deaton said during a press conference Thursday.

Ballad Health is also evaluating its ability to conduct antibody testing, which has been used to determine whether someone has been previously infected with COVID-19. Deaton noted that more information would be available on that effort in the coming days.

Deaton said the system is in the process of assessing its backlog of elective procedures. He added that Ballad will have a group of surgeons and other leaders looking at how to prioritize them.

Back from furlough

Ballad’s decision earlier this month to furlough about 1,300 staff members was derived from a roughly 70% drop in business during the epidemic, which was driven in large part by the decline in elective procedures.

Deaton said Thursday the system does plan to bring some people back from furlough, particularly those who would be supporting non-emergent and perioperative procedures.

"As we start to ramp that up, we obviously need the staff to help support that, so we will be calling on the team members that were doing a lot of that work before and also the support teams that help those team members," Deaton said.

Deaton said Ballad will do this in a phased manner, and the number of people brought back from furlough will depend on the final case count.

Be prepared

Ballad is using guiding principles from the American College of Surgeons, American Society of Anesthesiologists, the Association of periOperative Registered Nurses and the American Hospital Association to inform its internal plan for restarting elective procedures.

A joint statement from the organizations says that facilities, among other suggestions, should consider the timing for reopening elective surgeries, noting that there should be a sustained reduction in the rate of new COVID-19 cases over a 14-day period and that facilities should have an appropriate number of ICU and non-ICU beds.

The statement also says that facilities should use available testing to protect staff and patients and develop a policy for the requirements and frequency of those tests.

Additionally, the organizations suggest that hospitals develop a social distancing policy for patients, employees and visitors and should establish a prioritization policy committee for elective procedures.

Deaton said he wants the system to be cautious about how it adjusts its current restrictions to visitation, which he said is one measures that has helped protect residents and employees.

“As difficult as it is, we really do believe it has worked and been very effective, so as we bring surgeries back we’ll keep ... my expectation is we’ll keep many of those restrictions in place for some time to come and we’ll just evaluate that as we continue to enhance and grow more cases,” Deaton said.

COVID-19 numbers

As social distancing starts to relax, Deaton said local officials do expect to see an increase in COVID-19 cases.

Ballad Health is currently caring for 13 COVID-19 patients at its facilities and continues to have more than 300 beds available for potential cases.

The Tennessee Department of Health reported Thursday that there have now been 8,266 cases of COVID-19, an increase of 424 over the day before. The state also reported four new deaths, bringing the total to 170.

Statewide, there have now been a total of 793 hospitalizations and 4,193 recoveries, an increase of 181.

None of the new cases were reported in Northeast Tennessee. Locally, the state reports that Washington County has 46 cases, Sullivan has 47, Carter 5, Unicoi 1, Johnson 2 and Greene 37.

First steps

Lee delivered an update Thursday afternoon on efforts to reopen the state economy.

The state will allow restaurants, as long as they are following proper guidelines, to open April 27 at 50% capacity. Retail outlets operating at 50% capacity and following guidelines will be allowed to open April 29.

The state will provide more information during a press briefing Friday morning.

“As we consider federal best practices we want to be very clear that not every industry will be in a position to open safely immediately,” he said.

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