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Ballad Health will resume elective procedures May 4

David Floyd • Apr 29, 2020 at 6:33 PM

With the system now seeing a backlog of about 5,000 procedures, Ballad Health will resume elective procedures on Monday, a decision recommended by a subcommittee of physicians and organizational leaders.

Dr. Beth Jackson, a general surgeon and the co-leader of the Ballad Health committee, said the system will be adhering to Gov. Bill Lee's new recommendations for hospitals. The system will slowly resume surgical cases at the 11 facilities that perform them, adopting a phased approach to the process.

"This will be a stepwise progression limited to certain cases in the first few weeks so we can ensure these patients can be done and gone home on the same day," Jackson said. "And then we will expand these as we progress."

Jackson said testing for the novel coronavirus (COVID-19) will be a part of this process, and that patients contacted to schedule a date for their elective procedure should also expect to receive a time for them to be tested.

If patients do receive positive COVID-19 tests, their procedures will be delayed.

“We have established particular criteria to help us triage through these cases to make sure we’re doing the right cases at the right time to best serve our communities,” Jackson said.

Ballad Health CEO Alan Levine said resuming elective procedures has been more complicated than the process of halting them.

"We probably could have done this sooner except we really wanted to be sure that what we did was aligned with what the state's objectives were," Levine said.

Gov. Bill Lee announced earlier this week that he would allow the resumption of elective procedures on Friday, which is the day after an executive order prohibiting them will expire. Part of the motivation behind the initial executive order was to free up personal protective equipment for use in treating COVID-19.

Levine said the system’s 5,000 procedure backlog “sounds big but is manageable” and ranges from low-acuity interventional procedures to major procedures that require an inpatient setting.

He said the first procedures performed will be lower-acuity, outpatient cases, which will allow the system to ramp up and gradually dedicate more focus and staffing on procedures that require more time in a hospital in the coming weeks.

Levine said not many of Ballad’s employees have been brought back from furlough and he didn’t know how many employees would be brought back as elective procedures increase.

“It’s going to be a moving target because as the cases ramp up, we’ll be bringing more and more of the direct clinical staff back,” Levine said. “But that’s where we’re starting — those clinical staff that are needed.”

Spurred by the drop in elective procedures, Ballad Health announced earlier this month that it would furlough 1,300 employees, which Levine said would allow them to receive enhanced unemployment benefits offered by the federal government.

Levine reiterated Wednesday that Ballad Health will provide guaranteed work hours for each pay period for certain direct patient care roles, including bedside nursing, respiratory therapy, and nursing assistants and licensed practical nurses who support bedside nursing, until further notice.

The number of employees brought back will rely in part on the number of people that opt to go in for elective procedures, which will allow the system to match staffing levels with actual volumes.

Noting that the system's hospitals are safe and that Ballad has been taking precautions against the virus, Levine added that individuals with emergency conditions should not hesitate to go to an emergency department or visit an urgent care center.

"There is an increasing concern, bordering on serious concern, that people may perish because they simply didn't get help when they needed it," Levine said. "And we're seeing that all over the country."

More testing

Beginning Thursday, Ballad Health Chief Operating Officer Eric Deaton said the system will also be increasing its testing capacity, making it available to anyone who feels they need to be tested. Those individuals would still need to go through the system's nurse connect line, which is 833-822-5523.

The system will also add testing sites in Johnson City and Kingsport, which Deaton said Ballad will provide more information about early next week.

Ballad Health is currently caring for 12 COVID-19 patients in its facilities plus eight that are being investigated for COVID-19. The system has 300 beds available for potential COVID-19 patients.

Latest numbers

On Wednesday, the Tennessee Department of Health reported 314 new cases of the novel coronavirus, bringing the state’s total to 10,366. Of that number, 5,140 Tennesseans have recovered, an increase of 219.

The department also reported seven additional deaths from the virus, bringing the statewide total to 195, and 132 additional hospitalizations, bringing the total to 1,013.

Labs in the state have now conducted a total of 168,549 tests, an increase of 6,621 over Tuesday.

Locally, the health department listed a total of 191 cases, up two from Tuesday. One case each was reported in Sullivan and Greene counties. The state reports Washington County has seen a total of 54 cases, Sullivan 48, Carter 12, Unicoi 1, Johnson 3 and Greene 43.

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