What you should do now to prepare for elective surgery demand post-COVID-19

The COVID-19 pandemic has delayed most elective surgeries as health care organizations properly focus on the wave of patients overwhelming their care capacity.

Surgical patients are on hold, and providers have lost a valuable source of revenue to support their operations. Hospital strategists, in partnership with community surgeons, are already working to understand the financial impact. They must also now begin to create a purposeful plan for managing elective surgery demand after COVID-19.

Much is still unknown. But what is certain is that as regions emerge from the crisis, there will be a dramatic surge in demand for elective procedures. There is a short window right now in which our hospitals and health systems must take a data-driven approach to prioritize this pent-up demand. And develop a strategy for addressing it quickly and efficiently.

Hospital executives and surgeons must determine the demand forces that they must prioritize against:

1. Number of elective cases in the community per surgeon (inpatient or ambulatory)
2. Patient condition and need for care
3. Surgeon and case predictability by length of case and individual skill
4. Revenue generation per case
5. Length of time patient has been waiting for care

Creating a prioritization model requires matching those demands to facility capacity constraints:

1. Inpatient beds available to care for post-surgical patients
2. Availability of personal protective equipment (PPE), such as masks, gloves and gowns
3. Physician preference items (PPI), such as hip replacements, knee replacements and neurosurgical screws and plates
4. Staffing availability and skill sets, especially in light of exhausting our staffs during the crisis
5. Timing of COVID-19 patient number decline in current wave

Organizations will have to rethink their traditional models in favor of a rapid-response mentality. You can’t resume a business-as-usual approach where hospitals try and fit the pent-up demand into their current scheduling operations. That won’t work, and it will lead to capacity constraints.

Current levels of operational inefficiency, especially around traditional block schedule management, will get in the way of meeting both normal and pent-up demand. It doesn’t allow for the prioritization approach to succeed.

In particular, the need for a rapid post-COVID-19 response will require surgical suites to rethink their traditional individual surgeon block methodology. They’ll need to create usable free space and maximize the use of the entire operating room to meet the pent-up demand. The “rapid response” will need to include:

1. Boosting utilization to over 75% to allow more cases in their daily prime time. This means rethinking block management to create more capacity in the surgical suite prime-time hours.
2. Moving less intensive procedures (such as many dental and endoscopy cases) to dedicated Procedure Rooms. This removes them from the daily case load of the surgical suite.
3. Expanding the hours of surgical suite availability each day well into the evening and possibly open to elective cases on weekends.

Executing this strategy will require immediate action. You’ll need to use available data from both the hospital and its affiliated surgeons to:

• Understand community and hospital constraints
• Rethink operational processes
• Partner with community surgeons in ways most have never done

Organizations like Optum Advisory Services are ready to help in modeling, prioritizing and planning for the return of elective cases. Understandably, hospital executives are focused on responding to the current crisis. But there’s little time left to create a strategy to accommodate pent-up elective surgery demand. And you’ll need to rescue revenue generation so that hospitals can continue to serve their patient communities long past the current pandemic.

Gary Smalto, MD, MBA is Vice President for Optum Advisory Services. Optum® Advisory Services specializes in helping health care leaders address their biggest challenges with insights and strategies to assert control over their organization’s future. Learn more at www.optum.com/advisoryservices.