Pre-procedure Workflow
In order to prevent virus transmission, preserve PPE and protect patients, the typical and familiar pre-procedure workflow patterns should be significantly altered.
First, with regard to EP attending allocation, each day there is only one designated procedure attending in-house. A back-up attending is on-call within range of the hospital in case of a second emergent case. This shift-based arrangement is meant to prevent the potential for widespread and unintentional doctor-to-doctor transmission, and thus minimize the risk of “wiping out” an entire EP department, which would be devastating. Additionally, elderly (>60 years-old) attendings at high-risk for severe COVID-19 infection are encouraged to avoid hospital-based patient care and instead focus their attentions on telehealth visits or urgent out-patient clinic consultations.
Patient time in the pre-procedure “holding area” is minimized as possible and in-patients are brought down directly to the procedure room to prevent lingering in multiple different hospital areas. Although it is not current NYPH policy, with the medical-legal team and laboratory directors, we have considered transition of patient consent to a strictly verbal process in order to minimize patient-provider contact through touchscreen, pen or clipboard exchange.