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.