200528ind SCHUpdate

South County Hospital’s Emergency Department team poses for a photo from the organization, which recently began allowing elective surgeries to resume following a rollback of restrictions implemented at the beginning of the coronavirus pandemic.

SOUTH KINGSTOWN, R.I. –  Elective surgeries have resumed at South County Hospital, a change that staff and officials there welcomed after more than a month of idled operating rooms because of COVID-19.

Still, it’s more of an easing into the routine rather than a jump-start, as more appointments for postponed non-emergency medical procedures gradually fill the schedule.

Some patients are still, understandably, hesitant to venture into an operating room, especially after being told to shelter at home for weeks to help stop the transmission of the coronavirus.

But South County Health administrators say the facilities are safe, and ready for patients.

“We got the go-ahead from the Department of Health to resume elective cases and started that on May 4,” South County Health President and CEO Aaron Robinson said. “We were actually one of the first hospitals that was ready to resume elective surgery. I think we were the first in the state.”

The hospital, along with others throughout Rhode Island, had suspended “purely elective” non-emergency surgeries on March 20.

“The first week back, we ramped up to around 50 percent of pre-COVID levels, and then the subsequent week we were around 60 percent of pre-COVID levels,” Robinson said.

Before the closures, the hospital was performing about 150 surgeries per week, Robinson said. Since resuming, it’s back up to 75 to 100 per week, he said.

Surgical patients will be tested for COVID-19 in the days before their scheduled procedure, and more time is being taken in between surgical cases to give hospital teams time to clean operating rooms according to stringent standards.

The hospital also is getting the message out that those with emergencies – a fall, bad cut, heart attack, stroke or other critical condition – shouldn’t hesitate to seek immediate help.

“Our emergency volume is down 50 percent or more since COVID hit,” Robinson said, noting that fewer people with emergencies are calling ambulances. Those that do are sicker because they wait longer to call, he said.

“There’s a lot of concern relative to patient-related care. Our concern is, it could lead to higher mortality rates, worsening of symptoms or long-term prognosis,” he said.

But unlike places such as New York City, South County has seen a “very minimal impact” from COVID.

“It’s a very safe environment in the hospital,” Robinson said. “Particularly in Washington County and Southern Rhode Island.”

The hospital has been given an “A” rating for patient safety for six consecutive years because of its focus on preventing medical errors, injuries and infections by The Leapfrog Group, which describes itself as “a nonprofit watchdog organization that serves as a voice for health care consumers and purchasers.”

The hospital has taken many steps to ensure cleanliness. These include extra sanitizing of operating rooms and elsewhere, using techniques such as ultraviolet cleaning and a dry H2O2 system that provides continuous microbial reduction in occupied spaces. Common areas and patient rooms are treated with CDC-approved germicide. Public areas are undergoing increased disinfection procedures.

In addition, infection prevention experts have consulted with hospital staff, which has been given new training and tools to maintain a safe physical environment.

There’s also visible evidence of the strict infection prevention measures in place at the hospital.

Visitor restrictions enacted on March 12 remain in place, and face coverings are required for all patients and visitors.

“As we started to resume cases and resume normal activities, we felt like that would be the most cautious approach to ensure the safest environment,” Robinson said. “That’s been fairly consistent from health system to health system across the state.”

Staff members wear appropriate personal protective equipment including masks, face shields, gowns, shoe coverings and even full body coverings in certain areas.

COVID-19 screenings are mandatory for all patients, caretakers and healthcare workers. Screenings of symptomatic patients include in-house laboratory testing with a two-hour turnaround time.

Anyone suspected of being COVID-positive is moved to designated negative pressure isolation rooms located away from other patient care areas while awaiting testing results.  

As the summer approaches, the hospital is looking at potentials for a “summer surge” of COVID patients from out-of-state who vacation in the area.

“I would say there would have to be a significant increase, given that our capacity is still pretty insignificant, and our impact has been relatively low. But we have a surge plan and we’ve got indicators and triggers that we’re watching on an ongoing basis,” Robinson said. “But we’re certainly not concerned about folks coming back to southern Rhode Island for the summer.”

Looking beyond summer to the fall, and flu season, the hospital is being equally vigilant.

“We’re going to have a lot of lessons learned heading into the fall,” Robinson said. “We’re going to have a better testing scenario and better lead time to prepare than we did earlier this year.”

Hospital staff is also thanking the people and groups that have come to its aid with donations since the COVID-19 crisis began.       

“The community has been outstanding, as it always is, when supporting South County Health,” Robinson said. “We’ve had donations of protective equipment, of masks, donations of food. It’s been a major outpouring of support from the community in multiple ways.”

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