Elective surgery and COVID-19: Putting patient safety first

When Arizona Governor Doug Ducey issued an Executive Order allowing elective surgeries to resume on May 1, 2020, the first call David G. Rizik, MD, made was to patient Barbara Galecki, a mother and grandmother in her 80s.

"There is no question that she was my highest priority," said Dr. Rizik.

A serious heart condition

That’s because late last year Barbara was diagnosed with a leaking heart mitral valve, a serious cardiovascular condition called mitral regurgitation. In the weeks that followed, she had a pacemaker put in and began to take blood thinners to reduce her risk of clots forming in the heart, which can cause a stroke. The heart valve still needed to be repaired, though, so Dr. Rizik scheduled Barbara for a surgery in early March.

However, that’s exactly when elective procedures were halted in Arizona due to the COVID-19 pandemic. Because of the seriousness of Barbara’s condition, she was first on the list of patients to call when elective surgeries were allowed to resume.

Safeguarding elective procedures during COVID-19

To prepare to see patients for elective surgeries, HonorHealth spent several weeks putting policies and processes in place to protect patients from exposure to the coronavirus. 

“We took a number of steps to really ensure that elderly and susceptible patients coming in for an elective procedure would have no exposure to any room, patients or hospital personnel that had been involved in COVID-19 care,” said Dr. Rizik. 

HonorHealth designated a special unit on its HonorHealth Scottsdale Shea Medical Center campus for patients undergoing elective procedures. This unit is isolated from any COVID-19 treatment areas and ensures elective surgery patients have no exposure to COVID-19 patients or staff before, during or immediately after their procedures.

In addition, all elective surgery patients are tested for COVID-19 prior to having their surgery. Their healthcare providers are, too. “I also was tested multiple times,” Dr. Rizik explained.

Arizona’s first elective surgery patient 

On April 28, Barbara received a call from Dr. Rizik’s nurse asking if she would still like to have heart valve repair surgery. It turns out she did, and she arrived at the hospital at 5:30 a.m. on May 1, becoming the first Arizona patient to receive elective surgery after the temporary ban was lifted. Dr. Rizik used a catheter-based way of treating leaking heart valves, which is less invasive than other types of procedures. 

Barbara, who has had several surgeries prior to this one, noticed a few changes to the hospital this time. First, only essential staff members and healthcare providers were allowed in the surgical unit. Also, while her husband had been invited to sit in a waiting room during her previous surgeries, this time he had to leave after she checked in and couldn’t return until she was discharged. 

These precautions helped make her experience a success. “Everything went just perfectly,” said Barbara. “I never had discomfort or pain, and I was released the next day without restrictions.”   

The risks of postponing treatment

Dr. Rizik is relieved that patients with serious conditions like Barbara are able to receive elective procedures that are critical to their health and wellbeing. 

He notes that it’s a balancing act for these patients during the COVID-19 pandemic. It has to be safe for them to come to the hospital for care, and they also have to feel confident going to the hospital after social distancing and reading news about COVID-19 for so long.

However, often patients benefit from early intervention. Delaying treatment may put their health at risk since many conditions worsen over time. This counts for emergency room patients too, many of whom are nervous to come in for care even while experiencing serious symptoms. In fact, nationally, the number patients presenting to hospital emergency rooms with heart attacks has been decreased by 30% to 50% over the past eight weeks.

Dr. Rizik suggests these patients should ask themselves a question. “Would you have gone to the emergency room for these symptoms in November or December before the pandemic?” he said. If the answer is yes, then he advises patients to come in for those complaints now.

Because HonorHealth is taking steps to protect patients from COVID-19 exposure, they can feel comfortable coming in for the care they need to maintain good health, whether it’s for elective surgery or emergency services.

Back to her life in good health

Barbara is happy to move forward in good health after her heart procedure and is glad she took the opportunity to have this elective surgery despite the ongoing COVID-19 situation. 

“I trusted HonorHealth to open their doors [for elective surgery] on May 1 only if they knew that it was safe,” she said. “I had no question in my mind about trusting them.”

Likewise, Dr. Rizik is pleased that he can treat patients while keeping them safe. “I am so proud of HonorHealth and so proud of how seriously they are taking patient care and patient safety.”