Stanford Children’s Health Resumes Procedures Delayed by COVID-19 | #covid19 | #kids | #childern

Stanford Children’s Health Resumes Procedures Delayed by COVID-19

What You Should Know:

– Stanford Children’s Health announced they are ramping up services again six weeks after postponing non-emergent medical procedures due to the state-mandated suspension.

The health system will continue ongoing safety precautions including robust PPE standards; widespread access to COVID-19 and serology testing for all employees; testing all hospital patients; as well as using telehealth tools to reduce in-person visits whenever possible, among many other actions to protect our health care workers and patients alike.


Lucile Packard Children’s Hospital Stanford is anticipating an
increase in patient volumes after safely reintroducing deferred and delayed
clinical services last week. Services that resumed include surgeries,
diagnostic tests and imaging procedures. Operating room volume has reportedly
returned to nearly 70 percent of pre-COVID-19 levels this week as patients
return to receive needed treatment and care that had been put off since the
March 19th state-mandated suspension of non-emergent medical
procedures.

The steps to
scale back services resulted in a reduction of patient census (inpatient
occupancy) inside the hospital as well as cancellations of approximately 65
percent of clinical visits across the more than 65 Stanford Children’s Health clinics.

Ready for
the surge

Packard
Children’s Hospital played an important role in preparing for a potential surge
of COVID-19 patients, according
to Yvonne Maldonado, MD, chief of pediatric infectious diseases. “We were prepared to
provide care for pediatric patients from regional hospitals and for adult
patients from Stanford Health Care.”

Furthermore,
specially designated “landing zones” were established to accommodate patients
with suspected or confirmed COVID-19, to minimize the risk of spread to other
patients, their families, and health care workers. All of these precautionary
measures contributed to the decline in capacity and reduction of services.

“Now we’re on
the other side of the surge preparation, and we are focused on restoring
operations back to normal, in the safest way possible,” said Maldonado, who is
also professor of pediatrics, infectious
diseases, and epidemiology at the Stanford University School of Medicine.

“We are
tremendously proud of our staff and providers, who are ensuring that throughout
this crisis, our patients and families continue to receive the highest-quality
care,” said Paul King, president and CEO of Stanford Children’s Health. “Now,
as we focus on resuming the patient care that had been put on hold, I am
especially grateful for our teams’ commitment to ensuring a smooth transition
to serving our full patient population once again.”

Safely
resuming procedures

Stanford
Children’s Health leaders identified three essential criteria necessary to
safely resume services in the hospital and clinics. First, the availability of
sufficient supplies of personal protective equipment (PPE) remains at the
forefront of the defense against spreading the virus, according to Maldonado.
“We continue to follow government health agency PPE use recommendations to
safeguard our patients, families, health care workers and staff.”

Second is the
capability to broadly test patients and health care providers; Stanford
Children’s Health has made COVID-19 PCR (polymerase chain reaction) and antibody (serology) testing
available to all providers, staff, and patients, consistent with procedures
implemented across all of Stanford Medicine.

Routine
PCR testing is currently being performed for all hospitalized patients;
patients who are receiving certain procedures or diagnostic tests that need
general anesthesia; symptomatic outpatients; and patients who may have
significant exposure to COVID-19. Providers may also order antibody testing for
any patient seen at Stanford Children’s Health.

Based
on their experiences, clinicians plan to study how to optimally use serologic
testing to inform future recommendations for prevention and care.

“We are in a
fortunate position to have access to the Stanford Medicine-developed test that
was among the first FDA-approved COVID-19 tests in the nation,” said King. “It
allowed us to scale up testing quickly for our patients and health care
workers, thus creating a safer environment to provide care.”

“For health
care workers and patients alike, testing will continue to be central in
reducing community spread,” said Maldonado. To date, nearly 12,000 employees
across Stanford Medicine, including Stanford Children’s Health, have been
tested, and of that total, 99.7 percent of tests have been negative. “The data
demonstrates that the measures we’ve taken to slow the spread, including
appropriate supply and use of PPE, health care worker screenings, and masking,
have been effective.”

The third
criteria is to uphold physical distancing whenever possible, which is being
successfully supported through the increased use of telehealth. “During the pandemic,
we’ve made tremendous progress in familiarizing many families with the virtual
visit process, many of whom had not tried it before,” said Natalie Pageler, MD, who serves as the chief
medical information officer at Stanford Children’s Health and also works in the
pediatric intensive care unit. “While we know that telehealth isn’t necessarily
appropriate for every appointment, it can reduce the need for families to go to
the doctor for in-person visits. “Children and families will continue to
benefit from the convenience of this form of health care even after the
crisis.” Telehealth has also been used inside the hospital for inpatients; some
physicians can provide their consultations without needing to be physically
present in the patient’s room through the use of video monitors.

A protected
place for care

“We’ve seen
through this crisis that there are families who are frightened to come to the
hospital, even for emergent care, or to go to their pediatrician for routine
care, like immunizations,” said Lund. “From very early on we implemented
protocols to ensure that we are a safe place to come for those who need to be
here.”

And moving
forward will be no exception. COVID-19 health screenings will continue at the
entrances of the hospital and its clinics, and masks will continue to be
required for everyone. Existing visitor restrictions will also remain in place
to protect our patients and staff.

In Stanford
Children’s Health’s primary care offices, “healthy” patient visits are being
separated from “sick” patient visits. “If your child is sick and they need to
see their doctor, we are here,” said Pamela Kum, MD, a Stanford Children’s
Health pediatrician with Bayside Medical Group in Livermore, and the Livermore Pleasanton San Ramon Pediatrics Group. “We also want to make
sure that patients keep up with their immunization schedules. This provides
them with important protection from other dangerous viruses and bacteria. We
are taking extra precautions when seeing all patients, to ensure the safety of patients,
their families and our medical staff.”

According to
King, safety has been the organization’s guiding principle throughout the
crisis. “Our health care workers, patients and families have all had to make
drastic and swift changes to adapt. But everyone has risen to meet the
challenge, and together we’re moving forward.”


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