How Stanford Health Care is resuming elective care

As hospitals and health systems prepare to resume elective procedures and return to a "new normal," they must work to alleviate any fears patients and staff have related to the COVID-19 pandemic, according to David Entwistle, president and CEO of Stanford Health Care.

Mr. Entwistle joined the Palo Alto, Calif.-based health system in July 2016.  Now, he is leading the organization's pandemic response, including the process of resuming elective care. 

"As we talk about the new normal, I think different people — [patients and staff] — are going to have different expectations," Mr. Entwistle told Becker's Hospital Review. "Some will be fearful, so we're doing what we can to mitigate fears. We're also letting patients know: 'Don't delay the care you need.' I think trying to instill [that mindset] in the communities we serve is important to do." 

Here, Mr. Entwistle discusses Stanford Health Care's pandemic response and how the health system is resuming elective care.   

Editor's note: Responses have been lightly edited for clarity and length:

Question: What is your organization's greatest challenge to resuming elective care?

David Entwistle: During any given week in March, we would do between 1,300 and 1,500 elective procedures. We're now doing 250 per week. We made significant preparations to have capacity for a potential surge in COVID-19 patients. Thankfully — as a result of the shelter-in-place and physical-distancing measures ordered by the county — that surge is no longer expected. We had nine COVID-19-positive inpatients today and one in the intensive care unit. 

Q: How is Stanford Health Care ensuring employees and patients are comfortable with reopening for elective care?

DE: We have the ability to test patients and providers and the ability to acquire personal protective equipment and make sure we have an adequate supply. 

Q: How are you getting the word out to patients that you are resuming elective care?

DE: We have implemented telehealth, and before this occurred, we had roughly 2 percent of outpatient visits through telehealth. Seventy-one percent of outpatient visits are now through telehealth.  However, at the same time, we are getting the word out to patients that it's safe to come to the hospital for care, and important not to risk delaying care when you need it. 

Q: What is your advice for other hospitals that are preparing to resume elective care? 

DE: Your ability to stay open as a hospital is important. A lot are struggling financially. Fortunately, we haven't had to lay off employees. It's important to keep your staff there and make sure you have important protective equipment for them. I think from a clinician standpoint, they're more confident in doing surgery if [the organization is] doing testing and trying to instill confidence in patients.

We began proactively testing our 14,000 employees and have tested more than 11,000 across Stanford Medicine. So far, of those who were asymptomatic, 19 tested positive (0.3 percent), and a total of 117 were positive overall (1.1 percent). We're letting our staff and patients know they are safe. We already began rescheduling delayed cases last week. We were able this week to get another 500 of those 3,000 delayed cases scheduled for May. 


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