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Illinois Department of Public Health Issues COVID-19 Guidelines for Elective Surgeries

05/01/2020

Governor J.B. Pritzker recently announced that certain elective surgeries may resume after previously being postponed amidst the nationwide COVID-19 pandemic.

According to the Illinois Department of Public Health (IDPH), hospitals and Ambulatory Surgical Treatment Centers (ASTCs) previously deferred nonessential procedures to conserve resources for the care of COVID-19 patients. However, beginning on May 11, 2020, hospitals and ASTCs may begin to perform elective procedures under specific guidelines.

Elective outpatient procedures are defined by the IDPH as procedures where the patient will enter and leave the facility on the same day that the procedure is performed. Elective outpatient procedures are to be performed at hospitals or ASTCs. To determine whether an elective outpatient procedure is appropriate, medical decision makers are advised to evaluate the facts and conditions using the Elective Surgery Acuity Scale.

Elective inpatient procedures are defined by the IDPH as those where the patient is likely to remain in the hospital for more than 23 hours. The 23 hours begins at the time of registration and ends at the time of departure. Elective inpatient procedures (referred to as Regional Requirements for Elective Inpatient Procedures) are permissible so long as each of the following conditions have been satisfied:

  1. Hospital availability of adult medical/surgical beds exceeds 20% of operating capacity for adult medical/surgical beds;
  2. Hospital availability of ICU beds exceeds 20% of operating capacity for ICU beds; and
  3. Hospital ventilator availability exceeds 20% of total ventilators.

The IDPH retained the right to suspend elective procedures at a future time depending on the occurrence or a rapid resurgence or a second wave of COVID-19 and/or there is a decrease in statewide hospital COVID-19 testing.

Hospitals or ASTCs must adhere to the following conditions in proceeding with elective inpatient and outpatient procedures:

  1. Each facility must have a Surgical Review Committee that is composed of surgery, anesthesiology, and nursing personnel to provide oversight of the prioritization of elective inpatient procedures, among various other duties;
  2. Facilities must test each patient within 72 hours of a scheduled procedure with a COVID-19 test to ensure that patient is negative. Patients must also self-quarantine until the day of surgery after being tested. Patients must also have a temperature of less than 100.4 degrees Fahrenheit upon arrival;
  3. Facilities may resume procedures only if there is adequate personal protective equipment for the number and types of procedures that are to be performed, as well as enough to ensure adequate supply if COVID-19 activity increases for a two-week period;
  4. Facilities must be cleaned according to the established infection control procedures and, if possible, section off established “non-COVID care zones” for screening, temperature checks, and preoperative waiting areas. Facilities should also minimize time in waiting areas, maintain a 6-foot seating distance, and attempt to minimize the number of patients. Visitors should generally be prohibited.

Inpatient and outpatient elective procedures for pediatric patients are subject to the requirements described directly above, but are not subject to the Regional Requirements for Elective Inpatient Procedures.

A copy of the policy can be found here. For interpretation or guidance regarding the most recent IDPH policy for Elective Surgeries and Procedures, please contact one of the following Heyl Royster attorneys: