With Inslee’s OK, PeaceHealth resumes elective surgeries at its Bellingham hospital
PeaceHealth is once again providing some elective surgeries since Gov. Jay Inslee relaxed restrictions on medical and dental procedures.
Dr. Sudhakar Karlapudi, the chief medical officer and chief safety officer, explained what the governor’s decision means for PeaceHealth’s St. Joseph hospital in Bellingham.
“’We’ve been engaged since the onset of this pandemic in a collaborative effort with physicians to review the relevant criteria for cases to proceed for patients for whom delay in care would be detrimental to their health,” Karlapudi said to The Bellingham Herald.
He added: “The next phase of the service restoration process, which will begin now with clarification from the governor, is to expand services to include surgical and procedural interventions to address the progression of impairments and complications by further delay of care.”
Inslee issued a proclamation on March 19 that banned medical and dental procedures that weren’t urgent. The ban was meant to make sure there was enough room in hospitals and enough personal protective equipment for health care workers caring for COVID-19 patients.
“Many physicians and hospitals found the original proclamation vague in its intent. With criminal penalties attached to the original order, clinicians were cautious about proceeding with some medical procedures, largely focusing on those that would result in death or disability if postponed for three months,” the Washington State Medical Association said in a statement.
The order remains in place but the governor on Wednesday, April 29, clarified what type of medical and dental procedures are now permitted and laid out guidelines for what personal protective equipment healthcare workers should have and how long they should use it.
“Washingtonians have taken the threat of COVID-19 seriously, and that includes our doctors and nurses. But there are some much-needed procedures that aren’t being performed that should be, and we need to make sure that everyone gets the care they need during this time,” Inslee said.
The Washington State Hospital Association thanked Inslee for his decision.
“The requirements set forth are reasonable for when a hospital or clinic has the supplies and capacity to perform procedures, and we will continue to do everything we can to ensure our hospital members have the support they need to meet the requirements and continue serving their communities,” said Cassie Sauer, president and CEO for the association, in a prepared statement.
But the Washington State Nurses Association remained worried about having enough personal protective equipment, or PPE, saying that issue needed to be resolved before elected surgeries restarted.
“An overwhelming majority, 89% of (Washington State Nurses Association) represented nurses in 75% of the largest WSNA represented hospitals and facilities, are delivering care without sufficient PPE,” the union said. “This means they are continually operating in contingency or crisis capacity.”
Under the governor’s new guidelines:
▪ Procedures can be performed if delaying them would worsen a life-threatening or debilitating prognosis.
▪ Doctors can determine the need for elective procedures as long as they prioritize harm to patients.
The state didn’t define “harm” — leaving that up to doctors who were told to consider if a patient’s illness or injury was causing significant pain, significantly affecting their ability to function in daily life, or progressing or was at risk of getting worse, according to the regulatory Washington Medical Commission.
▪ Personal protective equipment supplies must be maintained and hospitals must leave enough beds open. For procedures that require an overnight stay, hospitals can’t exceed 80% of available bed capacity.
“Personal protective equipment continues to be in high demand, and we must make sure that all medical professionals have what they need to stay healthy and protected while serving the needs of their patients,” Inslee said.
Karlapudi said the decision represented a gradual reopening of the hospital and doesn’t mean a return to business as usual.
“Temperature checks, universal masking, visitor restrictions and social distancing will still be in effect for all visitors and caregivers as a way to continue to dampen exposure risk and keep our facility safe,” he said.
Karlapudi said the hospital’s emergency department will be divided into two.
One side will be for people with respiratory ailments that could be COVID-19 and the other for people with other critical issues such as chest pain, serious injuries, stroke symptoms and other non-respiratory issues, he said.
