Evidence map›Paper›PMID 33106786›Full record

ArticleSurgery open science2021

Getting back to work: A framework and pivot plan to resume elective surgery and procedures after COVID-19.

Oscar K Serrano, Rocco Orlando, Pavlos Papasavas, Mitchell H McClure, Ajay Kumar, Adam C Steinberg, Jeffrey L Cohen, Steven J Shichman, Rekhinder K Singh, William V Sardella and 1 more

Abstract read
In one paragraph

Article in Surgery open science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Oscar K SerranoHartford HealthCare, Hartford, CT.
Rocco OrlandoHartford HealthCare, Hartford, CT.
Pavlos PapasavasHartford HealthCare, Hartford, CT.
Mitchell H McClureHartford HealthCare, Hartford, CT.
Ajay KumarHartford HealthCare, Hartford, CT.
Adam C SteinbergHartford HealthCare, Hartford, CT.
Jeffrey L CohenHartford HealthCare, Hartford, CT.
Steven J ShichmanHartford HealthCare, Hartford, CT.
Rekhinder K SinghHartford HealthCare, Hartford, CT.
William V SardellaHartford HealthCare, Hartford, CT.
Bret M SchipperHartford HealthCare, Hartford, CT.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe COVID-19 pandemic has compelled a majority of hospital systems to reduce surgical and procedural volumes in an attempt to preserve resources. Elective surgery and procedures resumption has proven to be a calculated risk between COVID-19 exposure and resource depletion and patient morbidity and mortality from surgical deferral.

methodsWithin a few days of halting elective surgery and procedures, our 7-hospital (2427 in-patient beds, 26,647 inpatient surgeries) healthcare system developed a multidisciplinary Pivot Plan with the primary outcome of a phased resumption of elective surgery and procedures. The plan entailed the integration of our electronic medical record, order entry automatization, perioperative staff utilization, partnering with primary care providers, and a stepwise COVID-19 testing algorithm based on a predetermined hierarchy of case acuity and timeliness of patient care.

resultsThe Pivot Plan was instituted on May 10, 2020. Since then, 22,624 patients have been tested for COVID-19 in anticipation of an elective surgery and procedures; 140 (0.62%) tested positive for COVID-19 and had their procedure deferred. As our testing capability has increased, we have been able to increase our added elective surgery and procedures capacity from 13 cases per day to 531 cases per day. In turn, we have seen the case volume increase by 52%.

conclusionOur academic healthcare system located in one of the initial COVID-19 hotspots in the United States has successfully resumed elective surgery and procedures in part due to a receptive and supportive culture based upon nimbleness, agility, and rapid integration of multiple resources from a cohort of diverse disciplines applied to the perioperative services workflow.

Identifiers

PMID33106786
PMCPMC7578777

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.