Digital Debut

Joining Forces Against COVID-19 Pandemic

ASCs nationwide come together to help their communities

BY SAHELY MUKERJI | MAY 2020

As COVID-19 continues to ravage the US, healthcare workers across the country face shortages of personal protective equipment (PPE) and medical gear needed to treat patients. While many surgery centers shut down temporarily in compliance with their governors’ stay-at-home orders, some continued to perform emergency surgery and the rest worked hard to help their community.

Constitution Surgery Center East, Waterford, Connecticut

The ASC made a donation of surgical masks with eye shields to the local fire and ambulance department. “Several of our talented employees are also sewing and donating cloth masks for the local community,” says Robert Taylor, clinical director and total joint coordinator.

The two area health networks, Yale New Haven Health System and Hartford Healthcare, recommended that the ASC remains open to decompress the local hospitals of emergent and urgent cases, Taylor says. “We telephone screen every patient within 24 hours of arrival, check their temperature prior to entering the building and have prohibited visitors within the ASC.” The center anticipates continuing these practices once the emergency declaration is lifted and are investigating serology and or point-of-care testing kits becoming available via the US Food and Drug Administration’s Emergency Use Authorization. “We maintain a good supply of PPE, have reviewed all infection control practices, and are following all FDA recommendations,” he says.

Kona Ambulatory Surgery Center, Kailua-Kona, Hawaii

The ASC and Kona Community Hospital partnered to collect donated surgical masks and N95 masks.

“We have volunteered to be the donation site to collect items donated by our community,” says Nadine Calloway Reese, clinical manager and assistant director of the ASC. “My surgical team inspects the donated items and inventories them for use by our hospital. This has been rewarding for us to be able to support the hospital and our community.”

The center has temporarily suspended cases following its governor’s stay-at-home order and was working on creating a protocol for reopening. “Prior to closure, we had increased our screening process with preop and all employees. Now with the community spread of the virus, we are trying to decide if we will require lab testing prior to surgery for all patients. We are also prepared to assist the hospital as needed if there is to be an influx of patients.”

Mankato Surgery Center, Mankato, Minnesota

Joleen Harrison, RN, CASC, administrative director of Mankato Surgery Center started making masks back in March for a Covid-19-HELP group on Facebook. She used a sterilization wrap, or blue wrap, to make the masks. “This is a barrier material that we are not thinking about and has a rating for being a barrier for sterile supplies after it is sterilized,” she says. “Medline is where we are getting the supply of Gemini sterilization wrap. This is not N95 rated but similar as a surgical mask.” The manufacturer of the material says that the wrap is not meant to make masks and it cannot guarantee breathability, Harrison says. “I personally have tested wearing it for a few hours and the breathability is good.”

The material is easy to sew and she has devised a pattern to mirror the surgical masks with ties that are in use currently, she says. It has a twist tie or pipe cleaner for the nose bridge. The mask can also go over the N95 masks or be doubled up.

“We are putting the masks through a heat cycle after they are made and returned,” Harrison says. “I then seal them in a bag and also in a sealed tote for the length of time that the CDC recommends. I wait three to five days before giving them out.”

At press time, Harrison and her sewing group had made more than 4,000 masks and were expecting to finish 1,200 more soon.

Oregon Surgical Institute, Beaverton, Oregon

An employee of the ASC read an article about re-purposing sterile processing wraps, and the entire surgery center came together to make masks. “We gathered our entire team, along with doctors, physician assistants and reps and started to sew,” says Erin McKay, administrator. “Most of us have never used a sewing machine, but together we made 175 masks to share with our families, friends and local MD offices.” The team made masks in three sizes, she says, adult, child and toddler sizes. “Additionally, we gave 1800 surgical masks to our two local hospitals, Legacy and Providence.

“We know we are not on the front line but we are keenly aware that we have the ability and the resources to hopefully make difference,” McKay says.

The ASC has a group of trauma doctors and has been seeing patients in need of emergent/urgent surgeries, McKay says. “This has been good for staff and for our community, as we are still serving in a capacity that affords patients the ability to have a necessary surgery in a safe environment.”

The center has tightened up its screening process and is following guidelines similar to the hospitals, e.g., extensive screening, no visitors in the lobby, temperature screening for everyone walking through the door, including staff, and rescheduling patients if anything falls out of compliance with the guidelines, McKay says. “We are prepared if we need to act as a resource center for the hospitals as well as prepared to get back to business as usual- whenever that may be,” she says.

Mississippi Valley Endoscopy Center, Davenport, Iowa

“We closed our endo facility for a couple of weeks and then re-opened last week—just two days a week—to help take the burden off the hospital endo department,” says Michael J. Patterson, RN, ASCA Board member and president and chief executive officer of Mississippi Valley Endoscopy Center, at press time. “Our multispecialty ASC has been open the entire time but only performing surgery on Tuesday and Thursdays. We are performing ‘necessary surgeries’ only. Same thing with our endo facility.” Some of the team members have taken temporary assignments to assist with COVID-19 testing, others have decided to stay home because they have small children to care for or older family members that need assistance, he says. “We have supported each staff member in their decisions based on their individual circumstances.”

Valley View Hospital, the joint venture partner of Mississippi Valley Endoscopy Center, canceled elective surgeries at the hospital for the foreseeable future in the middle of March. When it did, the employees, headed by nurses Brady Heuer and Kristen Dirksen, started sewing masks out of the blue wrap cloth used to protect sterilized surgical tools from contaminants before surgery, according to a March 19 article in Post Independent.

For more information on COVID-19 and ASCs, visit ASCA’s COVID-19 Resource Center.