COVID-19 Update: ODH issues order allowing providers to resume some non-essential surgeries and procedures

On April 30, 2020, the Ohio Department of Health (ODH) issued the Director’s Stay Safe Ohio Order to reopen businesses in the state, with some exceptions. The order also allows resumption of some non-essential surgeries and procedures. 

The order provides that, as of 11:59 p.m. on April 30, 2020, Ohio medical providers, including dentists, may resume non-essential surgeries and procedures that typically do not require an inpatient or overnight stay only if the provider does all of the following:

1. Follows infection control and other environmental practices in accordance with the ODH and CDC guidelines.
2. Maintains adequate inventories of personal protective equipment (PPE), supplies, equipment and medicine in their facility for each patient, considering all phases of care the patient may require.
3. Creates a plan for conservation and monitoring that may include decontamination and reuse protocols to preserve PPE, supplies, equipment and medicine to be prepared for an influx of patients, including those who do not have COVID-19.
4. Evaluates access to a reliable supply chain to support continued operations for non-COVID-19 cases and to respond to an unexpected surge in COVID-19 cases in a timely manner.
5. Frequently counts PPE inventory. For hospitals, this information will continue to be reported to Ohio’s COVID-19 resource management system on a daily basis.
6. Defines processes for timely COVID-19 testing of patients and staff in accordance with the ODH guidelines.
7. Continues to use telehealth modalities whenever possible.
8. Develops an actionable plan for communication, outreach and equitable delivery of services that recognizes the underlying social determinants of health and the disproportionate impact of COVID-19 on minority populations, engages patients in discussion regarding the risk of contracting COVID-19, and engages patients in shared decision making regarding the need for and timing of health care services. (Surgeries and other procedures could still be delayed based upon mutual decisions made by patients and their clinicians.)

The order also states that providers should create or use existing internal strategies to prioritize cases based on the medical staff governance and resolution structure.

In addition, the order advises that providers should follow the Responsible Restart Ohio Guide for Health Care. The guide provides additional detail on restarting health care services and notes that care may be provided at ambulatory surgery centers, outpatient departments of hospitals, clinics and the offices of many other health professionals, including dentists and orthodontists, optometrists and chiropractors.

The guide also discusses the zone/region framework that enables hospitals, congregate care settings, and local public health departments to coordinate and collaborate on patient care, availability of resources and management of regional surges. 

Further, the guide addresses the creation of Ohio’s “virtual stockpile” of PPE and notes that if a facility falls short of needed PPE due to an unexpected increase in infections, “distribution from the virtual stockpile will be overseen by the state and regional public health structure.”