On April 17th, the American College of Surgeons released basic guidance to help health care facilities begin to prepare for resuming elective surgery. It’s important to clarify what “elective” surgery actually means, as Vivek N. Prachand, MD, FACS, explains. “Although we talk about these operations as being ‘elective’, that doesn’t mean they are optional. It’s just a matter of the surgeon and the patient having the opportunity to elect the time when the operation should take place. The procedures are more aptly called medically-necessary time sensitive.” The reality is many “elective” procedures are surgical options when there is a lack of good nonsurgical treatment options and delays in surgery could cause additional problems and complications.
This additional clarity is crucial as facilities try to organize the jumbled backlog of procedures that continues to pile up day after day during our COVID-19 focused world. Dr. Prachand, Professor of Surgery & Chief Quality Officer at the University of Chicago Medicine and Biological Sciences, and a team from cardiac surgery, vascular surgery, surgical oncology, transplantation, general surgery, otolaryngology and surgical ethics have developed a prioritization scoring system that the ACS recommends as part of their guidance for preparing to resume elective surgery. The scoring system is aptly titled MeNTS (Medically Necessary-Time Sensitive).
MeNTS identifies 21 factors related to outcome, risk of viral transmission to healthcare staff, and use of resources. Each of these factors are scored on a scale of 1-5 and the resultant net score illustrates the risk to the patient, the utilization of healthcare resources and the chance of viral exposure to the healthcare team. According to Prachand, “the factors are not hospital or practice specific, are fundamental and straightforward, and can help surgeons and hospitals provide the surgical care that patients need both now, in the thick of the pandemic, as well as when we get to the other side of the peak”.
Learn more about MeNTS here: https://www.journalacs.org/article/S1072-7515(20)30317-3/fulltext
As we prepare for the resumption of “elective” surgery, proper planning is crucial to preventing unanticipated outcomes, like the spread of COVID-19, while also making sure facility priorities can be achieved.
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