Northern Westchester Hospital Resumes Elective Surgery

Northern Westchester Hospital Resumes Elective Surgery: On May 16, Governor Andrew Cuomo rolled back his Executive Order prohibiting certain categories of elective surgery at New York State hospitals that went into effect over two months ago. Five days later, Northern Westchester Hospital (NWH) resumed its full range of elective surgeries. Dr. Michael M. Rosenberg, NWH Vice-President of Surgical Services said that one of the reasons the hospital waited to restart was to make sure they could continue performing elective surgeries if there’s an upsurge of Covid patients. “Of course, it depends on the size of the uptick, but I don’t expect anything drastic. We have the capacity to deal with a small uptick in an absolutely risk-free way.”

He also told us that “anyone coming in for surgery does not risk exposure to the coronavirus.” The path the hospital’s surgical services took to reopening, in a way where they feel it is as safe for surgery now as it was before the pandemic started, is worth exploring. In fact, NWH never completely stopped performing surgeries at any time during the worst phases of the COVID crisis. Because, for obvious reasons, the state never prohibited Tier IV Emergency Surgery. Surgery that must be performed in 12-24 hours or the patient risks losing life or limb. Even on the hospital’s peak COVID stress day (April 6) NWH was performing four operations a day.

At the time, however the hospital was severely limiting Tier III surgeries – surgeries that could wait 2 to 4 weeks without harm to the patient – because it was having a hard time separating COVID patients from non-COVID patients. And because so many of the hospital’s surgeons and nurses were redeployed to the its mobilization to meet the crisis. “I am a plastic surgeon,” he explained, “and I was deployed to help in one of our ICUs (Intensive Care Unit). Our operating room nurses were needed in the ICUs to care for very sick patients, as well as in the ER and on floors. Our anesthesiologists became critical care doctors.”

As the number of COVID patients declined and the hospital was able to reestablish a stable supply of safety equipment, NWH began to develop a multi-tiered safety regimen for performing surgeries. And by April 27, NWH was performing all necessary Tier IV surgeries plus a dozen Tier III surgeries a day. By then, Dr. Rosenberg told us, “we were already fully prepared for the day when we could resume our full schedule of surgeries.” That includes Tier II surgeries, procedures that need to be done but can wait up to 3 months without causing undue harm to the patient. Such as back surgery that is causing pain that can be controlled by medication, hip replacements and cataract surgery. And Tier I surgeries, procedures that can wait six months or more without harm to the patient. Clearly, the hospital paved a timely but careful path to fully prepare for their role in Westchester County’s long-awaited reopening.

Here are the safety measures NWH has in place to ensure surgery patients are not exposed to the coronavirus before, during and after elective surgery:

• In addition to normal pre-operative screening, all surgical patients are tested for Covid 48 to 72 hours before surgery.
• If a patient tests positive before surgery, we delay surgery and guide them through the quarantine process until they are asymptomatic and test Covid-negative. Then we proceed. That means…
• We only perform elective surgeries on patients who test negative for Covid.
• All staff members are screened for symptoms and their temperature is taken every day.
• All staff are wearing personal protective equipment to avoid any exposures and will continue to wear PPE for the foreseeable future.
• All pre-operative areas, operating rooms, and post-surgical units are separate from areas with Covid patients.
• In addition to our extensive pre-operative cleaning and disinfecting protocol for pre-operative areas, ORs and post-surgical units, our Hospital is one of the first in the state to add Purple Sun technology to our disinfecting process. Purple Sun involves a device using ultraviolet light, which kills viruses. We use this technology to do a final-stage disinfecting of each entire room and every surface in it. As a last step, we test each room for evidence of residual virus or bacteria using Swab ATP testing.  Swabbing a surface provides an immediate answer as to the presence of virus or bacteria.
• We are still limiting those who are allowed in the hospital. (Complete information can be found on the hospital’s website www.nwhc.net)

Read Dr. Rosenberg’s complete post.