New Guidance from Illinois Department of Public Health Opens Door for Elective Surgeries to Resume

The Illinois Department of Public Health (IDPH) has issued new guidance allowing hospitals and Ambulatory Surgical Treatment Centers (ASTCs) to resume elective surgeries. Beginning May 11, 2020, elective surgeries can resume when certain criteria regarding outpatient, inpatient, and pediatric procedures have been met.

Outpatient Procedures

According to the IDHP, an outpatient procedure is an elective procedure in which the likely and expected course for the patient undergoing the procedure is that they will enter and leave the facility on the same day that the procedure is to be performed. Outpatient procedures can resume on May 11, 2020 provided that:

• Each facility has convened and charged a Surgical Review Committee (SRC), composed of surgery, anesthesiology, and nursing personnel.
• Facilities test each patient within 72 hours of a scheduled procedure with a preoperative COVID-19 RT-PCR test and ensure COVID-19 negative status. Further, the patient must self-quarantine until the day of surgery after being tested, and a temperature check must be completed, with results less than 100.4 degrees, on the day of the surgery.
• Facilities ensure adequate personal protective equipment (PPE) with respect to the number and type of procedures performed, as well as to adequately supply a surge of COVID-19 activity within the next 14 days.
• Facility cleaning policies in all areas along the continuum of operative care follow established infection control procedures.
• Other areas of the facility that support perioperative services are ready to commence operation with uniformly heightened infection control practices, including sterile processing, the clinical laboratory, and diagnostic imaging.

Inpatient Procedures

IDHP defines inpatient procedures as an elective procedure in which the patient being considered for that procedure is likely to remain in the hospital for more than 23 hours, beginning from the time of registration and ending at the time of departure. Hospitals can resume inpatient procedures on May 11, 2020 if all the criteria for outpatient procedures has been met and each of the following criteria can be met:

• Hospital availability of adult medical/surgical beds exceeds 20% of operating capacity for adult medical/surgical beds.
• Hospital availability of ICU beds exceeds 20% of operating capacity for ICU beds.
• Hospital ventilator availability exceeds 20% of total ventilators.

Pediatric Procedures

Defined by the IDHP as elective procedures for pediatric patients—both outpatient and inpatient— pediatric procedures are not subject to the outpatient procedure requirements. They are, however, subject to inpatient procedure requirements.

IDPH has reserved the right to suspend elective procedures if (1) a rapid resurgence or second wave of COVID-19 occurs or (2) if there is a statewide decrease in hospital COVID-19 testing levels.