*OVMC Anesthesiology Dept – Implementing a Fast Track Program
The COVID-19 pandemic put unprecedented strains on the health care systems of the United States as well as the patients cared for by these health care systems. Due to concerns of disease transmission to patients and staff, as well as redeployments of staff to other areas in the hospital, drastic changes to standard operating procedure were needed to ensure patients presenting for surgery were medically optimized to undergo the stress of surgery and anesthesia. To facilitate this new paradigm in medicine, the Anesthesiology Preoperative Clinic made a transition from 100 percent (6518/6518) in-person visits prior to the pandemic, to 99.7% (5245/5261) telephonic visits during the COVID 19 pandemic. There was no decrease in the quality of care despite the monumental change in procedures – only 0.04% (2/5245) of cases evaluated by telephonic visit were cancelled due to a lack of preoperative optimization which was similar to the previous year of 0.02% (1/6518) and less than the prior 5-year average of 0.12%.
Furthermore, there was no increase in the rate of cardiovascular (0.08% vs 0.19%), respiratory (0.18% vs 0.25%) or neurological complications (0.06% vs 0.04%).
The transition from in-person to telephonic appointments allowed patients from throughout the region to access essential health care, while minimizing their risk of contracting Covid-19 in public transportation, the waiting rooms. These steps also protected our staff without compromising quality. Remarkably, while many other healthcare institutions across the country were at 25% or less capacity for elective surgeries, the Olive View-UCLA Medical Center was able to maintain its level of elective surgeries at 81% (5261 vs 6518) of the previous year’s level.