Remodelling elective hospital services in the COVID-19 era – designing the new normal

Abstract

The provision of elective clinical services has decreased during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic to enable hospitals to focus on acute illness. Any end to the pandemic through widespread vaccination, effective treatment or development of herd immunity may be years away. Until then, hospitals will need to resume treating other diseases while also attempting to eradicate transmission of COVID-19 within the healthcare setting. In this article we suggest six major themes which could affect the design and delivery of elective clinical services: hospital avoidance, separation of high-and low-risk groups, screening, maintenance of adequate infection control, and new ways of working.

Impact of COVID-19 on opioid use in those awaiting hip and knee arthroplasty: a retrospective cohort study

“…Hospitals worldwide were forced to restructure when the COVID-19 pandemic called for an immediate significant shift towards prioritisation of acute care. 1 This led to widespread postponement of elective orthopaedic procedures in concordance with the need for resource reallocation, as well as concerns over risk of nosocomial infection transmission and the impact of COVID-19 on surgical risk. 2 …”

“…Hospitals worldwide were forced to restructure when the COVID-19 pandemic called for an immediate significant shift towards prioritisation of acute care. 1 This led to widespread postponement of elective orthopaedic procedures in concordance with the need for resource reallocation, as well as concerns over risk of nosocomial infection transmission and the impact of COVID-19 on surgical risk. 2 While these changes have served to 'flatten the curve' and reduce some of the harm associated with COVID-19 infection, there has undoubtedly been an impact on patients whose elective procedures were postponed.…”

After-action Review of Hospital Environments Exploring the ‘New Normal,’ Focusing on Structural Management Aspects and Bacterial Culture in Thai Hospitals Amid the COVID-19 Pandemic

“…Hospitals also implemented various strategies for physical distancing, including widening the space between seats in waiting rooms, providing remote clinical and non-clinical services through online communication technologies like telehealth and telemedicine, sending prescribed medicines via post, and enforcing a no visitation policy. These arrangements collectively contributed to lowering the number of patients visiting the hospital and reducing hospital congestion (24).…”

Modeling the Recovery of Elective Waiting Lists Following COVID-19: Scenario Projections for England

“…And although elective capacity has mostly improved, will it be sufficient to effectively attack the backlog amassed in many healthcare systems? Especially if, while weakened, COVID-19 and associated infection control measures continue to restrict the hospital bed base beyond prepandemic levels, 18 , 19 , 20 with waves of the disease leading to appreciable staff absence, such as that seen during the Omicron wave in late 2021. 21 There is also the matter of whether perennial recruitment issues in the health sector will limit the potential of additional funds pledged by many governments for accelerating elective recovery.…”