The Ambulatory Surgery Center Association (ASCA) has released a checklist to help ASCs consider what they need to do to begin caring for non-COVID-19 patients. The full list is available for ASCA members, and we’ve outlined some of the most crucial factors below.

 

1. Administration

To resume elective surgeries, the appropriate authorities must sign off. Right now, we are looking for a downward trajectory in the rate of new COVID-19 cases for at least 14 consecutive days. For ASCs to re-open, consider that all appropriate sign-offs have been made by governing boards, accrediting organizations, and any affiliated hospitals. Administratively, you must have the necessary staffing in place and re-prioritize canceled procedures. Consider your communication strategy to patients and approach re-opening in phases. The administrative section of this checklist is the longest, so start at the top and work down. Only when administrative protocols are in place can ASCs move to preparation in other areas.

 2. Infection prevention

Right now is a good time to refresh all staff members on infection prevention policies, including hand hygiene, environmental cleaning, and proper donning of PPE. Additionally, your pre-admission paperwork must be updated to include information to screen for COVID-19, and procedures must be in place to screen for the virus. Have waiting rooms been adjusted for social distancing measures? These are just a few questions to ask before signing off on a safe re-opening.

 3. Building and facilities

It’s likely that staff have not been in the building for a few weeks now. Have daily temperatures been maintained in ORs and sterile supply closets? Has the fuel level of the generator been checked? Do HVAC filters need to be changed? Get a plumber to check all drains, specifically scrub sinks and autoclaves, that may have been unused for a while.

 4. Safety

Perform testing on all equipment that has been out of commission, such as anesthesia machines, ventilation, sprinkler systems, and fire alarms. Ensure that fire extinguishers are up-to-date and that all staff have reviewed emergency drill scenarios.

 5. Sterilization

All sterile packages and instrument trays must be checked for expiration dates and inspected. In light of COVID-19, consider if the ASC will be reprocessing N95 masks. Are the proper policies and procedures in place to do so? Before resuming surgery, ASC leaders must set aside time for additional infection prevention training with all staff members.

 

6. Pharmacy

Have any medications expired while the facility has been closed? Is narcotic inventory the same as it was before COVID-19? Have the temperatures in the building and/or in the tissue refrigerator been maintained? ASC leaders must also cross-check with the FDA list of drugs that are currently in short supply and for extended use dates of certain medications.

 

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