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Elective surgeries ramp up at Stanford Health Care after few workers found with COVID-19

Health system completes COVID-19 tests for 11K employees, increases safety measures

Stanford Health Care is rapidly resuming elective surgeries, diagnostic tests and other procedures, with more than 800 scheduled for this week at the main Stanford Hospital and outpatient clinics, President and CEO David Entwistle said in a phone call on Monday.

Typically, the hospital and clinics 1,200 procedures per week. The regional medical center performed 170 procedures on Monday, May 4. Gov. Gavin Newsom ordered hospitals to freeze all but essential procedures starting March 13 to free up hospital beds for a projected spike in COVID-19 cases. That spike, largely due to the state's and local counties' early shelter-at-home orders, did not occur. Newsom lifted the stay on April 22. Stanford took two weeks to test 11,000 of its 14,000 workers who would come into contact with patients and prepare additional safety procedures.

The coronavirus tests showed that only about 0.3% of asymptomatic employees tested positive for COVID-19, Entwistle said. (The overall rate for all employees was 0.1%.) Stanford began offering tests to asymptomatic employees two weeks ago and has been testing employees with symptoms since early March. The health system's hospitals have not had any recorded transmissions of the coronavirus between patients and health care workers, Entwistle said.

Stanford delayed more than 3,000 procedures, including colonoscopies and mammograms, for seven weeks. Of its 600 beds, about 300 were unoccupied to make room for any seriously ill COVID-19 patients, Entwistle said.

During the scaled-back procedures, in addition to Stanford Hospital, Stanford-ValleyCare and Stanford Children’s Health (Lucile Packard Children's Hospital Stanford) have also been treating COVID-19 patients and patients with needs that could not wait more than 30 days. Stanford Health Care's outpatient centers, including the Stanford Medicine Outpatient Center in Redwood City, Stanford Cancer Center South Bay, Byers Eye Institute and Stanford Health Care, Emeryville, had until this week been serving only patients with urgent needs.

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Given the very low infection rates, a strong supply of personal protective equipment and the implementation of numerous safety measures, Stanford Health Care determined that it was the right time to start treating patients who have been waiting for care after Gov. Newsom lifted the hold on elective procedures. Patients can now receive procedures such as diagnostic cardiac catheterization, orthopedic surgery, magnetic resonance imaging and other scans, he said.

Hospital leaders did extensive planning to protect the safety of patients and health care workers, said Entwistle, who with other hospital leaders urged community members to not delay necessary care.

"Stanford Medicine prepared for the worst, and now we're ready to resume much of what was put on pause during this health crisis. We have planned for this recovery and restoration, and I'm confident that we can hit the ground running," Entwistle said.

Stanford Health Care was able to quickly ramp up on procedures because its main hospital developed its own rapid test for the virus and has adequate protective gear for its workers, Entwistle said. The hospital acquired the equipment through local companies and donors, he said.

The health system also established new safety protocols while the procedures were on hold, including the consistent use of masks and other personal protective equipment among health care workers, symptom screening of employees before entering a building and testing certain patients prior to their hospital admission or procedures. Doctors also shifted to virtual visits, which don’t involve physical contact between providers and patients. Prior to the coronavirus outbreak, about 2% of consultations were telehealth visits. That number has grown to 71% of all outpatient visits, he said.

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The hospitals and clinics will continue to keep the new safety protocols in effect. Everyone inside a Stanford Health Care facility will still be required to wear a mask, visitors will not be allowed and health workers will have their symptoms checked daily.

Amy Semple, administrative director of operations, said in a statement issued by Stanford Health Care that she expects the hospitals and clinics will be back to 100% capacity within about three weeks. Providers are now performing all procedures except for cosmetic ones.

All patients will have their symptoms checked when they arrive at a hospital or clinic. Most will also receive swab testing for the coronavirus three days before scheduled procedures and will be asked to quarantine themselves during that time. Initially, about 10% of patients — those scheduled for procedures that pose a lower risk for infection risk, such as some imaging and injections, will not be screened for COVID-19. The health system is working to provide tests for these patients soon, she said.

Editor's note: This story has been clarified to state that the positive test results were for asymptomatic employees who were tested two weeks ago.

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

Follow Palo Alto Online and the Palo Alto Weekly on Twitter @paloaltoweekly, Facebook and on Instagram @paloaltoonline for breaking news, local events, photos, videos and more.

Elective surgeries ramp up at Stanford Health Care after few workers found with COVID-19

Health system completes COVID-19 tests for 11K employees, increases safety measures

by / Palo Alto Weekly

Uploaded: Wed, May 6, 2020, 5:10 pm
Updated: Thu, May 7, 2020, 10:17 am

Stanford Health Care is rapidly resuming elective surgeries, diagnostic tests and other procedures, with more than 800 scheduled for this week at the main Stanford Hospital and outpatient clinics, President and CEO David Entwistle said in a phone call on Monday.

Typically, the hospital and clinics 1,200 procedures per week. The regional medical center performed 170 procedures on Monday, May 4. Gov. Gavin Newsom ordered hospitals to freeze all but essential procedures starting March 13 to free up hospital beds for a projected spike in COVID-19 cases. That spike, largely due to the state's and local counties' early shelter-at-home orders, did not occur. Newsom lifted the stay on April 22. Stanford took two weeks to test 11,000 of its 14,000 workers who would come into contact with patients and prepare additional safety procedures.

The coronavirus tests showed that only about 0.3% of asymptomatic employees tested positive for COVID-19, Entwistle said. (The overall rate for all employees was 0.1%.) Stanford began offering tests to asymptomatic employees two weeks ago and has been testing employees with symptoms since early March. The health system's hospitals have not had any recorded transmissions of the coronavirus between patients and health care workers, Entwistle said.

Stanford delayed more than 3,000 procedures, including colonoscopies and mammograms, for seven weeks. Of its 600 beds, about 300 were unoccupied to make room for any seriously ill COVID-19 patients, Entwistle said.

During the scaled-back procedures, in addition to Stanford Hospital, Stanford-ValleyCare and Stanford Children’s Health (Lucile Packard Children's Hospital Stanford) have also been treating COVID-19 patients and patients with needs that could not wait more than 30 days. Stanford Health Care's outpatient centers, including the Stanford Medicine Outpatient Center in Redwood City, Stanford Cancer Center South Bay, Byers Eye Institute and Stanford Health Care, Emeryville, had until this week been serving only patients with urgent needs.

Given the very low infection rates, a strong supply of personal protective equipment and the implementation of numerous safety measures, Stanford Health Care determined that it was the right time to start treating patients who have been waiting for care after Gov. Newsom lifted the hold on elective procedures. Patients can now receive procedures such as diagnostic cardiac catheterization, orthopedic surgery, magnetic resonance imaging and other scans, he said.

Hospital leaders did extensive planning to protect the safety of patients and health care workers, said Entwistle, who with other hospital leaders urged community members to not delay necessary care.

"Stanford Medicine prepared for the worst, and now we're ready to resume much of what was put on pause during this health crisis. We have planned for this recovery and restoration, and I'm confident that we can hit the ground running," Entwistle said.

Stanford Health Care was able to quickly ramp up on procedures because its main hospital developed its own rapid test for the virus and has adequate protective gear for its workers, Entwistle said. The hospital acquired the equipment through local companies and donors, he said.

The health system also established new safety protocols while the procedures were on hold, including the consistent use of masks and other personal protective equipment among health care workers, symptom screening of employees before entering a building and testing certain patients prior to their hospital admission or procedures. Doctors also shifted to virtual visits, which don’t involve physical contact between providers and patients. Prior to the coronavirus outbreak, about 2% of consultations were telehealth visits. That number has grown to 71% of all outpatient visits, he said.

The hospitals and clinics will continue to keep the new safety protocols in effect. Everyone inside a Stanford Health Care facility will still be required to wear a mask, visitors will not be allowed and health workers will have their symptoms checked daily.

Amy Semple, administrative director of operations, said in a statement issued by Stanford Health Care that she expects the hospitals and clinics will be back to 100% capacity within about three weeks. Providers are now performing all procedures except for cosmetic ones.

All patients will have their symptoms checked when they arrive at a hospital or clinic. Most will also receive swab testing for the coronavirus three days before scheduled procedures and will be asked to quarantine themselves during that time. Initially, about 10% of patients — those scheduled for procedures that pose a lower risk for infection risk, such as some imaging and injections, will not be screened for COVID-19. The health system is working to provide tests for these patients soon, she said.

Editor's note: This story has been clarified to state that the positive test results were for asymptomatic employees who were tested two weeks ago.

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

Comments

Anonymous
Duveneck/St. Francis
on May 6, 2020 at 6:15 pm
Anonymous, Duveneck/St. Francis
on May 6, 2020 at 6:15 pm
1 person likes this

Thank you, Stanford! Some of us know how very important these medical services are.


Changing patient care
Another Palo Alto neighborhood
on May 6, 2020 at 7:00 pm
Changing patient care, Another Palo Alto neighborhood
on May 6, 2020 at 7:00 pm
4 people like this

What is the risk to the patients of being in contact with someone who swabs people for infection?

Has the emergency room changed things so that people aren't in a small room waiting with all the other sick people, maybe for hours? I read that people aren't going to the ER when they need to, and given my last visit to the ER some years ago, I don't blame them.

I've been so grateful to be able to get medical care without having to go in or get any more x-rays than absolutely necessary for a break, etc. Maybe the new normal could be more telemedicine, and even more remote medical sensing so that people can avoid the humiliation and potential infections of going to the ER if they aren't actually have a heart attack, or so that women especially know in advance that they will be treated with respect and not in a degrading and gross Victorian-era-psychologizing manner (they'll already know what to expect when they get there from preliminary data).

I'm really grateful for our local medical centers and personnel, but the heroism in regards to Covid won't necessarily translate to fewer women being sent home in the middle of a stroke (after hours of degrading treatment) etc. Covid19 isn't gone, neither are other infections, maybe it's time we developed a better way of handling potential emergencies so that people do go in when they should and can spare themselves the expensive, humiliating, and potential-for-infection treatment if they don't need to. At the very least that would make more room for social distancing in wait rooms.


chris
University South
on May 6, 2020 at 7:29 pm
chris, University South
on May 6, 2020 at 7:29 pm
Like this comment

Changing,

The hospital is in a brand new building as of November. The emergency room is much much larger and more modern.


TimR
Downtown North
on May 6, 2020 at 10:24 pm
TimR, Downtown North
on May 6, 2020 at 10:24 pm
Like this comment

The Life Flight's back in business I hear, too (literally). On Monday I counted three flights. It's hard to imagine having a business model where you hope for sick and dying people, but there it is.


Changing patient care
Another Palo Alto neighborhood
on May 6, 2020 at 10:33 pm
Changing patient care, Another Palo Alto neighborhood
on May 6, 2020 at 10:33 pm
4 people like this

@chris,
Lots of new modern airplanes and theater houses in the world, and they seat people closer together than ever. A new modern airplane is going to have those of us in coach crammed even closer together to make more space for the business and first class. In fact, that's the business model (as explained to me by someone in the industry) -- everyone thinks the airlines make more money by cramming people together to get a few more seats in, and that's not what's going on. They make money be creating as much misery among those who can't pay for business or first class as possible--cramming people so close they can't rest or move (or distance), scheduling things without regard to the stress/sleeplessness/need to eat, etc.--that anyone who possibly can be induced to buy a business class or 1st ticket, will get their company to or pony up themselves. The extra space is needed to get more business class room in, not to sell more coach seats, that's not how they make their money. But I digress.

The point is, bigger, new, that doesn't correlate with ordinary people being treated with more respect and concern. Tell me something that changes what ER doctors are taught about the mental health of women and how they are treated if the doctors don't know what is wrong, or see a common "atypical" presentation of a stroke in a woman. Tell me something about the sea change of attitude that makes me understand why people used to be left for hours and hours in waiting rooms with clearly sick coughing people, and now they aren't (did we used to not die of infections before this?)

Elaborate please in a way that is relevant to the concern at hand -- do they now not leave people in waiting rooms together with who knows what to pass along to each other?

Don't get me wrong, I am grateful we have these facilities and the medical professionals in this area, and I think many of them have earned their sainthood through this pandemic, but you haven't shared anything that makes me think patients are anymore respected or given more space. People can be both grateful for the broader response to the pandemic, and fearful about going to the doctor or hospital based on their own past experience.


Resident
Old Palo Alto
on May 7, 2020 at 5:14 am
Resident, Old Palo Alto
on May 7, 2020 at 5:14 am
1 person likes this

People are generally afraid of going to any hospital due to the risk of hospital acquired infections.
It is clear that doctors and hospitals can not stay in business without ordering expensive tests and performing elective surgeries. Clearly a for profit business.
Stanford Health Care hospitals employ 14,000 people.


Madison
Woodside
on May 7, 2020 at 9:22 am
Madison, Woodside
on May 7, 2020 at 9:22 am
Like this comment

Is there a prioritizing list/category for elective surgeries?

[Portion removed.]


For profit health insurance
Community Center
on May 7, 2020 at 9:33 am
For profit health insurance, Community Center
on May 7, 2020 at 9:33 am
3 people like this

- Clearly a for profit business.

Costs too high, lower outcomes than other industrialized nations.

M4A. Get rid of bloodsucking for-profit insurance companies.


Alexa
Mountain View
on May 7, 2020 at 11:19 am
Alexa, Mountain View
on May 7, 2020 at 11:19 am
Like this comment

I suggest that the folks who are whining about how our world class hospitals stay afloat go to the UK where people have to wait for months in line for procedures like hip replacements if they cannot pay for a private hospital. Stanford has a program to help patients pay for health care if they are in financial trouble. Further Stanford is not a for profit hospital like Cancer Centers of America, for example, is. Check your facts folksm


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