As the surge in COVID-19 patients begins to recede in some areas of the country, hospitals are considering when and how to resume elective procedures. But healthcare consumers may behave in unexpected ways. Health systems may overestimate how quickly or easily patients will want to move forward with their elective procedures, and it will likely require time and resources for physicians to convince patients to do so.
Those are the conclusions drawn by Vizient in a recent webinar panel discussion with patient and family advisors – patients and family members who have received care at healthcare organizations and who partner with them to improve quality, safety and the patient experience. Administrators, clinicians and staff engage PFAs through Patient and Family Advisory Councils.
Patients will most likely come back to their elective procedures in waves, Vizient found. The initial wave of patients will include those pining to move forward no matter the risk (oncology patients, patients impaired in their activities of daily living or those in pain), followed by a second wave that may feel safe because of their perceived low personal risk or need for a low-risk procedure with little follow-up.
Learn on-demand, earn credit, find products and solutions. Get Started >>
When these first two waves are scheduled for their elective procedures, physicians will need to engage the next potential group of patients – those who feel less safe – to ensure a steady stream of revenue. These patients are almost guaranteed to have questions and will need to have discussions with their doctor about their risks and benefits.
They'll also need details and data, and will take their time to decide. Discussions and data won't help the last group of patients move forward with elective procedures. They'll wait until there is a vaccine or a proven cure for COVID-19, and there will be no convincing them to do it sooner.
WHAT'S THE IMPACT?
The patient and family advisors, or PFAs, attending the webinar were polled on a series of questions, and tops on the list was how safe they would feel if they or a family member went to their preferred hospital for an elective procedure today. Only a small number of PFAs, 4%, felt "very safe" regarding having a procedure at their preferred hospital today. A higher number, 13%, felt "very unsafe" about it.
The majority of PFAs felt "somewhat safe," 56%, with 25%, feeling "somewhat unsafe."
As the hypothetical time frame shifted, so did the numbers. Roughly half of PFAs would feel "somewhat safe" having a procedure in three months – an interesting arc, given a higher number said they would feel somewhat safe today. A high number of PFAs, 32%, felt "neutral" about having a procedure in three months. The number of PFAs who would feel "very safe" in three months was 13%, an 11% increase when compared to the more immediate time frame.
The majority of PFAs would proceed with an elective procedure when their doctor or hospital says it's safe. Interestingly, 21% said they would proceed when a loved one is allowed to join them for the entire procedure. Slightly less, 18%, said they would wait until after they received a COVID-19 vaccine or there was a proven cure for the virus.
A whopping 84% said telehealth would be their preferred means of receiving care for minor illnesses.
Patients and families want to know what has changed from when they were told to stay at home, including details about hospitals' personal protective equipment inventory, infection rates and availability of COVID-19 testing, Vizient found. PFAs said they want transparent, frequent and consistent communication from healthcare organizations – general information provided through social media and local news outlets, as well as direct communication from physicians.
Patients and families also expect a detailed plan with checklists and instructions to help them and their family caregiver understand what will happen when they come to a hospital, including patient flow from pre-procedure through discharge. To feel safe, they want to see safety and infection-prevention processes in action, such as cleaning of handrails, elevator doors and other high-touch areas, as well as clinicians using personal protection equipment throughout the course of their procedure and stay.
THE LARGER TREND
Waystar estimates that the cancellation of elective procedures has cost hospitals about $161 billion as of mid-May. Meanwhile, the Advisory Board has advised hospitals that they should confirm their ability to safely manage elective procedures before resuming them.
Hospitals can safely do procedures when the region is past the COVID-19 curve; when there is state and local government approval; sufficient beds, supplies, including PPE, and staff; and there is the capability to screen patients and staff for COVID-19 symptoms, Advisory Board said.
ON THE RECORD
"When it comes to restarting elective procedures, healthcare organizations need more than speculation about how patients might behave – they need to be able to accurately forecast demand to ensure they have the proper capacity, supplies and staffing in place," said Kellie Goodson, director of performance improvement for Vizient. "The guidance provided by professional associates and industry experts is necessary, but leaves out a key piece of the puzzle: patient behavior."