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.