ABSTRACT
Objective: During the COVID-19 pandemic, there was a significant decrease in the number of operated elective cases due to the shutdown procedures. This situation created a substantial surgical backlog. Several visits are generally necessary before a surgical decision making and booking the surgery time. Improving patient access by creating “one-stop” clinics might help decrease the number of visits before the surgery. This study investigated the effect of one-stop clinic application as a new care model on COVID-19 surgical backlog clearance. Methods: We conducted a quasi-experimental, interrupted time-series, pretest-posttest study design in the northern areas of Saudi Arabia. The study outcomes were the number of surgeries and the time elapsed from the first seen day to the booked room day. Results: A total of 358 surgeries were included. Of them, 107 (29.9%) surgeries were performed before initiation of the one-stop clinic and 251 (70.1%) after initiation. The median (quartile Q1, Q3) time elapsed from the first seen day until the booked OR day post-one-stop clinic was 10 (6-17), which was significantly lower than pre-one-stop clinic 20 (11-33), P < 0.0001. Conclusion: One-stop clinics shortened the period between first visit and booking in the operating room. One-stop clinics may alleviate the surgical backlog resulting from the COVID-19 crisis. [ FROM AUTHOR] Copyright of Journal of Health Sciences (Qassim University) is the property of Journal of Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
BACKGROUND: Coronavirus 19 pandemic impacted the health system with more pressure on the critical areas, leading to direct manpower working in the Operating Room to help treat this new problem by postponing elective surgical cases and affecting some urgent ones. However, elective surgical services start to recover by establishing one or more hospitals that deal with COVID-19 free patients (green hospital) in each area with a dedicated one to treat COVID19 cases. Our research shows if this model's application assures safe and continued recovery of surgical services to reach the level before the pandemic. This study aimed to explore if assigning a green hospital to assure safe and continuous resumption of surgical services during a pandemic. METHODS: This study used a multicenter, national, quasi-experimental, post-test-only control group design. All hospitals assigned at least one hospital as a green hospital (COVID-19 free hospital) in the northern areas of Saudi Arabia were included in the study. We also included Riyadh's large tertiary care hospital as a control none green hospital. We reported the number of surgical backlog in each city, the number of surgical cases performed, the percentage of OR utilization in each city and the percentage of COVID-19 cases to the number of ICU bed cases in each city. RESULTS: This study included green hospitals in five cities in the northern area of Saudi Arabia. Besides, we included one none large green hospital in Riyadh city as a control group. The median of weekly procedures in green hospitals was 101 (99, 109.5) in Alqurayat, 233 (194, 237) in Tabuk, 180 (162, 199) in Haill, 108 (90, 120) in Al Jawf and 257 (155, 313) in Northern Borders. The median of weekly procedures in the control hospital was 245 (215, 259). Green hospitals contributed to reducing the surgical backlog by a median percentage of 74% (38, 108) in Alqurayat, 25% (21, 26) in Tabuk, 8% (7, 9) in Haill, 81% (54, 91) in Al Jawf and 78% (72, 88) in Northern Borders. While in the control hospital was 8% (8, 9). CONCLUSION: Implementing elective surgeries in green hospitals contributes to a continuous resumption of surgical services during the COVID-19 pandemic.