COVID 19: New and Updated Information and Resources
NJAASC has curated authoritative information and a list of resources for our Membership’s reference. We will continue to update this as more information becomes available.


PAST COVID E-BLAST HAVE BEEN ARCHIVED DUE TO SPACE RESTRAINTS AND TO KEEP THINGS CURRENT. 
TO VIEW PREVIOUS E-BLASTS, CLICK HERE

ASC PPE REPORTING PORTAL – 6/12/20
Licensed ASCs  will be receiving the e-mail below from DOH- Jean DeVitto.
This is the first step in following the guidance for PPE reporting.
 
This was a cooperative and collaborative effort between NJAASC and the Department, and I would thank them for reaching out including us, and incorporating our suggestions for reporting.
 
You will send back to them via the e-mail address noted all the contact information for the person(s) responsible for entering this information on the portal.
 
 
DO NOT REPLY UNTIL YOU RECEIVE THE OFFICAL E-MAIL FROM THE DEPARTMENT!
This is just a sample to show you what it will look like
 
At the bottom, you will also find the questions that will have to be answered. Some are one time only, the others will be weekly. 
In conference with the Department, NJAASC went over these questions last week and hashed them out, so they should be straight forward and answerable.
 
Everyone should also see that they are asking for information as regards issues with testing. This again should not be difficult, as you have been keeping track of this via the NJAASC data spread sheet for two -three weeks already. 
 
This is what the e-mail from The Department will look like; again  DO   NOT  respond now, wait for your official contact e-mail from the Department.
Good Afternoon,
The Department of Health Executive Directive XX-XXX states that all ambulatory surgical facilities (ASC) must comply with Governor Murphy’s Executive Order No. 111 (2020) concerning reporting of data, including PPE inventory and weekly cases. The portal designated by the New Jersey Office of Emergency Management under Executive Order No. 111 (2020) is maintained by the New Jersey Hospital Association. In order to receive access to the portal please send an email to  ASC.ResponsePlan@doh.nj.gov   with the name and license number of your facility in the subject line, the NAME and CONTACT information including Email for a maximum of two people that will be entering information into the portal.
 
DOH will send a link to the portal with registration and log-in instructions in a separate communication. Please send your email no later than Tuesday June 16, 2020 by close of business. 
 
Thank you in advance for your cooperation.
 
Ambulatory Surgical Centers
Reporting Associated with Guidance on Resumption of Elective Surgery and Invasive Procedures
Revised Questions 6/10/2020

Unless otherwise noted, data will be reported weekly. This may change to daily in event of surge. In addition, there will be one-time retrospective reporting of patient volume for each month from January 2019 to May 2020.

Category: Monitoring Patient Volume
 
Rationale for these questions:
·         Monitor if/when patient volumes return to pre-COVID “normal” levels.

Question
1.       How many patients were served (# cases of procedures or surgeries completed) during each month of 2019 and 2020?
Data variable requirements
Insert whole number for each month in 2019 and in 2020.
 
(At this moment, month by month data can be collected for January 2019 through May 2020).
Frequency of data reporting
Retrospective: One-time in June 2020.  Going forward: Ask mid-month for prior month (e.g. report June 2020 data by July 15).

Question
2.       Since my facility’s last report, how many patients were served (# cases of procedures or surgeries completed)?
Data variable requirements
Insert whole number.

Frequency of data reporting
Weekly

Category: Confirmation of Care Capacity
 
Rationale for these questions:
·         Prompts the ASC to actively monitor these metrics each day.
Question
1.       My facility has a current transfer agreement with the following licensed acute care hospital facilities:

Data variable requirements
List of acute care hospitals (checkbox)

Frequency of data reporting
Enter once.
Data available for editing each day, so ASC can  update as needed .

Question
2.       Since my facility’s last report, my facility  could not  perform cases due to capacity data in one or more of the following:

Data variable requirements
Checkbox.
1.       Transfer hospital was on divert (monitor NJDOH Hippocrates system).
2.       In transfer hospital’s region, hospitalizations were on an upward trajectory (monitor NJ COVID-19 data dashboard).
3.       Statewide capacity data (hospitalizations, ICU/critical care bed usage, med surge bed usage, and/or ventilator usage) were on an upward trajectory (monitor NJ COVID-19 data dashboard).
4.       Unable to confirm capacity of transfer hospital

Frequency of data reporting
Weekly


Category: PPE and other Supplies Inventory
 
Rationale for these questions:
·         Monitor burn rate at ASCs.
·         Monitor quantities needed to sustain services at ASCs.

Question
1.       For PPE that is necessary for care, how many days worth is currently in inventory on hand?
·         ASCs must have a minimum 7 days supply.
·         CDC PPE Burn Rate Calculator:  https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html

Data variable requirements
Insert whole number.

Frequency of data reporting
Weekly

Category: Testing

Question
1.       How many scheduled cases were delayed or canceled due to COVID test result not available at time of case?

Data variable requirements
Insert whole number.

Frequency of data reporting
Weekly

Question
2.       How many scheduled cases were delayed or canceled due to patient unable to get tested (specimen collection) within 6-6 days of the case?

Data variable requirements
Insert whole number.

Frequency of data reporting
Weekly

Question
2.A. If so, which reasons prevented patient testing (specimen collection)? Check all that apply.
·         Delay in obtaining pre-op prescription
·         pediatric patient
·         patient non-compliant
·         no nearby testing site
·         cost of test
·         unable to schedule testing
·         Other

Data variable requirements
Checkbox

Frequency of data reporting
Weekly

Question
3.       How many scheduled cases were delayed or canceled due to patient testing COVID-positive?
·         Some facilities and procedure types may serve COVID positive patients.

Data variable requirements
Insert whole number

Frequency of data reporting
Weekly


DATA COLLECTION SPREADSHEET – 6/12/20
Please forward your data collection spreadsheet by end of today if you have not already.
Send to:  akuris@njpsi.com
Do not sent it to me, please!
 
We are going to forward our collected data along with a letter to the Department on Monday, with our recommendations.

Q&A FROM THE DEPARTMENT – 6/12/20
Q:    Here are two more issues that are surfacing :
^ Physicians are considering doing testing in their offices to address the issue of the tests not being returned within 92 hours. The delay in response from the lab is very frustrating for the patients when they are cancelled. They are losing work time and must be quarantined again . In addition , there are additional costs to the center when done
there. PPE which is still hard to get and is required .
 
^The big question is: If the patient is positive when tested on the day of surgery, who reports the positive and does the staff who completes the test have to be quarantined because of the exposure to a positive patient is the test is positive.  Grant you the staff uses PPE for the test but must change their PPE.
 
^Another question: if the patient is injured and the physician wants to use the
ASC but there is not time for a test, can the center do the surgery. I said today but need your input.
 
^As you have mentioned in your publications the guideline is a rule. However physicians are not accepting the rules and ARE creating a lot of stress in the centers as you have heard.

A:  1) I'm not sure what you mean by who reports the positive. The LHD were the person lives must be notified and the person must be notified of the results.
 
2) Please review the CDC Exposure Risk Assessment. If the tester was wearing appropriate PPE and did not have unprotected exposure to the positive patient the tester will not need to quarantine. 
 
3)  A negative result is needed to have surgery in an ASC. 
 
4)  ASCs are required to follow this guidance. It is not optional.  

WE GAVE YOU A RESOURCE, PLEASE USE IT!
ACCEPTABLE MOLECULAR TESTS – 6/12/20
We provided a resource for all centers to be able to actually look up and verify applicable/acceptable COVID tests.
Please, please use the link below, it is easy, trust me!

I want to reiterate that the ONLY acceptable testing per DOH guidelines is Molecular, no serology. So you access the list via the link below and in technology column if it says: Molecular, you are good to go. If it does not, you cannot use it.
Thus for instance if you are using the Rapid Finger Stick Test- and I know centers are, you are in violation of the guidelines, while the Rutgers Saliva Test is acceptable.
DOH has indicated that they will be enforcing the guidelines as regards testing, so make sure you are doing the right thing.

Rapid Finger Stick Test: This would not be acceptable as it is an antibody test. Please see  https://www.fda.gov/medical-devices/emergency-situations-medical-devices/emergency-use-authorizations  for a list of acceptable molecular tests that have been granted emergency use authorization from FDA (in the table entitled “Test Kit Manufacturers and Commercial Laboratories Table:”).  Note the ‘technology” column indicates if tests are molecular or something else.
Questions? Contact Jeff Shanton at  jshanton@jssurgctr.com