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PAST COVID E-BLAST HAVE BEEN ARCHIVED DUE TO SPACE RESTRAINTS AND TO KEEP THINGS CURRENT.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
REVISED, ED 20-016 FROM 7/29/20- CLICK HERE

SUGGESTED TEMPLATE FOR OPTION #2 TESTING UNDER REVISED ED 20-016-7/31/20
Under the latest 7/29/20 revision of ED 20-016, the Department provides for two new options as regards testing- and retains a third ( Time Sensitive -p.9)
 
In my and most people I speak with opinion, option #1 is the best and absolutely the safest option for ASCs- as it assures that any patient seen in your ASC will have a negative test result even if delayed beyond the six days.
 
The Department has also given us Option #2.
#2 would allow for performing a procedure if test results have not been received in the requested time (6 days). This option CANNOT be used until the 6 day time frame has expired, remember that.
If you choose to utilize this option, there are several other things you need to do, including documentation.
See TESTING, p.7, i.
‘To proceed with the procedure as scheduled, provided the decision to proceed with the procedure as scheduled without a test result is based on a clinical assessment performed by a physician prior to surgery evaluating the risk involved if the patient is COVID positive during the procedure.’
‘The physician performing the assessment must note the rationale why awaiting the testing result is not necessary and it is appropriate to move forward with the procedure in the patient medical record’.
 
Thus it would seem appropriate that centers utilize a template akin to what is already being used (hopefully) for time sensitive cases, and retain it as part of the surgical chart.
 
Remember as well that in addition to the physician assessment and rationale for performing, you must treat the patient as if COVID POSITIVE.
This means following the IC guidelines of ED 20-016, which are found on page 9 h. ii.
You can only use option #2 if you do all of the above.

 
REMEMBER THERE IS A DIFFERENCE BETWEEN TIME SENSITIVE CASES AND THE NEW OPTION #2 - 7/31/20
I thought I would expound and explain this a bit, as there seems to be some uncertainty amongst centers.
 
In the revised ED 20-016 from 6/25/20, the Department gave us the option of ‘ time sensitive’  cases. This option remains in the new 7/29/20 revised ED as well, on page 9.
This option is strictly for emergency procedures- those that would ‘ endanger the health of the patient if delayed’  and requires documentation (for which we previously provided a template in June) and following IC protocols as outlined within the ED -page  9 h.ii.- you are assuming the patient is COVID positive.
You may perform a ‘time sensitive’ case at any time after the patient is tested, but without a current test result.
 
Option #2 in revised ED 20-2016 7/29/20 is found on page  7 b.i.
If you choose to utilize this option, you can only do so if a negative test result is not received  AFTER day six
You would follow the physician assessment guidelines as outlined in  b.i , and the IC protocols found in  h.ii. – you are assuming the patient is COVID positive.

RUTGERS SALIVA TEST- IS IT THE SOLUTION TO TESTING PROBLEMS? – 7/31/20
We have heard a lot about this test, but its use appears to be minimal. That seems strange as it is touted by the Governor and the State all the time!
This test is appropriate for pre-procedure screening of patients for ASCs, which makes it very attractive, as does its stated time frame for test results.
 
It would appear to be an optimal solution to ASC testing issues and concerns.
NJAASC intends to initiate discussion with both the DOH and Infinity as regards this test and options for use by ASCs.

FROM ASCA: New Jersey Revises Executive Directive Regarding Testing - 7/31/20
In a change to testing requirements, the New Jersey Association of Ambulatory Surgery Centers (NJAASC) successfully convinced the state’s Department of Health to revise its  executive directive  restarting elective surgeries to grant ASCs additional flexibility when dealing with testing delays at labs. ASCs in the state will now have two options if a test result is not received within six days: reschedule a procedure until after the test result is received or proceed with a procedure provided that infection control policies established by the Department of Health are followed. The revised directive additionally clarifies that antigen tests may not be used to fulfill state testing requirements.
Contact  Stephen Abresch  with any questions.   

Questions? Contact Jeff Shanton at  jshanton@jssurgctr.com