Northern Montana Hospital starting elective surgeries

On Friday, March 13, we experienced our first exposure to the COVID-19 virus here in Hill County. Our chief medical officer, our Administrative Council and our directors met and made the decision to limit access to Northern Montana Hospital and the Northern Montana Care Center to protect our patients and this community. Over the following weekend we expanded our precautions to include our clinics. We also reached the conclusion that we would need to temporarily eliminate elective surgeries at NMH, as other hospitals have done across the country.

One of the things we learned from our colleagues elsewhere is that the supplies of Personal Protection Equipment was going to be one of our biggest issues as we worked through this. These supplies were limited as a result of the Coronavirus in China, where the majority of these supplies are manufactured, and were now going to be further depleted by our need to protect our medical personnel, patients, and the public from exposure to the virus.

Elective surgeries were put on hold for several reasons. One of the reasons was to cut down on the amount of traffic entering NMH. We redirected employees from our surgical department to assist with other areas. Another reason was that the PPE normally utilized during surgeries is the same equipment needed for possible COVID-19 cases. We did not make this decision easily as we know our community relies on us to provide them with medical care.

We are now eight weeks into this crisis. We are holding strong with one confirmed case in Hill County. We feel that this is largely due to the combined efforts of the community, our public health officials, and our staff taking the situation seriously, making tough decisions and being committed to keeping this community healthy.

We are now at the point where we feel comfortable scheduling more surgeries and procedures here at NMH. Starting this week, we have been adding several procedures into our daily schedules. We are assessing the cases based on the urgency of individual situations and on possible risk/exposures. Monitoring our supplies as we move along will also be a factor in these decisions. We will be contacting our patients in order to reschedule their procedures.

Our normal processes have been altered as well during this time. We have implemented changes that allow us to keep our COVID-19 protocols in place while still serving our community. Patients are being asked to adhere to the following changes:

• Patients are being allowed one adult support person to accompany them into our building.

• Both the patient and the support person will be screened prior to entry. This screening consists of a temperature check, questions about symptoms, travel questions, and possible risk/exposures.

• Both the patient and support person will be masked. They are encouraged to bring their own, but if not, they will have one issued to them.

• They will then be escorted into a room in our Surgical Day Care area. Until the patient is released the support person will remain in this room in the SDC.

• Once the procedure/surgery is complete and the patient has recovered, we will release them to return home through a separate entrance of our building.

We may also perform rapid screenings for COVID-19 prior to scheduling patients. Our ability to test will remain a factor in these decisions. Our situation changes daily and we will do our best to make the correct decisions in regards to our patients. We feel confident that the changes we have made will allow us to protect our patients, the public, and our staff. We thank our community in advance for their understanding as we work through our backlog.

We are truly thankful to be a part of this community.

——

Damian Ymzon, MD, FACS, is chief of surgery at Northern Montana Hospital