In an attempt to consolidate resources to address the COVID-19 pandemic, medical facilities around the world had no choice but to delay thousands of elective surgical procedures [1]. Due to the resurgence of SARS-CoV-2 through new variants, the pandemic was prolonged, causing many medical facilities to operate at significantly reduced capacity throughout 2021 [2]. As a result, the list of pending surgeries stretched considerably and was expected to “grow to a cumulative backlog of more than 1 million cases [two] years after the end of elective surgery deferment,” with the size of the backlog at any individual facility depending on its location and size [2, 3]. Though COVID-19 has become better controlled and an accepted backdrop to daily life for many, the continuing surgical backlog in some places has significant impacts on health.
The consequences of this phenomenon are dire. First and foremost is the effect of the elongated backlog on the patients. Although elective surgeries do not “need to be done immediately ‘to maintain life or limb,’” this class of procedure still encompasses a wide range of operations with important consequences on patients’ quality of life and future health prospects [4]. To illustrate, consider how the pandemic had an especially detrimental effect on the volumes of cancer, orthopedic, cardiac, general, and urology surgeries performed nationwide [5]. Research indicated that elective surgeries across these specialties had yet to rebound significantly by the middle of 2022 [5]. While some surgeries can be delayed without detrimental impacts on a patient’s outlook, the long-term effects of neglecting cancer- or cardiac-related conditions, for example, can be disastrous even if not considered emergent at the time [5]. This phenomenon could explain the inconsistent recovery rates noted by patients post-pandemic; it could also contribute to rising death rates and morbidity in the future [5].
Medical facilities and practitioners have also been affected due to this considerable strain on resources. A report by McKinsey & Company found that, between March and June 2020 alone, the economic value of canceled surgeries was about $200 billion [3]. Decreased hospital revenue could impair the quality of healthcare services going forward, which feeds into the aforementioned crisis in patient care perpetuated by the pandemic. Additionally, increased work affects medical practitioners’ daily work schedules, potentially contributing to stress, burnout, and other mental health issues.
In response to the continuing surgical backlog, commentators have suggested various potential solutions. One recommendation is for medical facilities to apply data analytics that would allow them to prioritize procedures [3]. Phoenix Children’s Hospital introduced one such technology in the form of a dashboard that allows schedulers, surgeons, and others to coordinate care by serving as a central hub for all relevant information [3]. Thanks to their use of this tool, the hospital was able to successfully reschedule at least 3,000 backlogged surgeries [3].
Another possible solution is employing temporary staff to increase the capacity of struggling medical facilities [3]. By enlisting the help of therapists, lab techs, and/or travel nurses, institutions can schedule more surgeries and thus work on diminishing their backlogs [3]. In line with this strategy, the University of Utah Hospital brought a U.S. Navy medical team in for about 30 days to help them address the 500 surgeries it had delayed during the pandemic [4]. Similar approaches could be used in other areas to tackle their backlogs.
Whether a medical facility opts for one of these strategies or another option, the importance of coordinating a strategy to address the continuing surgical backlog cannot be understated. Proactive, informed ways to address the surgical backlog are one of several essential measures that medical institutions will need to return to pre-pandemic normalcy [4].
References
[1] T. Hampton, “Surgeries fail to return to pre-pandemic levels,” The Harvard Gazette, Updated August 23, 2022. [Online]. Available: https://news.harvard.edu/gazette/story/2022/08/surgical-procedures-havent-recovered-from-covid/.
[2] S. Ghoshal et al., “Institutional Surgical Response and Associated Volume Trends Throughout the COVID-19 Pandemic and Postvaccination Recovery Period,” JAMA Network Open, vol. 5, no. 8, August 2022. [Online]. Available: https://doi.org/10.1001/jamanetworkopen.2022.27443.
[3] A. Tank, “4 strategies for addressing an elective surgery backlog,” CHG Healthcare, Updated December 14, 2021. [Online]. Available: https://chghealthcare.com/blog/elective-surgery-backlog/.
[4] “How 7 health systems are tackling delayed surgery backlogs,” Advisory Board, Updated March 7, 2022. [Online]. Available: https://www.advisory.com/daily-briefing/2022/03/07/delayed-surgeries.
[5] E. Carbajal, “COVID-19 surgical backlogs persist: 4 things for hospital leaders to know,” Becker’s Hospital Review, Updated August 23, 2022. [Online]. Available: https://www.beckershospitalreview.com/care-coordination/covid-19-surgical-backlogs-persist-4-things-for-hospital-leaders-to-know.html.