Inslee issues additional clarification of limits on elective surgeries and procedures

OLYMPIA-On April 30, Gov. Jay Inslee announced additional guidance for the existing order on limiting non-urgent medical procedures.

The Governor's 'Stay Safe, Stay Home' proclamation  ensured appropriate surge capacity and personal protective equipment (PPE) in hospitals and other health care facilities to manage an influx of COVID-19 patients.

This new guidance provides clarification on what type of non-urgent surgeries are permitted under the order.

"Washingtonians have taken the threat of COVID-19 seriously, and that includes our doctors and nurses. But there are some much needed procedures that aren't being performed that should be, and we need to make sure that everyone gets the care they need during this time," Inslee said. 

All services considered to be "emergent" or "urgent" for which delay would result in worsening a life-threatening or debilitating prognosis are allowed.

The Proclamation limits, "healthcare services, procedures, and surgeries that, if delayed, are not anticipated to cause harm to the patient within the next three months..." 

The Proclamation does not provide a definition of "harm." To clarify, the Governor leaves assessment of harm up to the individual clinician.

In order to assess harm, clinicians should consider if a patient's illness or injury is: causing significant pain, significant dysfunction in their daily life or work, and whether leaving them untreated could make them more vulnerable to COVID-19.

Clinicians should also weigh these factors:

• Expected advancement of disease process 

• Possibility that delay results in more complex future surgery or treatment 

• Increased loss of function 

• Continuing or worsening of significant or severe pain 

• Deterioration of the patient's condition or overall health 

• Delay would be expected to result in a less-positive ultimate medical or surgical outcome 

• Non-surgical alternatives are not available or appropriate per current standards of care 

• A patient's co-morbidities are risk factors if inflicted with COVID-19 after procedure is performed 

Examples of procedures to delay, include, "most joint replacements, most cataract and lens surgeries, non-urgent cardiac procedures, cosmetic procedures, some endoscopy and some interventional radiology services." 

Furthermore, diagnostic imaging, diagnostic procedures or testing should continue in all settings if disease is suspected.

Outpatient clinic visits, both in hospital-based clinics and other outpatient clinic settings are permitted.