Plans to reactivate gastroenterology practices following the COVID-19 pandemic: A survey of North American centers Journal Article

Authors: Kushnir, V. M.; Berzin, T. M.; Elmunzer, B. J.; Mendelsohn, R. B.; Patel, V.; Pawa, S.; Smith, Z. L.; Keswani, R. N.; on behalf of North American Alliance for the Study of Digestive Manifestations of Covid-19
Article Title: Plans to reactivate gastroenterology practices following the COVID-19 pandemic: A survey of North American centers
Abstract: Background & Aims: Practices dramatically reduced endoscopy services due to the COVID-19 pandemic. Because practices now are considering reintroduction of elective endoscopy, we conducted a survey of North American practices to identify reactivation barriers and strategies. Methods: We designed and electronically distributed a web-based survey to North American gastroenterologists consisting of 7 domains: institutional demographics, impact of COVID-19 on endoscopy practice, elective endoscopy resumption plans, anesthesia modifications, personal protective equipment policies, fellowship training, and telemedicine use. Responses were stratified by practice type: ambulatory surgery center (ASC) or hospital-based. Results: In total, 123 practices (55% ASC-based and 45% hospital-based) responded. At the pandemic's peak (as reported by the respondents), practices saw a 90% decrease in endoscopy volume, with most centers planning to resume elective endoscopy a median of 55 days after initial restrictions. Declining community prevalence of COVID-19, personal protective equipment availability, and preprocedure severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing availability were ranked as the 3 primary factors influencing reactivation timing. ASC-based practices were more likely to identify preprocedure testing availability as a major factor limiting elective endoscopy resumption (P =.001). Preprocedure SARS-CoV-2 testing was planned by only 49.2% of practices overall; when testing is performed and negative, 52.9% of practices will continue to use N95 masks. Conclusions: This survey highlights barriers and variable strategies for reactivation of elective endoscopy services after the COVID-19 pandemic. Our results suggest that more widespread access to preprocedure SARS-CoV-2 tests with superior performance characteristics is needed to increase provider and patient comfort in proceeding with elective endoscopy. © 2020 AGA Institute
Keywords: major clinical study; demography; prevalence; medical education; medical practice; cross-sectional study; safety; gastrointestinal endoscopy; health care access; north america; online system; telemedicine; pandemic; hospital volume; gastroenterology; web browser; gastroenterologist; human; article; north american; severe acute respiratory syndrome coronavirus 2; coronavirus disease 2019; covid-19; personal protective equipment; endoscopy operations; anesthesiological procedure
Journal Title: Clinical Gastroenterology and Hepatology
Volume: 18
Issue: 10
ISSN: 1542-3565
Publisher: Elsevier Science, Inc.  
Date Published: 2020-09-01
Start Page: 2287
End Page: 2294.e1
Language: English
DOI: 10.1016/j.cgh.2020.05.030
PUBMED: 32447019
PROVIDER: scopus
PMCID: PMC7242181
Notes: Article -- Export Date: 1 September 2020 -- Source: Scopus
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