The COVID-19 pandemic has led to disruptions in elective and outpatient procedures. Guidance from the Centers for Medicare and Medicaid Services provided a framework for gradual reopening of outpatient clinical operations. As the infrastructure to restart endoscopy has been more clearly described, patient concerns regarding viral transmission during the procedure have been identified. Moreover, the efficacy of the measures in preventing transmission have not been clearly delineated. We identified patients with pandemic-related procedure cancellations from 3/16/2020 to 4/20/2020. Patients were stratified into tier groups (1–4) by urgency. Procedures were performed using our hospital risk mitigation strategies to minimize transmission risk. Patients who subsequently developed symptoms or tested for COVID-19 were recorded. Among patients requiring emergent procedures, 57.14% could be scheduled at their originally intended interval. COVID-19 concerns represented the most common rescheduling barrier. No patients who underwent post-procedure testing were positive for COVID-19. No cases of endoscopy staff transmission were identified. Non-COVID-19 related patient care during the pandemic is a challenging process that evolved with the spread of infection, requiring dynamic monitoring and protocol optimization. We describe our successful model for reopening endoscopy suites using a tier-based system for safe reintroduction of elective procedures while minimizing transmission to patients and staff. Important barriers included financial and transmission concerns that need to be addressed to enable the return to pre-pandemic utilization of elective endoscopic procedures.

中文翻译：

---

在不断演变的大流行和患者感知的影响中安全地重新启动选择性内窥镜检查

COVID-19 大流行导致择期和门诊手术中断。医疗保险和医疗补助服务中心的指导为逐步重新开放门诊临床操作提供了框架。由于重新开始内窥镜检查的基础设施已得到更清楚的描述，因此已经确定了患者对手术过程中病毒传播的担忧。此外，这些措施在防止传播方面的有效性尚未明确界定。我们确定了从 2020 年 3 月 16 日至 2020 年 4 月 20 日期间取消大流行相关程序的患者。患者按紧急程度分为等级组 (1-4)。使用我们的医院风险缓解策略执行程序，以最大限度地降低传播风险。记录随后出现症状或进行 COVID-19 检测的患者。在需要紧急手术的患者中，57.14% 的患者可以按照原定的时间间隔进行安排。COVID-19 问题是最常见的重新安排障碍。没有接受术后检测的患者对 COVID-19 呈阳性。没有发现内窥镜检查人员传播的病例。大流行期间与 COVID-19 无关的患者护理是一个具有挑战性的过程，随着感染的传播而演变，需要动态监测和协议优化。我们描述了我们使用基于分层的系统重新开放内窥镜套件的成功模型，以安全地重新引入选择性程序，同时最大限度地减少对患者和工作人员的传播。重要的障碍包括需要解决的资金和传播问题，以便使选择性内窥镜手术恢复到大流行前的使用状态。