Anouk van Alphen, MD
Maastricht University

COVID-19 has put a lot of pressure on healthcare systems worldwide. Hospital resources necessary for critical care were needed for the COVID-19 patients. As a result, surgical resources—such as operating rooms (OR) or surgeons—were reassigned. This led to less available capacity for surgical care. Consequently, surgeries were deferred and the backlog of patients awaiting surgery accumulated. Even though the last COVID-19 wave occurred some time ago and we have the impression to be in calmer waters, the longstanding impact on our healthcare delivery is immense.

Since the surgical capacity was reduced over the past years, physicians were forced to make difficult decisions on which patients to treat first, so-called prioritization. This process of prioritizing patients within hospitals was far from objective nor transparent. During the pandemic, this potentially could lead to conflicts of interest across hospital departments. With our research, we tried to support physicians during the difficult decision-making process by providing them with a model to establish the urgency of surgeries objectively. Thereafter, this urgency was combined into an overall ranking of surgeries that could be used by physicians to prioritize patients from different surgical departments.

With our current research, we added more surgeries to our model, thereby increasing the usefulness for daily practice, as more surgeries are represented. One of the main advantages of this specific extension is that it also adds elective surgeries to the ranking. Elective surgeries are non-emergency surgeries and have therefore oftentimes been rescheduled or postponed during the pandemic. Hence, the main part of the current surgical backlog consists of elective surgeries. By adding these surgeries, our ranking could be of more practical use for the problems healthcare organizations are currently dealing with.

The current research can be seen as a paradigm shift: we propose a new way of thinking about prioritization. We think that models could support healthcare professionals working in the field and will therefore be vital in the foreseeable future. COVID-19 challenged our healthcare systems dramatically, and looking forward, there will be other disruptions leading to scarce surgical resources, such as budgetary constraints or personnel shortages. Future research should focus on the optimization and implementation of such models, which will hopefully lead to thoughtful and transparent prioritization. 

Abstract will be presented in the Friday Afternoon Poster Presentations: Slot 6 on 21 October, 3:00 pm – 3:15 pm. 

This newsletter editorial represents the views of the author and does not necessarily reflect the views of ISOQOL. 

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