Essentia Health recently resumed elective surgeries after those kinds of medical procedures were suspended per the Minnesota governor’s orders related to the coronavirus pandemic.

“During the month of March through April, we were probably running at 20% to 30% of our budgeted number of cases that we typically would do, so it was a drastic reduction,” Dr. Troy Duininck said during a phone interview.

The health care provider was dealing with preparations for a possible surge of COVID-19 cases but since has made changes to enable it to continue safely with elective surgeries, according to officials.

“If delaying the surgery any longer would have either made the surgery significantly more challenging or would have potentially caused long-term harm to the patient … we started allowing some of those cases to go forward,” he said of changes made in May.

Essentia Health is also now performing other diagnostic tests across all specialties, including ear, nose and throat, orthopedics, ophthalmology, urology, general surgery, plastic surgery and oral surgery, but its offerings are dependent upon the COVID-19 pandemic.

“We suspended all what we would refer to as ‘elective surgery,’ so these are surgeries that there wasn’t any urgency or emergency to them. What we continued to do was any type of trauma surgery, fractures that needed to be repaired,” Duininck said.

Duininck, chairman of the surgery department for Essentia Health in the Brainerd lakes area, elaborated on what was continued under Gov. Tim Walz’s order.

“We’d continue to do most of our cancer operations or oncologic surgery. And then there were some operations that also continued things like if patients had kidney stones that were causing either severe pain that they needed to be hospitalized,” he said.

Walz later permitted elective surgeries to resume, and the Minnesota Department of Health issued a document outlining what each hospital needed to have in place before they could resume with elective surgeries.

“We started with only outpatient cases because we wanted to make sure we were able to continue all the safeguards we had in place already … keeping people socially distanced, making sure we had staff available, making sure we had PPE (personal protective equipment) that was adequate,” Duininck said.

Availability of testing for COVID-19 played a role as well in rescheduling elective surgeries, he explained.

“The other thing was that we wanted to have the ability to test every patient you’re operating on … so once we started opening surgery up, each of the surgeons that had patient backlogs started adding patients back onto the schedule, and the largest group of patients was with our orthopedic department,” Duininck said. “Specifically for surgery patients, we are testing all of our surgery patients. All of our surgery patients are getting tested for COVID prior to coming in for surgery.”

If an Essentia Health patient had a surgery that was canceled, the person’s doctor’s office will reach out to him or her to discuss the next steps and determine along with a care team what is best for that person’s health situation going forward.

“Most of the surgery areas — general surgery, urology, obstetrics and gynecology — are back now to having gone through their backlog and gotten the patients back on the schedule, who had been taken off the schedule,” he said.

Essentia Health staff analyzes almost daily whether it has a sufficient number of beds, workers, PPE such as face masks or face shields based on Minnesota Department of Health guidelines, according to Duininck.

“We have set in place certain triggers that, if we meet those triggers, we will then start backing off on elective surgery. But where we’re at right now, in the setting we’re at, we’re pretty much doing everything we had been doing prior to this pandemic hitting us in early March,” he said.

Elective surgeries were allowed to start again May 11, bringing in more people and revenue for non-emergency work. But the loss of revenue leading up to that resulted in Essentia’s plans to eliminate about 6% of its overall workforce amid the COVID-19 pandemic, or 900 of its workers.

Essentia Health separates its medical patients from its surgical patients at its facilities, along isolating those with COVID-19, for example, keeping them on different floors, according to Duininck.

“Regarding the fact that we are in the midst of a pandemic and there is some slight risk of contracting COVID coming into a hospital or even an outpatient surgery setting, we have those discussions with our patients,” he said.

Essentia Health elective surgeries

• General surgery,

• Hernia repair,

• Colorectal surgery,

• Cancer-related surgeries, including breast, colorectal and lung,

• Gynecologic surgery,

• Urologic surgery,

• Endocrine surgery,

• Podiatry related surgeries,

• Robot-assisted surgery with the da Vinci surgical robot, and

• Joint replacement surgeries.

Essentia Health safety measures

• Universal masking for all patients, visitors and staff.

• Limiting visitors.

• Screening for COVID-19 symptoms at entrances.

• Rigorous hand hygiene.

• Redesigned common areas to ensure social distancing.

• Cleaning/disinfecting common waiting areas.

• Following meticulous room disinfection guidelines.

• Expanded COVID-19 testing for patients scheduled for a treatment or procedure.

• Restricted designated floors/units specifically to care for patients with COVID-19.

• Converted COVID-19 hospital rooms to create negative air pressure with special filters and increased the number of air exchanges per hour to limit exposure to the virus in the air.

FRANK LEE may be reached at 218-855-5863 or at frank.lee@brainerddispatch.com . Follow him on Twitter at www.twitter.com/DispatchFL .