Interim Guidance last updated 27 March 2020

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Context

Public health recommendations have been issued related to the risk of COVID-19 infection: people who have been overseas in the last 14 days or who have been in contact with a person with confirmed COVID-19 while infectious must self-isolate for 14 days following last contact.

The following advice regarding elective surgery and outpatient clinics reflect these recommendations.

Elective surgery

All non-urgent elective surgery is temporarily suspended. Only Category 1 and some exceptional Category 2 surgery will continue until further notice.

For urgent surgery only, staff are required to ask patients at the time of booking confirmation if they have:

Criteria​​ Action
  • Been overseas in the last 14 days
  • Been in close contact with a person with confirmed COVID-19 while infectious, during the 14 days before their scheduled surgery
  • postpone surgery until 14 days after the last contact day if it will not significantly impact patient outcomes – this decision will require discussion with the clinical team
  • ensure the surgery is re-scheduled as soon as practicable after the 14 day exclusion period has lapsed

Note: if the patient has fever or acute respiratory illness ask that they seek health advice (from their GP or by calling healthdirect on 1800 022 222) to exclude COVID-19 as well as to resolve any other health issues.

Outpatient clinics

Before attendance at outpatients

  • Develop a system, prior to attendance (e.g. phone call, SMS), to ask patients whether they’ve been overseas or have had close contact with a person with confirmed COVID-19 while infectious, in the 14 days before the scheduled outpatient appointment.
  • If the patient meets the above criteria:
    • consider alternate of methods of conducting the appointment if appropriate (e.g. telephone or tele-medicine)
    • if it is not possible to conduct the appointment in an alternate way, reschedule their appointment unless it is medically necessary
    • reschedule the appointment for as soon as possible after the 14 day exclusion
    • remind them they are to self-isolate at home for 14 days after they returned or if they have had close contact with a person with confirmed COVID-19 while infectious
    • remind them if they develop respiratory symptoms or fever to call healthdirect on 1800 022 222 or call their GP.
  • Note, facilities will need to develop a system to implement the above steps, including appointing an appropriate person to assess whether or not it’s safe to defer the outpatient appointment.

During outpatient attendance

  • Consider options to identify patients in the outpatient clinic waiting room, e.g.
    • waiting room signage
    • asking patients at reception whether they have been overseas in the last 14 days or have had close contact with a person with confirmed COVID-19 while infectious, in the previous 14 days
  • For patients who meet the above criteria:
    • ask the patient to wear a surgical mask
    • ask the patient if they have any respiratory symptoms or fever.
  • For patients who meet the above criteria within 14 days of their appointment and who do not report any respiratory symptoms or fever:
    • the attending doctor should make a clinical assessment about the presence of respiratory symptoms
    • if no symptoms/signs continue the outpatient consultation as normal, with the patient wearing a surgical mask
    • remind the patient that they should self-isolate themselves at home for 14 days after they returned or have had contact with a person with confirmed COVID-19 while infectious.
  • For patients who meet the above criteria and who report symptoms manage the patient in conjunction with the emergency department as per the clinician guidance.
  • Other guidance: ensure availability of surgical masks and hand hygiene facilities
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Page Updated: Friday 27 March 2020
Contact page owner: Health Protection NSW