Interim Guidance last updated 27 March 2020
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- Context
- Elective surgery
- Outpatient clinics
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:
- 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
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- 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
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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