Perioperative Considerations for Covid-19 Patients: Implementation Sciencebased Approach for Practicing Perioperative Surgical Home (PSH)

Abstract

The Covid-19 pandemic presents unprecedented challenges for anesthesia professionals and their surgical patients. Beyond managing the infection risk, positive Covid-19 surgical patients add additional challenges to their perioperative care, where perioperative risk is superimposed onto an already baseline anesthesia risk in real-time in an unknown and unpredictable fashion. Recent evidence suggests that surgical procedures for both current and recovered Covid-19 patients are associated with elevated morbidity and mortality. These risks must be well managed. However, the anesthetic risk aside from transmission is yet to be fully understood; consequently, effective and speedy dissemination of practice changes is vital to effective health care delivery. However, the traditional “knowledge to action gap” of 17 years or more in healthcare is a hinderance. We herein designed and implemented a new but simple perioperative criterion for previous Covid-19 patients based on the principle of the perioperative surgical home (PSH) within the Consolidated Framework for Implementation Research (CFIR). Given these tools, implementation and/or implementation components of the pathways based on recommendations which are fast evolving can readily be done, nearly live