COVID-19 model-based practice changes in managing a large prostate cancer practice: following the trends during a month-long ordeal

• Published in: Journal of robotic surgery 2021-04, Vol.15 (2), p.251-258
• Main Authors: Bhat, Kulthe Ramesh Seetharam, Moschovas, Marcio Covas, Rogers, Travis, Onol, Fikret F., Corder, Cathy, Roof, Shannon, Sighinolfi, Chiara, Rocco, Bernardo, Patel, Vipul R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Decision analysis; Disease control; Epidemics; Florida - epidemiology; Health Care Rationing - methods; Health Care Rationing - organization & administration; Health Services Accessibility - organization & administration; Hospital systems; Hospitals; Humans; Infection Control - methods; Infection Control - organization & administration; Italy - epidemiology; Male; Masks; Medical supplies; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Models, Theoretical; New York - epidemiology; Original; Original Article; Pandemics; Patients; Physical Distancing; Practice Management, Medical - organization & administration; Prostate cancer; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - therapy; Risk assessment; Social distancing; Surgery; Telemedicine; Threat evaluation; Trends; Urology; Ventilators; Viral diseases; Waiting Lists
• ISSN: 1863-2483; 1863-2491; 1863-2491
• DOI: 10.1007/s11701-020-01100-8

Coronavirus (COVID-19) has been a life-changing experience for both individuals and institutions. We describe changes in our practice based on real-time assessment of various national and international trends of COVID-19 and its effectiveness in the management of our resources. Initial risk assessment and peak resource requirement using the COVID-19 Hospital Impact Model for Epidemics (CHIME) and McKinsey models. Strengths, weaknesses, opportunities, and threats (SWOT) analysis of our practice’s approach during the pandemic. Based on CHIME the community followed 60% social distancing, the number of expected new patients hospitalized at maximum surge would be 401, with 100 patients requiring ventilator support. In contrast, when the community followed 15% social distancing, the maximum surge of hospitalized new patients would be 1823 and 455 patients would require a ventilator. on April 15, the expected May requirement of ICU beds at peak would be 68, with 61 patients needing ventilators. The estimated surge numbers improved throughout April, and on April 22 the expected ICU bed peak in May would be 11.7, and those requiring ventilator would be 10.5. Simultaneously, within a month, our surgical waitlist grew from 585 to over 723 patients. Our SWOT analysis revealed our internal strengths and inherent weakness, relevant to the pandemic. A graded and a guarded response to this type of situation is crucial in managing patients in a large practice.