Colorado Orthopaedic Society Uncategorized Member News Alert: April 28, 2020

Member News Alert: April 28, 2020

Colorado COVID-19 Response
Resuming Voluntary or Elective Surgeries and Procedures
Governor Polis’ announcement on Sunday evening of the Safer at Home executive order marks the next stage in Colorado’s COVID-19 response and for many orthopedic surgeons provides a much-needed path to get their practices back to work. The suspension of non-urgent/elective procedures on March 29, 2020, was met with determination as orthopedic surgeons across the state quickly responded to help limit the spread of the virus. Similar resolve and continued thoughtfulness are now necessary as orthopedic practices begin to resume certain surgeries and other procedures.

The following details Executive Order D 2020 045 (EO) and Public Health Order 20-29 (PHO) that permit non-urgent, voluntary or elective surgeries and procedures to begin again under certain conditions (effective April 27, 2020-May 26, 2020).   

According to this FAQ document from the state and a statewide webinar presentation from the Governor’s office, Executive Order D 2020 045 applies statewide, regardless of local jurisdiction orders. 

COS knows that the suspension of these services has had profound impacts on orthopedic practices around the state. We encourage you to review the entire Executive Order and PHO. Failure to comply with these orders could result in penalties, including jail time, and fines and may be subject to discipline on one’s professional license.

The following provides a summary of the medical facilities section of the PHO. If you perform procedures at an ASC then refer to section IV starting on page seven of the the PHO for other important information for “hospital and other surgical facilities.”

Voluntary or elective surgeries and procedures (procedures) may resume only if all of the following requirements are met:
2-week supply of PPE: Must have access to enough PPE to sustain recommended use for 2 weeks without having to implement emergency PPE-conserving measures.
Extended use/reuse of PPE must follow CDC guidance. Proper doffing and donning training is required.
Infection control: Strict infection control policies as recommended by the CDC must be utilized.Universal symptom screening: A universal symptom screening process must be used for all staff, patients, and visitors. Symptomatic patients/visitors should be referred to their PCP and special steps must be taken for symptomatic employees.
Facemasks: Nonmedical personnel must wear a facemask (cloth if necessary), unless their health prevents it. All patients and visitors must wear a face covering (cloth if necessary). Masks may be removed when social distancing of at least 6 feet is possible. Provide masks to those who arrive without one.
Social distancing: Continue social distancing of at least 6 feet wherever possible and use physical barriers within patient care areas when possible.
Staggered patient scheduling and increased cleaning: Schedule patients so that providers have sufficient time to change PPE and ensure rooms and equipment can be cleaned and disinfected between each patient.
Telehealth and virtual check-in: Continue to maximize the use of telehealth and virtual office visits. Utilize virtual check-in when possible or have patients remain outside the building until the treatment room is ready.
Stick to the plan: Establish guidelines to ensure adherence to the principles outlined above. Consult with the treating provider(s) about whether the procedure is elective or non-essential.
2-week checkup: Reassess operations every 2 weeks.
Stop if surge: Be prepared with a plan to reduce or stop procedures if there is a surge or resurgence of COVID-19 cases in the region.

COS continues to collaborate with other medical societies across the House of Medicine on the COVID-19 response. In addition, we are actively advocating with the Governor’s office, state and local health departments, legislative leaders and other policymakers on your behalf on issues ranging from securing more PPE, enhancing testing capacity especially for health care workers to ensure a viable workforce, and public and private payer outreach to minimize administrative burdens. Stay tuned for more details.
COS Board joins 60 current and former AAOS leaders to urge a NO vote on AAOS bylaws amendments 1 & 2
Dear Orthopaedic Colleagues, 

Earlier this month, the Colorado Orthopaedic Society (COS) Board of Directors voted to join more than 60 former AAOS presidents, past BOC officers and members in asking you to vote no on Amendments 1 & 2 which will be coming soon for a vote by all AAOS members. This article contains new and updated information from a prior COS newsletter and includes links to four separate documents to enable Colorado COS and AAOS members to be informed prior to the vote.

The following is a summary of the signed letter from 60 current and former AAOS leaders. In addition to these four bullet points, please read the letter and supporting arguments for more detail..

The AAOS will soon request your vote to approve a change in AAOS Bylaws via proposed “Amendments 1 & 2” that would allow the AAOS Board of Councilors (BOC) to be significantly modified without approval of the AAOS membership.

We urge you to vote against these amendments.

The BOC represents the grass roots of the orthopaedic profession. BOC members advocate for the practicing orthopaedists in their area, bringing priorities of their state societies and members to the AAOS leadership. One example of improvements arising from the rank and file orthopaedic community through the BOC was changing our maintenance of certification requirements to allow an alternative path to the ‘high stakes’ test.

The letter below was signed by some of the more than 60 former AAOS presidents, past BOC officers and members who are asking you to vote to reject Amendments 1 & 2. We join them in requesting your vote against these amendments.

Once the letter and FAQ were released and sent nationwide by all fifty state orthopedic societies to their members, AAOS recognized the controversy surrounding this vote and sent its own Bylaws FAQ to all AAOS members. Please read this Response to the AAOS FAQ to help understand why we continue to recommend a no vote. Finally, for those who would like a deep dive into the bylaws amendment resolutions proposed by AAOS that were released in advance of the since-canceled March AAOS annual meeting, please click here to read them in full.
Respectfully requested,
Colorado Orthopaedic Society Board of Directors  
Mark Conklin, present BOC member from Colorado Orthopaedic SocietyDan Moon, present BOC member from Colorado Orthopaedic Society
Kim Furry, past BOC member from Colorado Orthopaedic Society
Jeff Nakano, past BOC member from Colorado Orthopaedic Society 

P.S. Now is a good time to check that your AAOS website login/access is up-to-date in preparation for the vote against Amendments 1 & 2, which is still expected to come soon.
In case you missed it
Colorado Coronavirus (COVID-19) Resources
The Colorado Department of Public Health and Environment is working hard to keep guidance up to date for all stakeholders. Click here for CDPHE resources for local public health agencies and health care providers. Be sure to navigate across the menu bar to visit the special page for healthcare providers and local public health agencies. You will also find the home page an excellent source for current regulations on what’s closed and what’s open throughout the state.
Stay up-to-date and participate with the Coronavirus (COVID-19) statewide physician discussion board hosted on the CMS websiteJoin the statewide physician COVID-19 discussion board on Basecamp, a password-protected discussion and file-sharing platform that is hosted by Colorado Medical Society and actively moderated by CMS and COS staff. This forum is meant to increase collaboration and problem-solving around COVID-19 among Colorado physicians and has been opened to all Colorado physicians, regardless of membership in CMS or COS. It has already stimulated peer-to-peer discussion around provider shortages, access to tests, telehealth, supply shortages and care protocols. Sign up here.
National AAOS and AMA Coronavirus (COVID-19) ResourcesThe American Academy of Orthopedic Surgeons has created a COVID-19 information page, a with relevant information to help surgeons through this crisis as well as policy positions taken by AAOS like supporting ACS recommendations to discourage elective surgery. Access it here
The American Medical Association has created a COVID-19 Resource Center, a curation of comprehensive CDC, JAMA and WHO resources, that will quickly help physicians prepare their practices, address patient concerns and answer the most pressing questions. Access it here

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Daniel Moon, MDDaniel Moon, MD

After receiving a BS & MS in Mechanical Engineering from the Massachusetts Institute of Technology, Dr. Moon worked as a management consultant advising large corporations including pharmaceutical and technology companies.