Table 2.

Phased-In Model for Restarting Interventional Elective Procedures During the COVID-19 Pandemic

Phases	Cases	Dependencies	Tactics
Phase 1: urgent/emergent procedures and those not affecting surge resources 25% usual capacity	1.Category I patients 2.Patients who have been waiting >4 weeks	1.Nursing staff to open procedure rooms to accept elective outpatients 2.“Clean” waiting area 3.“Clean” area for overnight stay 4.Equipment removed to support other areas 5.Recover TAVR and high-risk patients in the procedure room 6.Availability of cardiac anesthesia and cardiac surgery 7.ICU bed availability	1.Return of 25% of catheterization laboratory nurse FTEs 2.Physicians review patient list to identify priority patients 3.No visitors 4.Greeter to escort through separate entrance 5.Direct to room/social distancing 6.Open holding area or dedicated overnight stay area 7.Anesthesia machines, procedure tables, and equipment carts reclaimed 8.Testing all outpatients prior to arrival 9.COVID-19 procedure room for outpatients 10.Careful patient selection to reduce likelihood of needing ICU bed 11.Cluster procedure types
Phase 2: semiurgent procedures, possibly affecting surge resources 50% usual capacity	1.Category I and II patients 2.Patients who have been waiting >3 weeks	As above 1.Holding area space reopened for pre-/post-procedural care 2.Staffing and room availability 3.Throughput	As above 1.Universal COVID-19 testing for outpatients 2.Continue to isolate high-risk population to reduce exposure 3.Adequate staffing for cases (nursing and technologists) 4.Adequate staffing to provide pre-/post-procedural care 5.Return of 1 FTE for environmental services and patient transport
Phase 3: routine procedures 75% usual capacity	1.Category I, II, and III patients 2.Patients who have been waiting >2 weeks	As above 1.Staffing and room availability 2.Throughput	As above 1.Return of 80% FTEs to procedural area including transport, environmental services and catheterization laboratory and holding area nursing
Phase 4: 110% of FY20 budgeted procedural cases	1.Category I, II, and III patients	As above 1.Staffing and room availability 2.Throughput	As above 1.Running 1 procedure room on Saturday 2.Reestablish all blocks for ORs and anesthesia support 3.Return of all clinical/nonclinical staff members to procedural and pre-/post-procedural care areas 4.Seek additional blocks as needed

COVID-19 = coronavirus disease 2019; FTE = full-time equivalent; FY20 = fiscal year 2020; ICU = intensive care unit; OR = operating room; TAVR = transcatheter aortic valve replacement.