• Article
  • September 1, 2020

Adapting Schedules to Accommodate Elective Surgeries

Phoenix Children’s revamps scheduling processes to continue providing non-urgent surgeries during the pandemic


Children's hospitals took agility to new heights during COVID-19—instantly thinking and working in new ways out of necessity. It didn't take long for changes to start driving efficiencies, improving experiences for staff, patients and families and enhancing care. That's why many adjustments the pandemic has brought to children's hospitals will be here to stay even in a post-COVID world.

In the summer issue of Children's Hospitals Today, we take a closer look at the ways children's hospitals are improving outcomes—now and into the future—with innovations born out of the pandemic response. Here's one such glimmer of hope: how one children's hospital maintained its commitment to patients’ surgical needs.

Despite pandemic, elective surgeries increase

It’s a statistic that seems almost impossible during the COVID-19 pandemic.

During the months of June and July—amid a surge of COVID-19 cases across Arizona—Phoenix Children’s Hospital performed 166 more elective surgeries than it did over the same time frame in 2019.

“It wasn’t really a surprise—we worked hard for that,” says Vinay Vaidya, M.D., senior vice president and chief medical information officer at Phoenix Children’s. “People were motivated.”

Dispelling elective surgery stigma; safety is essential

A major part of the hospital’s motivation to find a safe solution to maintaining the surgeries was understanding the importance of the elective procedures. 

“Elective surgery has a connotation—it’s plastic surgery, non-essential surgery, cosmetic surgery—that it’s optional surgery,” says Vaidya. “Some portion of that may be true, but because kids have summers off these major scheduled surgeries—including non-urgent spine, chest and heart surgeries—are routinely scheduled during summer months.”

Maintaining those surgeries in the safest manner possible relative to the pandemic was the hospital’s top priority, according to Vaidya. Phoenix Children’s followed the Children’s Hospital Association’s Guidance for Pediatric Patient Care Reengagement, including prioritization of patient care and regulating supplies of personal protective equipment (PPE). It was then up to Vaidya and his team to figure out how to schedule the nearly 8,000 surgeries planned from May to September.

Data, priority scale drive scheduling process

Vaidya’s team built dashboard tools for staff across the organization to use in planning and executing the surgical schedule. Though Phoenix Children’s had been gathering the data used to populate and regularly refresh the dashboards for years, the new tools provided everyone involved in the surgical process the opportunity to see it in one place—in real time.

The only new wrinkle was a prioritization process added in May. Using guidelines developed by senior hospital management and division chiefs, surgeons assigned a priority number to each case so schedulers could slot patients into available time frames appropriately.

Vaidya says applying a priority system to the mountains of readily available data at the hospital was a game-changer.  

“All the decisions, which were not captured previously and were perhaps only in the surgeon’s thought process, were now being captured in a granular, structured manner that could feed the data,” Vaidya says. “We extensively use data in all aspects of our clinical care and planning, and the infrastructure we’ve built up over the last five to seven years really came to our rescue.”

Everyone has tools on hand to replicate this success

There are several steps in the surgical planning process—including the need for pre-admission COVID screening—and because the dashboard helps streamline the workflow, it’s likely to remain a fixture beyond the pandemic.

“The scheduling staff tells us they can’t believe how we operated without this information before COVID,” Vaidya says.

Meanwhile, as children’s hospitals around the country are beginning to resume elective surgeries, Vaidya says he’s fielded inquiries from colleagues about the process. He says it’s easy to get bogged down in the myriad of questions and potential scenarios, but most hospitals already have the resources they need to make it work.

“These tools are not difficult—everyone has the schedule data and knows the types of cases,” Vaidya says. “I think it’s scalable, exportable and reproducible.” 

For more, check out the summer issue of Children' Hospitals Today, including "Glimmers of Hope: Emerging Bright Spots from the COVID-19 Pandemic." Send questions or comments