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Surgical Innovation Amidst COVID-19

Transformational Leadership

The UHealth/University of Miami Hospital and Clinics' UHealth Tower has led the institution through the Division of Perianesthesia Services and the Preoperative Assessment Center during the era of COVID-19. During the pandemic, nearly all non-urgent perioperative services were paused as efforts of the entire nursing team were focused on commitment to patients affected by COVID-19, nursing care and engagement with evolving and emerging COVID-19 knowledge, and grasp of current practices related to personal protective equipment (PPE) for staff and patient protection. As Terri Jennings, BSN, RN, Director of Perianesthesia Services and the Preoperative Assessment Center noted: “In our ‘old normal’, surgery and surgical nursing care were critical aspects of our approach to care, but in a pandemic unlike what has occurred in over a century, new priorities emerged.” Jennings and Clemencia Silk, MSN, RN, Associate Vice President for Clinical Operations for UHealth Surgical and Perioperative Services, described their impressive, interprofessional approach to same day surgical procedures for bariatric and orthopedic patients. In partnership with physician colleagues, COVID-19 testing occurred prior to the same day admission by nurse practitioners and anesthesia staff. Phone screening occurred to assure that patients were well prepared for the new surgical approach to same-day procedures.

With the orthopedic population, a strong partnership was built with physician colleagues and interprofessional colleagues to identify patients who were optimal candidates for the new abbreviated hospital stays. For orthopedic patients, a team approach with post-anesthesia care nurses fully engaged in mobilizing patients postoperatively to assure that they would be ready for discharge. Nurses, advanced practice providers (nurse practitioners and physician assistants), physicians, physical therapists, occupational therapists, and case managers engaged in a team approach to assure a nimble response in the complex times of COVID-19. Nurses, case managers, occupational therapists, and physical therapists partnered to assure that patients had the skills for mobility post-discharge and coordinated with social services for post-operative discharge instructions, diet, wound care, pain management, and patient education regarding signs and symptoms of infection. Postoperative follow-up upon discharge was another key component of the new approach to same-day surgery. Nurses and nurse practitioners were pivotal, as well as the nurse educator to the success of this new cutting-edge program. UHealth Tower exemplified transformational leadership in surgical innovation amidst COVID-19.