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Multiple safety measures put orthopedic surgery patient at ease

By Cliff Mehrtens
Novant Health

Kenny Martin was ready for his hip replacement. But it wasn’t enough to ease all his anxiety about getting the operation done. He’d never been to Novant Health Clemmons Medical Center, a department of Novant Health Forsyth Medical Center. His orthopedic surgeon was new to him, too.

Mix in the uncertainty of the COVID-19 pandemic and it’s easy to understand Martin’s worry. But his damaged left hip wasn’t getting any better on its own. Martin’s previous health care system wanted to delay surgery until August. He instead opted for Novant Health, which resumed non-time-sensitive surgery and procedures May 4.

Like many patients, Martin was concerned about safety at the hospital and clinic. His fears were quickly allayed.

“Safety was the top priority and Novant Health put me at ease,” said Martin, 65, who lives in Denver, North Carolina, about 60 miles from Clemmons. “The screenings and expertise were very thorough. I wasn’t worried once I saw the rules being followed.”

Novant Health orthopedic surgeon Dr. Charles Craven performed Martin’s hip replacement surgery in early May. Martin, like all patients, was screened long before he reached the entrance of a hospital or clinic.

About 24 hours before his clinic visit to Novant Health Orthopedics & Sports Medicine – Clemmons, Martin received a call that included screening questions. Do you currently, or have you had a fever? A cough? Shortness of breath? Any other symptoms?

If a patient answers “yes” to any of the questions, their appointment is postponed. They’re directed to a local clinic and encouraged to be tested for COVID-19.

If there are no symptoms, they’re reminded to wear a mask to their clinic visit. If not, a mask is provided at the clinic. Clinics allow one healthy visitor to accompany a patient, and that visitor is screened, too. Everyone in a Novant Health building gets a temperature check, including team members prior to their work shift. Then, patients are again asked the screening questions.

Every Novant Health team member is wearing a mask.

Patient Kenny Martin gets a temperature check as he enters the clinic.

Clinic lobbies and examination rooms are cleaned after every patient visit. Bathrooms are cleaned every 30 minutes. Seating has been reconfigured to allow for social distancing. The number of people in a lobby is monitored to avoid overcrowding, and sometimes patients are asked to wait in their car.

“We try our best to limit the amount of exposure,” said Stephanie Geruso, clinic administrator for Novant Health Orthopedics & Sports Medicine facilities in Winston-Salem, King and Clemmons. “There is a lot of repetition with the questions, but the patients recognize our commitment to safety. They often thank our teammates when they’re cleaning the lobby.”

Staying safe during clinic visits

At Martin’s follow-up visit to have his surgical staples removed in late May, he walked through the clinic automatic sliding door without having to touch it. He went past a lobby water fountain that has been disabled, to prevent multiple people from touching the lever. The lobby seats were spread and two other people sat 25 feet from him.

Martin was summoned to the exam room, but first was stopped in a hallway to have his temperature checked. A few minutes later, his staples were removed and he was examined by Craven.

Social distancing is in effect at all Novant Health facilities.

“I am proud of the way that we at Novant Health have re-engaged in elective surgeries in a very purposeful, deliberate and safe manner to our patients,” Craven said. “For all elective arthroplasty procedures that I perform, every patient gets a COVID test. I think that has really put patients at ease knowing that they’re entering a safe environment.

“In addition, in the clinic setting here, and even in the hospital, all of us as team members are getting daily screenings, our temperature is taken and we are answering a variety of questions,” Craven said. “If there’s any concern, we are removed from the work environment. All of that I think is very meaningful to patients, that we continue to perform elective surgeries during this uncertain time in a very safe manner.”

Added screening and safety measures for surgery

Every patient at Novant Health is screened for COVID-19 and tested 72 hours before their arrival for surgery. If results are negative, the patient is required to be quarantined during that time leading up to the day of surgery. If results are positive, surgery may be delayed or canceled. When patients arrive for surgery, they’re screened again before entering the hospital.

Operating rooms are “positive pressured,” which means air must be pressured to flow out of the room, so there’s no potential for air coming into the room and possibly exposing a patient to infection. That’s not anything new since COVID-19, just normal procedure in a setting with robust cleaning and sterilization.

To further protect patients, ORs are set to completely “turn over” the amount of fresh air every three minutes to further enhance infection prevention. In an average office building, it can take two to four hours for a turnover of fresh air.

Martin, a retired investigative social worker, said he’s looking forward to regaining mobility that will help him complete projects and land back on Lake Norman in his fishing boat. He’s much more comfortable knowing safety procedures are in place at Novant Health.

“It was comforting to know that that they knew what they were doing,” Martin said. “They knew the procedures that had been put in place to follow, and that reassured me as far as my own personal safety as well as theirs. It gave me the assurance that I’m going to be taken care of properly and I’m in good hands.”