TY - JOUR
T1 - Institution-Specific Strategies for Head and Neck Oncology Triage During the COVID-19 Pandemic
AU - Freeman, Michael H.
AU - Shinn, Justin R.
AU - Langerman, Alexander
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2022/12
Y1 - 2022/12
N2 - Background: This work seeks to better understand the triage strategies employed by head and neck oncologic surgical divisions during the initial phases of the coronavirus 2019 (COVID-19) outbreak. Methods: Thirty-six American head and neck surgical oncology practices responded to questions regarding the triage strategies employed from March to May 2020. Results: Of the programs surveyed, 11 (31%) had official department or hospital-specific guidelines for mitigating care delays and determining which surgical cases could proceed. Seventeen (47%) programs left the decision to proceed with surgery to individual surgeon discretion. Five (14%) programs employed committee review, and 7 (19%) used chairman review systems to grant permission for surgery. Every program surveyed, including multiple in COVID-19 outbreak epicenters, continued to perform complex head and neck cancer resections with free flap reconstruction. Conclusions: During the initial phases of the COVID-19 pandemic experience in the United States, head and neck surgical oncology divisions largely eschewed formal triage policies and favored practices that allowed individual surgeons discretion in the decision whether or not to operate. Better understanding the shortcomings of such an approach could help mitigate care delays and improve oncologic outcomes during future outbreaks of COVID-19 and other resource-limiting events. Level of Evidence: 4.
AB - Background: This work seeks to better understand the triage strategies employed by head and neck oncologic surgical divisions during the initial phases of the coronavirus 2019 (COVID-19) outbreak. Methods: Thirty-six American head and neck surgical oncology practices responded to questions regarding the triage strategies employed from March to May 2020. Results: Of the programs surveyed, 11 (31%) had official department or hospital-specific guidelines for mitigating care delays and determining which surgical cases could proceed. Seventeen (47%) programs left the decision to proceed with surgery to individual surgeon discretion. Five (14%) programs employed committee review, and 7 (19%) used chairman review systems to grant permission for surgery. Every program surveyed, including multiple in COVID-19 outbreak epicenters, continued to perform complex head and neck cancer resections with free flap reconstruction. Conclusions: During the initial phases of the COVID-19 pandemic experience in the United States, head and neck surgical oncology divisions largely eschewed formal triage policies and favored practices that allowed individual surgeons discretion in the decision whether or not to operate. Better understanding the shortcomings of such an approach could help mitigate care delays and improve oncologic outcomes during future outbreaks of COVID-19 and other resource-limiting events. Level of Evidence: 4.
KW - head and neck oncology
KW - organizational response
KW - pandemic response
KW - qualitative research
KW - surgical ethics
UR - http://www.scopus.com/inward/record.url?scp=85097136172&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85097136172&partnerID=8YFLogxK
U2 - 10.1177/0145561320975509
DO - 10.1177/0145561320975509
M3 - Article
C2 - 33275034
AN - SCOPUS:85097136172
SN - 0145-5613
VL - 101
SP - 668
EP - 670
JO - Ear, Nose and Throat Journal
JF - Ear, Nose and Throat Journal
IS - 10
ER -