Crawford County Memorial Hospital

Crawford County Memorial Hospital (CCMH) will resume limited elective surgeries on Wednesday, according to CCMH President and CEO Erin Muck.

In a proclamation released on April 24, Gov. Kim Reynolds announced that elective surgeries would be allowed to resume the following week; she initially ordered such surgeries to be halted March 26.

Muck said at the end of April that CCMH could not safely meet several of the requirements of the governor’s proclamation and would not restart elective surgeries at that time.

On Monday, Muck told the Bulletin and Review that CCMH is now satisfied that elective outpatient surgeries can be slowly resumed.

Heather Rasmussen, CCMH executive director of care integration, said she is confident in the decision.

“There were a lot of players at the table that came to the same consensus that we’ll start slow with outpatient (surgeries) and go from there,” Rasmussen said.

Muck said the CCMH quality and surgery/anesthesia committees, which include the hospital’s surgeons and anesthesiologists and the operating room manger, along with Muck and Rasmussen, have been meeting weekly to see if the hospital could safely meet the requirements of the governor’s proclamation.

“One of the biggest hurdles was testing and being able to get that test back in 48 hours,” Muck said.

The proclamation requires that a patient receive a negative COVID-19 test within 48 hours of surgery.

“We have noticed a great improvement in the turnaround time for testing,” she said.

CCMH is using a laboratory in Omaha, Nebraska, to test nasal swabs for COVID-19 infection.

The State Hygienic Lab can’t be used for testing for elective cases, she said.

The Omaha lab is consistently returning tests in 24 to 48 hours, which eliminates one of the big hurdles to the resumption of elective surgeries, Muck said.

The other hurdle is the amount of personal protective equipment (PPE) needed for surgeries.

Muck said at the end of April that elective surgeries would use too many of the hospital’s PPE resources, which would be needed in the case of a severe COVID-19 outbreak in the county.

“We’ve definitely seen a surge of patients through the clinic and through the emergency department, but for inpatients the majority have been able to quarantine and manage at home,” Muck said.

“In our region what we have been seeing is anywhere between four and six inpatient admissions at a time and we haven’t seen it go much over that.”

She said the Test Iowa site in Denison was effective in getting many people tested who might not have been otherwise tested.

As of Sunday, no patients in the region were on ventilators, she said.

The increase in cases in Crawford County in recent weeks has not translated into a surge of admissions that would have caused CCMH to burn through PPE supplies, Muck said.

“I think we’re doing something right in our community,” she said. “I thought these positives would translate into a surge but it has been extremely manageable.”

She said the hospital currently has a “comfortable” amount of PPE, which will allow elective surgeries to resume.

CCMH will halt the surgeries immediately if the situation changes, Muck said.

A hospital group meets every morning, Monday through Friday, to look at hospital resources, PPE, testing issues, and COVID-19 case numbers.

“If some of these positive cases end up in the hospital and we have a lot of patients, we’d definitely have to discontinue the surgeries, if needed,” she said.

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