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Do you have recommended language that we could use in patient medical records when cancelling elective procedures?

Here’s our recommended context and language for patient medical records:

“On March 11, 2020, the World Health Organization declared the COVID-19 (Novel Coronavirus) viral disease to be a pandemic. As a result of this emergency and a rapidly evolving situation, practice patterns for physicians, physician assistants, and nurse practitioners are shifting to accommodate the need to treat in conjunction with unprecedented guidance from federal, state, and local authorities—which include, but are not limited to, self-quarantines and/or limiting physical proximity to others under any number of circumstances.

In March 2020, the CDC put out a public health reminder and many states followed suit, requesting all hospitals and ambulatory surgery centers suspend all elective and non-urgent procedures and surgeries in an effort to conserve personal protective supplies needed by frontline healthcare providers to treat COVID-19 patients.

It is within this context (and with the understanding that treatment decisions by healthcare providers and patients must take into account the patient’s best interest as well as the health and safety of other patients and the public) that this patient’s procedure/surgery has been:

Scenario 1 [if patient’s decision and doctor agrees]

postponed/canceled at the patient’s request. This decision is appropriate and reasonable under the circumstances given my understanding of the patient’s particular circumstances at this time. While I do not believe that the patient will be harmed by this postponement/delay, the patient has been advised of the potential risks of this decision and has agreed to postpone/delay the procedure/surgery. Any and all of the patient’s/patient’s family’s questions on this issue have been answered, and I have made no promises or guarantees to the patient regarding the effects of this postponement/delay. The patient has also been advised to contact this office for worsening conditions or problems, and seek emergency medical treatment and/or call 911 if the patient deems either necessary.

Scenario 2 [if patient’s decision and doctor’s recommendation is contrary]

postponed/canceled at the patient’s request. Taking into account all circumstances, I recommended the procedure/surgery go forward given my understanding of the patient’s particular circumstances at this time. I believe that the patient will be harmed by any postponement/delay, and the patient has been advised of the potential risks of postponement/delay which are not limited to but may include: ________. Any and all of the patient’s/patient’s family’s questions on this issue have been answered, and I have made no promises or guarantees to the patient regarding the effects of this postponement/delay. The patient has also been advised to contact this office for worsening conditions or problems, and seek emergency medical treatment and/or call 911 if the patient deems either necessary.

Scenario 3 [if physician’s recommendation]

postponed/canceled. This patient’s procedure/surgery is elective and non-urgent. This decision is appropriate and reasonable under the circumstances given my understanding of the patient’s particular circumstances at this time. While I do not believe that the patient will be harmed by this postponement/delay, the patient has been advised of the potential risks of postponement/delay and has agreed. Any and all of the patient’s/patient’s family’s questions on this issue have been answered, and I have made no promises or guarantees to the patient. The patient has also been advised to contact this office for worsening conditions or problems, and seek emergency medical treatment and/or call 911 if the patient deems either necessary.”

Source: https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/index.html

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All Curi recommendations are based on current CDC criteria at the time of publication. CDC guidance for SARS-CoV-2 infection may, or may not, be adopted by state and local health departments to respond to rapidly changing local circumstances. Providers should always check with their local health department to see if the CDC’s guidance on any given topic has been modified (particularly if more restrictive) from the CDC’s recommended guidelines. Follow this link https://www.cdc.gov/publichealthgateway/healthdirectories/index.html for contact information to your state/local health department. If local recommendations vary from those of the CDC, and you are unsure what recommendations to follow, then it is safer to follow the more restrictive guidelines/recommendations.