Hospitals seek to alter COVID-19 testing, visitation policies; some may delay elective procedures

Crain’s asked several other health systems in Michigan about whether they plan or are considering changing testing protocols or reducing volume of elective procedures because of the growing pandemic.

Most systems say they either leave testing decisions to physician discretion or follow Centers for Disease Control and Prevention recommendations for hospitals and outpatient centers. But this leaves patients confused.

Doug Jones, general manager of Metro Airport Truck in Taylor, said his mother was treated and admitted on different days by doctors at Michigan Medicine, St. Joseph Mercy Ann Arbor and Beaumont Hospital, Dearborn for a non-coronavirus symptom.

Jones’ mother was tested for COVID-19 (negative) at Michigan Medicine and St. Joe’s but not at Beaumont Dearborn.Nick Gilpin, D.O., Beaumont’s director of infection prevention, said Beaumont Health doesn’t test all patients entering emergency departments or hospitals. It leaves those decisions to the physician’s discretion, he said.

Gilpin said the majority of pre-op and labor-and-delivery patients are tested and most patients who present with any symptoms consistent with COVID-19 are offered testing.

On delaying elective procedures, Gilpin said Beaumont has considered the possibility. He said Beaumont has sufficient PPE, along with hospital beds and staff.

With more than 1,300 hospitalized COVID-19 patients during a single day in early April, Southfield-based Beaumont Health treated more patients for the coronavirus than any other health system. On Friday, it had 210 coronavirus-positive patients in its hospitals, up from 96 on Oct. 1.

“This year, we have learned quite a bit about COVID-19. We do not see the need for patients to delay non-COVID-19 care at this time,” Gilpin said in an email. “We have taken numerous precautions to provide a safe environment. Eliminating non-essential surgeries again would be unlikely at this point.”

Mary Masson, a spokesperson with Michigan Medicine, said the Ann Arbor-based health care organization has not canceled any elective surgeries. “We are constantly monitoring and planning for patient surges and we could make changes in the future,” Masson said.

At Detroit Medical Center, doctors order COVID-19 tests on all patients who meet the appropriate criteria as designated by the CDC.

“This includes testing all symptomatic patients being admitted for hospitalization, all pregnant women admitted for delivery, all babies born to mothers who are COVID-positive and those patients undergoing aerosol-generating procedures,” DMC spokesman Brian Taylor said.

Livonia-based Trinity Health Michigan also has designed its COVID-19 screening process based on guidance from the CDC, MDHHS and local health departments, spokesperson Laura Blodgett said.

“Patients who present to the emergency room at one of our facilities are tested for COVID-19 if they are symptomatic, fall into a high risk category, or if they are going to be admitted or observed for any reason,” Blodgett said. “Patients having a scheduled invasive procedure are tested for COVID-19 three days before their scheduled procedure.”

Trinity hasn’t made a decision on postponing elective procedures. Blodgett said the system believes it has sufficient PPE and staff resources, especially because it can tap into resources provided by the health system’s 92 hospitals.

At Ascension Michigan, a 12-hospital system based in Warren, spokesperson Chris Gleason said the Catholic system is following CDC guidelines for the time being.

Gleason said Ascension hospitals also has a surge plan that allows it to quickly adapt to patient needs and health care demands by grouping patients and creating additional intensive care space for COVID-19 patients.

“We need everyone to take this seriously and do what they can to slow the spread,” Gleason said.

Henry Ford Health System, a six-hospital system based in Detroit, also said doctors evaluate patients and test them if necessary. Surgery patients are tested or if a patient is to be admitted, even if asymptomatic, spokesman John Gillespie said.

“All obstetric patients will be asked COVID screening questions upon arrival to labor and delivery unit” and all emergency departments, Gillespie said.

“If screened positive, the patient should be tested for COVID-19 regardless of whether she is admitted or placed in observation,” he said.

Gillespie said Henry Ford hasn’t decided yet to postpone elective surgeries. He said the system has a 100-day supply of PPE.

“Henry Ford has had a formal systemwide group in place since midsummer to leverage everything we learned during the first surge to guide our operational decisions in the event of a second surge,” he said. “This includes provisions to deploy our resources so that we may continue to meet the health care needs of the community while also caring for ambulatory and hospitalized COVID-19 patients.”