Restarting care-related activities in the context of COVID-19: Prioritization, protocols, and procedures. Experience of a gastroenterology outpatient unit in Bogotá, Colombia

Abstract

The Colombian Government ordered a mandatory nationwide quarantine in March 2020 due to the spread of the SARS-CoV-2 virus. Since then, outpatient endoscopy units were closed and only urgent procedures were performed in the hospital setting, resulting in a repression of sensitive, priority and elective outpatient endoscopic procedures. The rate of spread of the virus was contained and it did not progress exponentially as in other countries; in the meantime, gastroenterology services were provided in the form of teleconsultation. The mitigation measures and the containment of the virus allowed the Mayor’s Office of Bogotá and the National Government to issue notices with recommendations for the provision of some regulated outpatient services in May 2020, thus creating a window of opportunity to care for patients with sensitive diseases. Under this legal and epidemiological framework, the provision of digestive endoscopy services was restarted at EMDIAGNOSTICA S.A.S. This study presents the strategies for scheduling and performing endoscopic procedures in an outpatient gastroenterology unit during COVID-19 pandemia in Colombia and describes a system for prioritizing procedures according to medical criteria, ranging from care by teleconsultation and/ or an application of a telephone survey and the use of a medically necessary, time-sensitive (MENTS) scale adapted for digestive endoscopy. It also describes changes in infrastructure, methodology implemented for protection of human talent and patients, and post procedure follow-up for feedback, safety and satisfaction degree evaluation in care.