With Keck Medicine of USC now accepting patients for all needed health care services, clinicians, administration and staff have worked extremely hard to minimize the risk of COVID-19 transmission. This ongoing series covers the changes that patients, visitors and even students can expect as the pandemic continues.

This story focuses on the efforts being made by the orthopaedic surgery team to make sure their patients, whether recently injured or dealing with chronic pain, can receive the care they need when they need it — and as safely as possible.

Telehealth and orthopaedic surgery

At first glance, it may be difficult to determine how such a hands-on specialty as orthopaedic surgery can effectively use telehealth.  After taking a comprehensive assessment of the patient journey, the physicians and the administration developed a telehealth strategy. 

First, many patients who require follow-up visits to assess a response to a specific treatment, surgical procedure, physical therapy or to review an imaging study can often be accommodated with a telehealth visit.  Second, some new patients can be evaluated via telehealth to determine the severity of their condition and the tests they need.  Third, telehealth has allowed the physician to monitor patients that cannot come into the office for a visit because of health concerns. 

The use of telehealth has enabled the physicians to see fewer patients in the office, which has improved the efficiency of the office visits and enhanced the safety for the patients.  USC Orthopaedic Surgery will continue to expand telehealth options for patients.

A modified approach to in-person care

“We have worked in conjunction with the USC Care administration and our staff to provide a safe environment for our patients who come to the office for a visit,” said Jay R. Lieberman, MD, director of USC Orthopaedic Surgery at Keck Medicine and chair and professor of the Department of Orthopaedic Surgery at the Keck School of Medicine of USC. “All patients have to fill out a health questionnaire and have their temperature checked prior to their visit.  All examination rooms are thoroughly sanitized between each visit. In addition, all the clinicians, staff and patients wear masks.”

In order to provide a safe environment for patients, staff and physicians it was clear that the office environment needed to be modified.

The waiting rooms at the various office sites were rearranged to provide the appropriate social distance for patients. The number of chairs in the waiting room were significantly reduced and appointment times were spread out to reduce wait times for patients and to allow the staff ample time to sanitize each room after each use. 

At the present time, the orthopaedic and spine services have been able to return to their normal patient capacity by combining in-person visits with telehealth. The office locations at the Health Sciences Campus, Beverly Hills, Glendale, El Segundo and Downtown Los Angeles are all open for outpatient visits.

Coming back to the operating room

During the shutdown only urgent surgical procedures were performed. For the orthopaedic surgery and spine subspecialty services at Keck Medicine, the reopening began with rescheduling delayed elective surgical procedures in order of urgency.  At the present time both simple and complex surgical procedures are being done and the operative schedule is almost at pre-pandemic levels. All patients are tested for COVID-19 prior to their elective surgical procedure.

“Our physicians, staff, and leadership used a systematic approach to create a new health care paradigm for our patients,” Lieberman explained.  “We realize this is a stressful time for everyone.  Fortunately, we are able to provide our usual excellent orthopaedic care in an environment that is safe for our patients and their families.”

— Kate Faye