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Table 5 Strategies for arthroplasty service planning during the next pandemic

From: Lessons learnt from the impact of COVID-19 on arthroplasty services in Hong Kong: how to prepare for the next pandemic?

Pre-pandemic • Build a consensus among stakeholders for prioritization of arthroplasty services, including inpatient, outpatient and operation, during different degrees of severity of a pandemic
• Establish guidelines for infection control measures for patients and health care workers during the pandemic
• Establish guidelines for operating on a confirmed infected case during the pandemic
• Set up telemedicine infrastructure for preoperative education, outpatient consultation and follow-up, and telerehabilitation
• Set up ERAS services for arthroplasty procedures
During the pandemic • Adjust clinical services according to the severity of the pandemic
• Increase the capacity for supporting ERAS services in arthroplasty to shorten hospital stay and reduce the burden on inpatient care
• Provide telemedicine consultations for pre-operative education and postoperative follow-up
• Provide telerehabilitation to maintain mobility and knee function; ensure access to drug-refill clinic for patients on waiting list for arthroplasty
• Provide telerehabilitation for postoperative rehabilitation after arthroplasty
• Develop a post-pandemic arthroplasty resumption plan for the anticipated backlog
Post-pandemic • Prepare manpower and hospital capacity for the post-pandemic increase in clinical service (e.g., extend operating room schedules)
• Utilize orthopaedic block times for arthroplasty procedures
• Enhance mental health support for healthcare workers to cope with the increase in workload during the post-pandemic phase