Stanford Deploys New OR Decision Algorithm for COVID-19
Risk assessment preserves PPE while protecting healthcare workers
March 26, 2020
Stanford has deployed a new decision algorithm to help triage Personal Protective Equipment (PPE) to the highest risk situations and keep front line health workers safe during the novel coronavirus pandemic.
“We convened a team to develop a strategy for our interventional platform and I called on [Dr. Joe Forrester] to be our surgical frontline representative,” said Mary Hawn, chair of the Department of Surgery. “Joe showed up with this algorithm and it was essentially adopted with very minor changes.”
The “Forrester Algorithm,” as it is being colloquially referred to, uses criterion including the urgency of the operative case, risk that the patient is infected and risk of transmission of virus from the type of procedure to preserve the critical supply of PPE while protecting those in the highest risk circumstances.
“It’s basically a flow chart that helps the team determine the type of PPE they need to wear in the OR using risk stratification,” said Dr. Joseph Forrester, a clinical instructor in the Division of General Surgery who developed the system.
PPE—such as masks, face shields, and gloves—protect the wearer from infection. There is currently no shortage of PPE at Stanford Hospital, however, a number of steps have been taken to reserve equipment as part of COVID-19 surge preparedness plans.
Forrester designed the algorithm by building off his experience as an Epidemic Intelligence Officer for the US Centers for Disease Control and Prevention (CDC) during the Ebola virus epidemic in Liberia in 2014.
“[Dr. Forrester’s] experience as a CDC field officer during the Ebola outbreak is a huge advantage for our system thinking during a pandemic,” said Dr. Hawn.
Dr. Hawn said she shared the algorithm with a number of other surgical chairs and hopes it will be a guide.