FeaturesA Conceptual Framework for Rescheduling Elective Pediatric Gastroenterology Procedures Following COVID-19 Pandemic LockdownKaur, Panamdeep MD; Attard, Thomas M. MD; Fishman, Douglas S. MD; Zapata, Fernando MD; Ditsch, Donna BSN, RN, CPN; Thomson, Mike MD; Schurman, Jennifer V. PhD Author Information Panamdeep Kaur, MD, Children's Mercy Hospital Kansas City, Kansas City, Missouri. Thomas M. Attard, MD, is Professor of Pediatrics, University of Missouri School of Medicine, Children's Mercy Kansas City, Kansas City, Missouri. Douglas S. Fishman, MD, is Professor of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. Fernando Zapata, MD, is Assistant Professor of Pediatrics, University of Missouri School of Medicine, Children's Mercy Kansas City, Kansas City, Missouri. Donna Ditsch, BSN, RN, CPN, is Assistant Nurse Manager, Children's Mercy Kansas City, Kansas City, Missouri. Mike Thomson, MD, is Professor of Pediatrics, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom. Jennifer V. Schurman, PhD, is Professor of Pediatrics, University of Missouri School of Medicine, Children's Mercy Kansas City, Kansas City, Missouri. Correspondence to: Thomas M. Attard, MD, Children's Mercy Hospital Kansas City, 2401 Gillham Rd, Kansas City, MO 64108 ([email protected]). The authors declare no conflicts of interest. Gastroenterology Nursing: September/October 2020 - Volume 43 - Issue 5 - p 375-381 doi: 10.1097/SGA.0000000000000544 Buy Metrics Abstract Elective surgical and endoscopic procedures were suspended nationwide during the March 2020 COVID-19 pandemic to minimize exposure and healthcare resource utilization. This resulted in an unprecedented backlog of procedures in most clinical practices including pediatrics. Our group developed an internal process toward the rational development of an algorithm prioritizing elective procedures. This was based on patient disease severity defined by the presence of alert symptoms, symptom severity for dysphagia and abdominal pain, and diagnostic investigation findings. The underlying rationale is to prioritize patients in whom suspected disease course would be greatest impacted by endoscopy. We developed a nurse phone call-based process utilizing REDCap®, identifying relevant symptoms categorized by severity, and a validated functional impairment questionnaire for abdominal pain. We abstracted key laboratory and radiological findings also categorized by severity. The order of priority of procedures was established on the basis of a 4-tiered system factoring both presence and severity of symptoms or prior diagnostic testing results. We present the framework that we have adopted toward prioritizing procedures with the assumption that it offers an objective methodology and that can be efficiently and more broadly applied to other similar practice scenarios. Our tool may have wide-ranging implications both in the current COVID-19 pandemic and in other scenarios of limited resource allocation and deserves further investigation. © 2020 Society of Gastroenterology Nurses and Associates.