Methods
The MD Anderson Head and Neck Surgery Consortium incorporates faculty and advanced practice providers from the five subsections of the Department of Head and Neck Surgery at the University of Texas MD Anderson Cancer Center: Head and Neck Surgical Oncology, Head and Neck Endocrine Surgery, Oral Oncology and Maxillofacial Prosthodontics, Ophthalmology, and Speech Pathology and Audiology. In a collaborative effort, the following guidelines were prepared to provide clinicians subsite-specific guidance for triaging surgical case acuity. Expertise was sought from our Radiation Oncology and Medical Oncology colleagues for non-surgical treatment options when surgery could be reasonably deferred, and for patients requiring multi-modality therapy. These guidelines are intended to serve as direction in a time of crisis such as the COVID-19 pandemic and not as a strategy for permanent change in patterns of practice.
Our weekly Multidisciplinary Planning Conference is currently conducted over a web conferencing platform in accordance with institutional and national social distancing recommendations. When a case is selected for surgery, a case posting request is placed and sent to the Division of Surgery Surgical Posting Committee for daily institutional review. This committee is comprised of surgical department chairs and quality officers, the Operating Room Committee leadership, and anesthesiologists. In Head and Neck Surgery, the guidelines described below are currently being used to assess treatment decisions and to make recommendations to the Division of Surgery Surgical Posting Committee. Approved cases are forwarded to the surgical scheduling team. An institutional bioethicist is available as needed.