Suburban hospitals worrying about their ability to staff the fall COVID-19 surge

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As Illinois sets another single-day record for COVID-19 infections, hospitals are preparing to feel the strain of a fall and winter surge after weeks of steadily rising patient numbers.

Some medical centers are tightening visitor restrictions. Hospital administrators are hoping they won’t have to postpone elective surgeries again. But national trends are leaving suburban hospital officials anxious.

"I am extremely worried about staff," said Dr. Sanjeeb Khatua, chief physician executive and COVID-19 incident commander at Edward-Elmhurst Health.

Nine months into the pandemic, hospital leaders say they’re equipped with protective supplies, can find ways to add bed capacity, and can quickly adjust surge plans.

In earlier peaks, some hospitals could bring in out-of-state medical workers to help with the COVID-19 response. The difference now is a new wave of infections is blanketing much of the country, adding to concerns over the availability of workers to handle a crush of patients.

"Every state around Illinois is surging," said Danny Chun, a spokesman for the Illinois Hospital Association. "Look at Wisconsin. Look at Missouri. Look at Iowa. They’re all surging. There’s a limited pool of health care professionals."

All but 11 states reported a rise in the number of people hospitalized this week, according to the COVID Tracking Project.

Illinois hospitals had 3,092 patients with COVID-19 as of Thursday night, still below a high in April when more than 5,000 were hospitalized.

But health care systems are bracing for an influx because admissions tend to lag behind new infections.

Edward-Elmhurst was treating 96 patients with confirmed cases of COVID-19 across its two hospitals as of Friday morning. Three weeks ago, there were 33.

A new visitor policy on Friday limited patients to "one care partner" with some exceptions.

"Now that the whole nation is dealing with this, and you think about staffing as a whole and more community prevalence and spread, I worry about our workforce getting sick," Khatua said. "I also worry about the ability to staff for all of our patients with what’s happening nationally and the need for labor."

Khatua wants to avoid delaying elective procedures, a measure that would enable hospitals to redirect staff members to COVID-19 care, but it remains within the realm of possibilities.

"We don’t want to get there, but depending on the numbers, if they continue to increase threefold every two to three weeks, I could foresee that happening," he said.

‘The second wave’

Edward-Elmhurst Health staff members walk outside the east entrance to Elmhurst Hospital where decorative daffodils are being placed to represent each patient who has been discharged after treatment for the COVID-19 virus. Since March 24, 655 patients have been discharged from Elmhurst Hospital after treatment for COVID-19.

 

Edward-Elmhurst Health staff members walk outside the east entrance to Elmhurst Hospital where decorative daffodils are being placed to represent each patient who has been discharged after treatment for the COVID-19 virus. Since March 24, 655 patients have been discharged from Elmhurst Hospital after treatment for COVID-19.

– Brian Hill | Staff Photographer, April 2020

At its peak in the spring, NorthShore University HealthSystem had about 170 to 180 COVID-19 patients.

Physicians are "definitely seeing the second wave," with 61 COVID-19 patients at Glenbrook Hospital on Friday, said Dr. Sarah Donlan, an emergency medicine specialist and medical director of the capacity management center.

Glenbrook has 72 hospital beds for COVID patients, including ICU and medical/surgical beds.

"We’re still centralizing the patients with this uptick to Glenbrook," Donlan said. "So if you have COVID and require a medical admission, unless there’s an extenuating circumstance, you would be admitted or transferred to Glenbrook, depending on which pavilion you presented to through the emergency departments."

One positive sign? For virus patients, the length of stays has generally decreased.

"We are seeing that through our experience and through our comfort level with treating COVID that the majority of patients are requiring less time in the hospital," Donlan said.

That trend also is mirrored at Edward-Elmhurst.

"We haven’t had to use ventilators as often," Khatua said. "Our mortality rates have gone down, which are all good things."

At St. Alexius Medical Center in Hoffman Estates, the number of COVID-19 patients has increased from just six at the start of the month to 34 Thursday morning. Amita Health had a total of 260 Wednesday.

Physicians are caring for "much younger" patients and patients with seemingly less severity, said Dr. Michael Handler, Amita’s regional chief medical officer.

The system is reevaluating staffing needs several times a week.

"We are looking at temp agencies and so on as needed, but there’s only so many qualified people out there, even among those agencies," Handler said.

The emotional toll

As a mental health resource, Edward-Elmhurst has support groups available for front-line workers. Physicians also can seek counselors anonymously.

"Just like the general public, I think people are forgetting that health care workers throughout this whole pandemic have had to come to their jobs daily with the same struggles of everyone else about having kids, doing remote learning, trying to find child care, coping with isolation," Khatua said.

But they’re still facing lax attitudes around public health measures. Gatherings during the holidays and the looming flu season could add to the burden on hospitals.

"I think it’s really frustrating for health care workers when we see cases where people are having sleepovers," Khatua said.

Experts keep coming back to the same refrain: Wear masks. Wash your hands. Keep physical distance. And stay within your bubble.

"The hospitals are prepared, but the numbers cannot keep surging," said Chun, of the hospital association. "If they keep surging, hospitals will be overwhelmed. They will. It’s just a matter of time."

via Daily Herald

October 30, 2020 at 07:38PM

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