Hospital staffing a growing concern as facilities add beds for COVID patients

As the COVID-19 pandemic grows, hospitals have the flexibility to add needed beds to handle the influx of patients.

The biggest challenge in effectively managing the influx of patients comes from securing clinical staff – doctors, nurses and others – to treat the growing number of COVID-19 patients who require hospitalization.

“Physical space is not an issue,” said Dr. Justin Grill, chief medical officer at Mercy Health Muskegon. “Staffing is an issue.”

In response to the surge in western Michigan, Mercy Health Muskegon, Spectrum Health and Metro Health-University of Michigan Health said today they are once again temporarily delaying elective surgeries that require hospitalization for one or more nights. This frees up beds and staff for COVID-related care.

Hospitals will continue to perform medically necessary procedures such as heart surgeries.

“At this time, we are aiming to continue as many surgeries for which the patient can be discharged home the same day. We are postponing procedures that require overnight admission, if not urgent. We will continue to assess surgical cases daily based on our hospital census,” Metro Health said in a statement today to MiBiz.

The 208-bed Metro Health Hospital in Wyoming today had 40 patients positive for COVID-19 and had an occupancy rate of 86%.

The moves by hospitals to delay elective procedures come after COVID-19 cases and positive test rates soared in October, threatening to overwhelm available capacity.

Patients hospitalized with COVID-19 at Mercy Health Muskegon have quadrupled in the past seven to 10 days, Grill said. Mercy Health Muskegon’s 267-bed hospital campus had more than 120 hospitalized patients with COVID-19 to date.

As of midday today, Mercy Health Muskegon still had 10-15 ER patients who had tested positive and were awaiting transfer to an inpatient bed.

“We have a significant burden of COVID right now, no doubt,” Grill said.

Spectrum Health today had 288 hospitalized COVID-19 patients in its system. The health system’s volume of COVID-19 inpatients has tripled from 20 days ago and is three and a half times that of spring, President and CEO Tina Freese Decker said during a briefing. press on Wednesday.

COVID-19 cases are coming in across all age groups and the region’s death rate has increased over the past three weeks, Freese Decker said.

Spectrum Health and other health systems are all working on ways to increase the ability to handle thrust by converting space. Staffing additional beds can be more difficult.

Unlike in the spring, the continued surge is being felt in all regions of the state, limiting the ability of health systems to collaborate and share personnel.

“We know our colleagues at other hospitals and healthcare facilities are experiencing the same exponential trend as we are,” Freese Decker said. “It’s quite different from the last time when there were places we could go across the state or the country for our staffing and for the availability of services for people. … This means that we have very few opportunities to share clinical staff or transfer patients.

Under current conditions, Spectrum Health hospitals will reach capacity “within days,” Freese Decker said.

“So we have to change that community spread trajectory,” she said. “That’s why we need the help and support of our community. We need to flatten that curve like we did last spring.

On Wednesday, the state reported 6,008 new confirmed cases and 42 additional deaths. Michigan has nearly 230,000 total confirmed cases and 7,766 deaths. Kent County now has the highest number of cases per million population – 32,851 – in the Lower Peninsula.

Emergency capacity approved earlier

Last spring, most hospitals in western Michigan sought and quickly received state emergency approval to add more than 1,500 beds to deal with a surge in COVID-19 patients.

Spectrum Health this week sought emergency approval to add 16 additional beds to the Butterworth Hospital campus, citing “the alarming increase in the number of patients requiring acute hospital care for COVID-19,” according to a filing. with the state.

In the spring, Spectrum Health received emergency state approval to add nearly 390 beds to its hospitals.

Grand Rapids hospitals are also in “active discussions” with local and state officials about opening an alternative care site like the one that opened in Detroit at the TCF Center.

The challenge with this option remains securing the necessary medical personnel, said Dr. Darryl Elmouchi, president of Spectrum Health West Michigan.

“Even if we had another site with hundreds of beds available, the staff will absolutely be a problem if it comes to that,” Elmouchi said.

To help mitigate the current rate of spread of the coronavirus, Elmouchi and others are urging people to wear face masks, keep a distance from each other and avoid large crowds. He strongly advises people to spend the upcoming Thanksgiving holiday with only immediate family and avoid large gatherings with extended families and friends.

“I know it will be so difficult for everyone, but given what we are seeing here in West Michigan, we are very concerned that if large groups start to gather, the spread will go even further,” did he declare.

Hospitals have also seen large increases in the rates at which people test positive for COVID-19, “and this tells us that over the next few weeks we will see a markedly increasing number of patients in our hospitals with COVID-19” .

In Muskegon, Mercy Health has a 19.6% test positivity rate this week, Grill said.

“As long as it’s that high, it basically spreads like wildfire,” he said.

Mercy Health Muskegon can increase bed capacity by moving from private to semi-private rooms on one floor in a new patient tower that can accommodate 70 patients.

While the hospital and patients prefer private rooms: “In a pandemic, you do what you have to do,” Grill said.

Mercy Health Muskegon, which recently consolidated inpatient care to the Sherman Boulevard Hospital campus, is making further adjustments to maximize space. It is looking to use space freed up on the Hackley Hospital campus which would start with 20 beds and “wisely” grow to a 40-bed unit, Grill said.

The extra capacity at Hackley could open as early as next week as an alternative COVID-19 care site, he said. Mercy Health Muskegon is working with other health systems in West Michigan and a regional collaboration to open beds on the Hackley campus, Grill said.

Mercy Health Muskegon is working to recruit staff for the Hackley unit.

“We are working diligently on this,” he said. “We hope in the very near future that we will have the staff to enable us to host a COVID care site at Hackley Hospital from next week.”

Another option in Muskegon is a temporary care site at Muskegon Community College Health and Wellness Center for 50 hospital beds for overflow and lower acuity patients, Grill said.