Op-ed: COVID-19 capacity challenges

8 mins read

There was some sobering news two weeks ago regarding our health care system, including here at Franklin Community Health Network.

At a news conference featuring leaders from across our MaineHealth system, it was described how a confluence of trends have come together to put a severe strain on our hospitals and other health care providers.

Across our MaineHealth system, Emergency Departments have been full, with some having to divert all but the most critical cases. Non-urgent procedures have had to be rescheduled. At nearly at every hospital, they are at or near capacity, often with long waits for care.

Here at Franklin, we have seen a significant uptick in those requiring hospitalization for COVID-19, and an overall increase in patients with medical conditions made worse by social isolation.

So what’s behind this unprecedented capacity challenge?

The COVID-19 pandemic is certainly a factor. The Delta variant of the virus has torn through unvaccinated populations in our region with Franklin County being hit particularly hard. Our community transmission rate remains very high at 16.1%. Generally, local outbreaks are thought to be coming under control when this rate drops below 3%. The result has been record numbers of people hospitalized with COVID-19.

Also, during the early days of the pandemic, a lot of people understandably delayed care and avoided the hospital and their doctor’s office. Unfortunately, that means the patients we are seeing today are much sicker than we typically see.

This increased demand for care comes at a time when there is a shortage of health care workers. That shortage is not new. A year ago, across our MaineHealth system, vacant positions were equal to about 6.8 percent of our workforce, or about 1,350 positions at the time. Burnout from the pandemic and the labor shortage that developed across the economy in COVID’s wake has pushed that number to 10.3 percent, or about 2,900 positions as of last month. This includes openings for about 790 registered nurses and 279 certified nurse assistants.

Some blame vaccination requirements for this shortage of health care workers, and it is true that we unfortunately lost some colleagues who chose not to get the vaccine. However, we believe having our full care team vaccinated is not only what is best for our patients, but it will help preserve and protect our workforce, reducing the number of people out of work due to COVID-19.

And this labor shortage is also hitting nursing homes and other services hard, and that is making it hard to discharge patients from the hospital to transitional care. There is also a shortage of community-based mental health services, leaving patients waiting for behavioral health care in our Emergency Departments with as many as a third to half of ED beds across our system being taken up by those awaiting such care. Here at Franklin, we’ve seen a dramatic increase in emergency mental health patients, including more youth in crisis.

So, what are we doing to address this problem?

Across MaineHealth we’ve formed a work group specifically targeting capacity management. That group uses a capacity dashboard that enables us to see on a daily basis where beds are available across our health system, and where we may be able to transfer patients, as appropriate, so they can receive the best possible care.

We are also reducing non-emergent procedures at many of our local health systems as another way to try to manage the volume. And across the system, the MaineHealth Medical Group is expanding outpatient access, extending primary care, walk-in clinic, urgent care and telehealth hours to help reduce the strain on our Emergency Departments.

Our Supply Chain team is also remaining vigilant to ensure we continue to have the right equipment to keep everyone safe.

As to staffing, MaineHealth made $61 million investment in care team wages in August, with an emphasis on increased pay for some of the most difficult positions to fill. We’ve significantly increased the employee referral bonus and new employee bonus. We continue to invest in training programs for critical positions and are working both internally and with community partners to promote these opportunities. Longer term, we are investing nearly $5 million next year in partnership with community colleges and institutions of higher learning to build a workforce pipeline into the future.

All of this should help, but we can’t do it alone. Our vision at MaineHealth is, “Working together so our communities are the healthiest in America,” and today, more than ever, we need you to be together with us in achieving that goal.

First and foremost, please get vaccinated. The CDC reported in August that unvaccinated people are 29 times more likely to be hospitalized for COVID-19. Not only will you be protecting your own health by getting vaccinated, but you’ll be helping reduce the strain on our hospitals.

Whenever possible people should try to access the right level of care. The greatest restrictions on access are at the ED and in the hospital, so where available, make use of walk-in clinics, urgent care centers, or just call your doctor for an appointment if it’s something that can handled in the office.

But be patient. We are busy at all our locations. Unfortunately, it’s not unusual to have to wait to get labs drawn, get in to see a provider or get access to other services. We prioritizing our sickest patients. This doesn’t mean we are sacrificing quality, but convenience is going to take a hit.

And I want to make a special appeal to our policy makers, legislators, employers and insurance carriers: We need your support in important areas such as behavioral health, work force development, COVID-19 relief, wages, and more.

Finally, to everyone, please be kind to our care team members. They are doing all they can. They’ve been through a lot. They deserve our respect.

Ross Isacke, D.O. is Chief Medical Officer at Franklin Community Health Network.

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