The state today ordered hospitals to dramatically reduce the number of elective procedures that would require patients to stay overnight or longer, not so much because of the rise in Covid-19 patients directly but because of hospital staffing shortages and because of the seasonal increase of people coming in with non-Covid-related conditions.
In its "guidance" to hospitals, the state Department of Health and Human Services says:
On a statewide basis, hospitals are currently operating at over 90% inpatient capacity even as many hospitals have reduced their non-essential non-urgent scheduled procedures and implemented organizational measures to expand hospital bed capacity; this is compounded by 500 fewer acute care inpatient beds available as compared to January 2021 as a result of unprecedented staffing shortages. Furthermore, historical trends indicate that hospitalization rates increase by over 10% from late November through January.
The guidance does not apply to specialty hospitals or hospitals that have a certain minimum of free beds. The state had told hospitals last month to cut back elective inpatient procedures by 33%.
DPH defines non-essential, non-urgent scheduled procedures as procedures that are scheduled in advance because the procedure is not a medical emergency and where delay will not result in adverse outcomes to the patient’s health.
This reduction does not apply to ambulatory services that are not likely to lead to inpatient admission and preventative services, pediatric care or immunizations, pregnancy terminations, and essential, urgent inpatient procedures that have a high risk or would lead to a significant worsening of the patient’s condition if deferred. Accordingly, such services and procedures should continue.
The state also gave hospitals more flexibility to assign ICU nurses to other units, especially if they can help reduce the need for hospitalization - for example, by work in the emergency room.
In addition to telling hospitals to curb certain elective procedures, the state is also giving them permission to use space not normally allowed for care for non-invasive outpatient procedures and to use "alternate licensed inpatient spaces" for patients requiring hospitalization. These spaces have to meet certain standards for spacing between beds and easy access to medicine, medical equipment and hand-washing sinks.