UVM Medical Center plans to set up five additional ICU beds in pre-op space for the rest of the month and to reduce their number of operating rooms in use from 22 to about 15. A hospital spokesperson said this is to ensure enough staffing for those additional ICU beds, and to reduce the number of patients who need an ICU bed to recover after surgery.
The additional beds are expected to become available Monday, Dr. Stephen Leffler, medical center president and chief operating officer, said at a press conference Wednesday.
Expansion of the intensive care unit comes amid increased Covid-19 hospitalizations and strain on ICU capacity. On Wednesday, all but two of the Burlington hospital’s 46 intensive care beds were full. Seven of those ICU patients were being treated for Covid.
Hospital leaders have said the strain on capacity is not just because of Covid infections, but also because the pandemic has caused delays in other, more routine care.
“Patients continue to be sicker when they arrive, requiring more acute care and regularly pushing the limits of ICU capacity,” the UVM Health Network said in a press release on Tuesday.
The hospital plans to hire about 30 more traveling staff — including nurses and respiratory therapists — to care for patients in the additional ICU beds, said spokesperson Annie Mackin. Travelers would work alongside full-time staff.
The hospital estimates additional ICU staff will cost about $250,000 per week, Mackin wrote in an email.
“We don’t currently have a specific agreement with the state to fund these steps,” she wrote. “It’s not clear if we will be reimbursed or not.”
The hospital has also asked the Federal Emergency Management Agency to send additional staff, Mackin said, but it has not yet received a response.
Last week’s models predicting Covid and ICU capacity were “really concerning” for this week and through the end of the year, Leffler said.
“Early last week, I want to say Monday or Tuesday of last week, the projections for this week were really high, and next week looks worse,” Leffler said. “And that’s really when we started to put this in play.”
He said the move to increase capacity is not related to the Omicron variant, which has now been detected in two dozen countries, including the United States. However, he said the hospital is expecting a surge in Covid cases because of Thanksgiving gatherings.
To use surgical spaces for intensive care, the hospital will have to postpone likely hundreds of non-emergency scheduled surgeries, hospital leaders said Wednesday. They plan to meet with surgical staff to determine which procedures can be postponed until the new year, and those patients will be contacted directly.
Leffler said the hospital is working with state regulators and insurance companies to try to ensure that patients expecting their surgery this year — who may have already met their annual deductible — don’t have to pay more for their procedure because of delays. However, Leffler said those discussions are still in the works.
“We’re extremely sorry for anyone who’s getting a procedure delayed. We don’t take that lightly. We know that’s a big deal for people,” Leffler said. “We know it’s not elective for them, but it’s critically important right now that we make this adjustment so we can be here for the sickest Vermonters who need us.”
He said the medical center could increase ICU capacity even more if necessary — up to 90 beds — but next week’s expansion is meant to cause as little disruption as possible to surgical services.
Mackin later clarified via email that the hospital’s theoretical 90-bed maximum ICU capacity is linked to the fact that the hospital has 90 ventilators.
“Staffing that would be a serious challenge, but it’s our theoretical threshold for ICU max,” Mackin wrote.
In addition to the five additional ICU beds, the Burlington hospital plans to add 10 more Covid beds next week.
Central Vermont Medical Center in Berlin, an affiliated hospital, plans to hire additional staff and expand capacity by about three beds, though Anna Noonan, the hospital’s president and chief operating officer, said the hospital had yet to secure additional traveling nurses as of Wednesday.
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Correction: An earlier version of this story incorrectly described where the additional ICU beds will be placed.