The workforce crisis that pushed the state’s largest hospital to enact emergency staffing procedures is expected to get worse, leaders at the University of Vermont Medical Center said.
The medical center enacted the crisis procedure Thursday morning after exposures to Covid-19 driven by the Omicron variant sidelined more than 400 employees, roughly 5% of the 8,500-employee workforce.
Emergency staffing procedures are an extraordinary measure — and typically temporary — that hospitals can take to maintain enough staff to remain open. If staffing levels fall too low, hospitals may have to turn patients away and refuse transfers.
Stephen Leffler, the medical center’s president and chief operating officer, told VTDigger on Thursday afternoon that the staffing crunch would likely intensify over the next week. The crisis staffing policy will remain in place while the surge continues — at least seven to 10 days.
“Our community counts on us and relies on us, so we’re doing what we need to do to be here for as long as it takes,” Leffler said.
The medical center’s plan involves significant shuffling of staff to fill areas of high need. Executives with medical training would fill some staff vacancies. Nurse managers may tend to patients instead of overseeing the normal operations of their departments. Nurses may need to fill vacancies in other departments or pick up shifts beyond their normal schedules.
It’s a predicament many hospitals have faced since the pandemic began, and it’s one they try to avoid when possible, said Carri Chan, who studies hospital operations at Columbia University in New York City.
For the past two years, UVM Medical Center used every other tool it had to avoid enacting emergency staffing procedures, from canceling elective procedures to hiring hundreds of costly temporary staff and leaning on personnel from the Federal Emergency Management Agency.
But the highly contagious Omicron variant has pushed the hospital to the brink as coronavirus hospitalizations surge and hundreds of health care workers are calling in sick. UVM Medical Center’s plan comes days after Vermont set a record of 101 people hospitalized for Covid-19. As of Wednesday, 91 people were in the hospital with the virus, including 28 in intensive care.
Leffler said he is confident the hospital’s crisis staffing will help UVM Medical Center weather the surge but said executives will review and adjust the plan daily.
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The medical center can also request additional equipment and staffing from Vermont’s state Emergency Operations Center, according to Will Terry, spokesperson for the Agency of Human Services.
If, despite every effort, hospitals cannot accommodate every patient who walks through the door, the state and the health care system can institute an extreme policy known as crisis standards of care.
“If there are more patients than there are ventilators or beds, the protocol would be that you look at a priority list,” Chan said. “Patients who fall into the highest priority will get the last bed or will get that last ventilator. And patients who are lowest on the priority list will have to wait and hope that their condition doesn’t deteriorate without the care that they would normally get if there was an abundance of resources.”
Terry did not say how the state determines if such measures are necessary, but Leffler said the hospital can enact crisis standards on its own, without a state of emergency declaration from the governor.
“We’re not there now,” Leffler said. “If that did happen, we would report it to them and then we partner with them to make sure we have the resources we need to care for people.”
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