April 14, 2021

No pandemic lasts forever. I’m sure those in the Middle Ages must have thought that there would never be an end to the Black Death, but it eventually subsided after seven years. Many in the early twentieth century no doubt believed that the Spanish flu would keep visiting tragedy upon much of the world; but, after two years, it, too, was eventually vanquished. We can only hope, then, that whatever this current pandemic entails, it is not immortal, but has a limited shelf life and a certain expiration date.

Despite the short-term nature of pandemics, it is clear that we are not out of the woods just yet as it concerns COVID. The virus that began in 2019 is still a factor in certain hot zones, including at least 5 U.S. states. Michigan, for example, is currently experiencing the biggest surge in cases—despite its history of mask mandates and rigid lockdowns. This raises the question of how American hospitals, as a group, are handling the 2021 version of COVID. One government agency decided to get some answers to that question.

In late February of this year, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) conducted a series of interviews with the administrators of 320 hospitals of varying sizes across 45 states (plus the District of Columbia and Puerto Rico). Results were tabulated and a report was issued in late March. The following will act to summarize a few highlights of the report’s findings.

Current Challenges

The OIG first wanted to determine what were the most difficult challenges being faced by hospitals in light of the COVID-19 pandemic. Here are some of the responses:

High occupancy continues to be a problem for many hospitals. At the time of the survey, 40 responding hospitals had over 90-percent inpatient occupancy and 56 had over 90 percent of their ICU beds occupied.

There have been issues with discharging COVID patients during their recovery, which has affected available bed space throughout the hospital. The longer stays are creating bottlenecks throughout the facility, including in ICUs and emergency departments.

Increased hours and responsibilities, as well as other stressors caused by the pandemic, often result in staff being exhausted, mentally fatigued, and sometimes experiencing possible PTSD.

High turnover and competition for medical staff are causing staffing shortages. This, in turn, is often negatively affecting patient care.

Some hospitals are still facing problematic supply chains as it concerns personal protective equipment (PPE). Supplies of surgical gloves and N95 masks are particularly unpredictable.

Hospital expenses have increased, as prices for PPE soar and new costs for data reporting have been introduced. Some administrators indicated that the Medicare reimbursement for COVID patients is insufficient, as these patients typically require additional staff, resources and days in intensive care units.
So, that’s a brief rundown of some of the issues hospitals have dealt with in 2021 due to COVID’s continuing presence in many of our communities. Let’s now turn to ways in which hospitals are attempting to meet these and other challenges.

Current Strategies

The second question on the minds of OIG officials revolved around the ways in which hospitals were currently addressing the challenges imposed by the pandemic. Here are some of the strategies hospitals are now incorporating:

To address shortages and the rising cost of PPE, some hospitals reported sanitizing and reusing PPE to preserve supplies.

Telehealth is being used to increase patient access to care while reducing risk and workload for hospital staff. Some hospitals now use this technology to remotely connect specialists to the ICU, conduct follow-up and mental health visits, and provide education for at-home care.

Assistance programs and other social support systems have been established to enhance employee morale and reduce burnout. Hospitals are encouraging staff to share their experiences through support groups or attend counseling sessions.

Hospitals reported reallocating staff from different departments or supplementing their workforce with staff from other hospitals within their networks. Staff are being offered higher pay, overtime incentives, bonuses, and additional benefits. New graduates with less experience are also being recruited, along with nurses from other countries, in order to fill vacancies.

Many hospitals have come to rely on resource networks and communication with other hospitals to facilitate transfer and discharge of patients. Hospitals that are part of a network or with the ability to access regional systems have been using these resources to identify open beds for patient transfers.

Targeted outreach is being used to discourage patients from putting off treatment. For example, hospital staff are personally contacting higher-risk patients with underlying health conditions and are prioritizing visits for those patients.

To rebuild the public’s trust in hospitals as safe places to receive medical care, many administrators have used newspapers, social media, radio, and meetings with community groups to reinforce what their facility has done to mitigate the risk of getting COVID while in the hospital.
The mother of invention is necessity, and hospital administrators are doing what they can to be creative and innovative in addressing these COVID-induced challenges. As each hospital has its own unique set of challenges, each administrator must find what works best for their facility—whether that involves making use of the strategies recounted above or inventing a new, customized solution.

Looking to the Future

As part of the interview process, the OIG asked hospital administrators to unpack their crystal ball, in effect, and provide their take on what they see coming down the pike for their facility and their patients. The following reflects some of their responses:

Hospitals expressed concerns about the future of their workforce, as the recruitment pool for nurses and other healthcare workers continues to shrink.

Administrators expressed fear that an erosion of trust in hospital safety would continue to keep patients from seeking needed care. This, in turn, will only lead to a further deterioration in the health of many Americans.

Administrators are also concerned that COVID and its variants will not entirely dissipate, and that it will become a seasonal illness, such as the flu. “We are going to have to learn to live with COVID,” one administrator told the OIG.

Looking toward the future, hospital administrators expect telehealth to be a larger part of the way they deliver care, although they expressed concerned that it could not be delivered equally to lower-income patients without broadband access.
In conclusion, we are still dealing with a health crisis in America; but, according to the OIG’s report, hospitals have developed ways to cope with the crisis, even as they make plans for a potentially difficult future. For a copy of the OIG’s full report, we encourage you to go to the following link: Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery, OEI-09-21-00140 (hhs.gov). Remember that we at MiraMed Global Services are here to assist you in your business needs. You can find a list of our services by going to info@miramedgs.com.