Hospital capacity

At a recent news conference, leaders from across our MaineHealth system, including myself, described how a confluence of trends have 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. Nearly every hospital is at or near capacity, often with long waits for care.

At PBMC and WCGH, we are faced with similar strains. Our emergency departments are seeing unprecedented numbers of patients with severe illness, in addition to an increase in behavioral health patients. The labs at both hospitals are seeing sharply higher demand for blood work, and this has increased wait times. Like other hospitals in the state and across the nation, we too have had to reschedule some non-urgent surgeries so that we can focus on patients with the most serious conditions. Despite these challenges, one thing has not changed; we remain committed to providing safe and effective care in order improve the health of our communities.

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. 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.

This labor shortage is also hitting nursing homes and other services hard, and 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 taken up by those awaiting such care.

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 a $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. 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.” 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 better yet, call your doctor for an appointment if it’s something that can be 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 are 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.

Mark Fourré, MD, President

Pen Bay Medical Center | Waldo County General Hospital

Halloween Day Storm

During the numerous public meetings via zoom during this past year on the City Council’s ordinance to construct new detached Accessory Dwelling Units or ADUs, and on the proposal to provide a Contract Zone for the MaineHousing Authority, Knox County Homeless Coalition and their representative entity, Knox County Habitat, for a new housing construction project at 165 Talbot Avenue, informed and knowledgeable members of the public forewarned the city council and the general public about impending heavier and more frequent storm events from climate change leading to more severe incidences of street and property flooding, especially east of Broadway. From Lindsey Brook overflowing its embankment onto city streets, continued infill development on smaller lots  already built-out, and building in wetland areas, takes away from much needed open space in which to absorb the additional and more frequent rain falls thereby lessening brook, street and property flooding.

The past Oct. 31 Halloween day storm confirmed their dire warnings. Unfortunately, a majority of the council dismissed these predictions out of hand as not being germane to the issues at hand, and proceeded to vote for zoning changes which will only aggravate street, property and Lindsey Brook flooding during even more frequent and heavier rain storm events; however, the damage and hazardous conditions caused by the Halloween day storm to our city streets and to private properties validated their warnings.

As a note, pictures of the proposed development site at 165 Talbot Ave after the 2021 Halloween day storm — which will go down in history like the April Fools Day Flood in Maine of 1987, in which I was also a participant — showed standing water or flooding in areas of the site. If the site had been fully developed, as proposed, the downstream flooding to Lindsey Brook and to the city streets could have been worse

Rodney Lynch