Hospitals told a federal watchdog they are having a difficult time balancing complex care needed for COVID-19 patients and jump-starting efforts to resume routine hospital care.
The Department of Health and Human Services’ Office of Inspector General (OIG) released a report Wednesday (PDF) that detailed responses from hospital administrators employed by 320 hospitals across 45 states and the District of Columbia.
Several hospitals reported they are facing major clinical challenges caring for patients.
“Hospital clinicians have had to keep up with emerging treatment protocols, often without sufficient specialty staff, such as infectious disease specialists, pulmonologists, respiratory therapists and clinical nurses trained in treating COVID-19,” the report said.
A major challenge has been treating COVID-19 patients suffering long-term effects who need complex care. Some of the major post-COVID-19 conditions include pneumonia, blood clots and heart problems.
One of the hospitals told the OIG it predicts a “tsunami of people going forward” who experience long-term effects.
Monitoring this balancing act has been a major strain on hospital resources. “Hospitals reported having difficulty integrating COVID-19 care into normal operations, chiefly because of concerns about infection control,” the report added.
At the same time, hospitals reported patient delays and cancellation of routine patient care have led to worsening conditions.
Hospitals across the country have seen their patient volumes plummet. “Administrators predicted that such widespread delayed care would result in higher hospitalization rates and a need for more complex hospital care in the future,” the OIG said.
Administrators have also said that some in their communities are questioning whether it is safe to go to their facility for fear of getting the virus. “Some administrators speculated that this could be in part because of confusion over evolving public health guidelines during the pandemic,” the report added.
As the need for more complex care has emerged, staff are dealing with major stress, burnout and some trauma.
“Hospitals reported that increased hours and responsibilities, and other stressors caused by the COVID-19 pandemic, resulted in staff being exhausted, mentally fatigued, and sometimes experiencing possible [post-traumatic stress disorder],” the report said. “Hospitals reported that for the past year, staff have worked longer hours, extra shifts and mandatory overtime.”
This stressful time has led to major staff turnover. For example, 38 of the hospitals reported facing a critical staff shortage during the week before the pulse survey in February.
Nurses had the highest amount of turnover, but hospitals also reported losing respiratory therapists, nursing assistants, lab technicians and other staff vital to hospital operations.
“Many hospitals attributed the increased turnover of staff to stress and burnout caused by COVID-19, leading some staff to retire early or seek jobs outside of healthcare,” the report said. “Hospitals also cited competition for healthcare workers and the opportunity to earn more money by leaving a hospital to join a staffing agency.”
The American Hospital Association has called for a federal investigation into massive price spikes for travel nurses, which have become in hot demand during the pandemic.