Washington hospitals are sounding the alarm on overcrowded facilities and long wait times stemming from discharge challenges, care backlogs and other demands on the state’s healthcare system.
The Washington State Hospital Association (WSHA) told local media in a Monday news briefing that numerous member healthcare facilities—particularly those in the western, more populated counties—are at 120% to 130% capacity.
The result is worsened patient care, long emergency department wait times and disruptions to ambulance services, they said.
“We are doing our best, but many of our hospitals ... are more strained today than really at any other point since the pandemic began,” Steve Mitchell, M.D., medical director of Harborview Medical Center’s emergency department and the Washington Medical Coordination Center, told reporters during the briefing.
The culprits, according to hospital leaders participating in the call, include staffing shortages, unique state guardianship laws, previously delayed procedures and—to a limited extent—new COVID-19 admissions.
The staffing shortages are impacting both hospitals and post-acute care options such as skilled nursing facilities; however, the latter is having a direct impact on how many patients can be transferred from a hospital to a more appropriate site of care and forcing some patients to unnecessarily stay in the hospital for months, leaders said.
Additionally, Washington’s laws restrict a family member or close friend from consenting to a facility transfer on behalf of an incapacitated patient, WSHA Vice President Taya Briley explained. Without power of attorney, the state requires a time-consuming process appointing a legal guardian, she said.
“We are unique in the nation in our state taking this position about the required appointment of a guardian, and we are feeling that pain across our healthcare system,” Briley said. “It is not a practical way to move patients through the system.”
All the while, the pandemic has hamstrung hospital finances and placed consistent volume pressure on healthcare facilities. Per state-collected statistics, COVID-19 hospitalizations now are claiming about 11% of Washington’s hospital beds—down from nearly 32% in January but well above the 3.5% of April.
Steve Brooks, president of the Washington state fire chiefs association, said during the briefing that the difficulties are frequently forcing paramedics to wait at the emergency department with their patient, in at least one case up to four and a half hours. The fire chief also noted that his organization encourages people to consider alternatives such as telehealth or urgent care when possible.
WSHA said it has petitioned state government to reconsider its guardianship laws and is now calling for temporary, rapid response teams that could help address the backlog.
“We have solutions that we know will decant the system,” she said. “We need to make sure these strategies are being deployed as quickly as they can be to support the acute care part of the system so folks can get the care they need when they need it.”