Hospitals face 2 surges: Critically ill COVID-19 and sicker non-COVID patients

Some hospitals are facing two patient surges — patients who avoided or couldn't get medical care amid the pandemic, alongside a rising number of COVID-19 patients.

"We have seen a post-pandemic overall surge of inpatient needs and capacity," Dale Beatty, DNP, RN, chief nurse executive and vice president of patient care services at Stanford (Calif.) Healthcare, told Becker's. "We're at 100 percent capacity."

The organization is "outstripping beds everyday," Dr. Beatty said. And it's not just COVID-19 patients. The hospital is seeing "sicker" patients, reporting higher volumes of critically ill non-COVID-19 patients.

Who are the patients making up the surges?

Some of the non-COVID-19 patients had care delayed or elective procedures pushed back, Dr. Beatty said.

COVID-19 long-haulers are also accounting for a significant portion of the patients, Dr. Beatty said. The patients are no longer testing positive for COVID-19 but still require care related to damage from the virus. Many patients require extracorporeal membrane oxygenation and are quite resource-intensive.

Stanford's emergency department is also seeing higher patient volumes through ED. The rising number of adult ED visits speaks to the level of people coming back to acute care. Stanford's transfer center has also been active lately, with a higher level of patients transferred in the area.

How is Stanford meeting new demands?

In November 2019, the organization moved into a new building, which provided space for additional beds, Dr. Beatty said. To meet new patient flow demands, patients either go to critical care beds or acuity-adaptable beds, and then resources are shifted accordingly. The goal is to reduce patient transfers and handoffs. The strategy has given Stanford some flexibility and adaptability, thereby improving quality and safety.

The organization also added advanced practice providers to care in neuromedical units, intensive care units and oncology departments, a move that has better positioned the system to meet an increase of patients.

The next move

"There's some speculation we will see an additional COVID spike," Dr. Beatty said, noting that Stanford is monitoring the situation closely.

"We're planning for the upcoming flu season on top of COVID-19 because we don't have universal masking this season, which could prove to be challenging," Dr. Beatty said.

Leadership is working on building surge capacity right now so it has the ability to expand for the winter to meet peak census. Stanford's contingency plan focuses on workforce and bed count, and Dr. Beatty said the organization feels confident they will be able to manage any potential surge.


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