Montana hospital enacts crisis standards of care; state updates guidance for hospitals

Helena, Mont.-based St. Peter's Health enacted crisis standards of care Sept. 16 as their critical care units and morgue hit 100 percent capacity, according to KTVH-DT.

Under crisis standards of care, providers may have to triage patients by survival chances, medication may be rationed and patients who would normally be kept for observation may be sent home for recovery.  

"We are giving our staff permission to not do it all," said Shelly Harkins, MD, the hospital's chief medical officer. "The hardest thing they will do in their careers is not giving the care they are used to giving, but they simply can't."

St. Peter's Health said their intensive care unit, advanced medical unit and morgue are all full.   

"We are still very much here to provide care to our community and we are doing absolutely all we can to keep all services open," Dr. Harkins said. "True emergencies will always receive priority." 

In recent weeks, the system has received calls from providers in North Dakota, Idaho, Utah, Washington and Texas to see if they had any open beds, according to Dr. Harkins. On Sept. 16, the Idaho Department of Health and Welfare activated crisis standards of care for all hospitals statewide. 

"There are not enough beds in the Mountain West to serve the need," said Dr. Harkins.

Meanwhile, St. Peter's is facing provider burnout and a staffing shortage, with 200 positions currently unfilled. The system has asked the Montana National Guard for help, a request they are unsure will be granted. 

Nearby, Bozeman (Mont.) Health said it's close to implementing a surge plan and Billings (Mont.) Clinic is looking to activate crisis care standards.  

On Sept. 15, Montana's Department of Public Health and Human Services updated existing crisis care guidance developed in 2020. The revision is an effort to ensure the guidance takes into account state-specific resources, populations and needs.


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