'We no longer have the staff, the space, or the beds': Providence Alaska Medical Center activates crisis standards of care

Anchorage-based Providence Alaska Medical Center, the state's largest hospital, has activated crisis standards of care for the hospital, which is facing a shortage of staff and other resources amid the latest COVID-19 surge.

Kristen Solana Walkinshaw, MD, chief of staff for the hospital, announced the decision Sept. 14 in a letter to Alaskans.

"While we are doing our utmost, we are no longer able to provide the standard of care to each and every patient who needs our help. The acuity and number of patients now exceeds our resources and our ability to staff beds with skilled caregivers, like nurses and respiratory therapists," Dr. Solana Walkinshaw wrote in the letter, which was cited by The New York Times. "We have been forced within our hospital to implement crisis standards of care."

At Providence Alaska Medical Center, the hospital said more than 30 percent of hospitalized adult patients have tested positive for COVID-19, the emergency room is overflowing and patients wait in cars for hours to see a physician for emergency care.  

This means the hospital must prioritize scarce resources and treatments "to those patients who have the potential to benefit most," Dr. Solana Walkinshaw said.

"We have been required to develop and enact policies and procedures to ration medical care and treatments, including dialysis and specialized ventilatory support," she said.

The hospital said elective surgeries, some of which already have been delayed for months because of the pandemic, may also be continually postponed.

"What happens at Providence Alaska Medical Center and in other Anchorage hospitals impacts our entire state. Many specialty medical cares can only be provided in Anchorage," Dr. Solana Walkinshaw said. "People from all around Alaska depend on Providence to provide medical care for people statewide. Unfortunately, we are unable to continue to meet this need; we no longer have the staff, the space, or the beds. Due to this scarcity, we are unable to provide lifesaving care to everyone who needs it."

Alaska, where new daily COVID-19 hospitalization rates have increased 38 percent over the last two weeks, is among states where hospitals are strained because of the pandemic. On Sept. 6, Idaho also activated crisis standards of care for hospitals in the state's northern region.

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