Andrew Mueller, MD, chief executive of MaineHealth, said much of the challenge can be traced to a workforce shortage that has been building for some time, and he talked at length about the need to train more clinical professionals. He also said other factors are making it harder for health care providers to keep up with demand at this time.
“We’re still battling, just a really hot pandemic. We’re seeing the largest numbers of hospitalized patients since the pandemic began, right now,” said Mueller.
In addition, Mueller said, many patients who understandably delayed care are now arriving at MaineHealth hospitals much sicker, putting greater demand on the organization’s care team. Mueller also noted that the ongoing labor shortage is not just impacting MaineHealth, but health care organizations across the region. That in turn is making it hard to transition patients out of the hospital to skilled nursing facilities and to behavioral health facilities.
Mueller said that, while departures from the health care workforce over the state of Maine requirement to be vaccinated against COVID-19 will have some impact in the short-term, the real challenge is with overall long term trends in the labor market. Mueller presented data that showed that infections and quarantines related to COVID-19 have been a significant challenge for the health care system and that vaccination was the right way to keep care team members, patients and communities safe.
“It’s very clear to us that the vaccine mandate really helps to protect and preserve our work force.,” said Mueller, who added that having the full care team at MaineHealth vaccinated is not only consistent with what is best for patients and the community, but supports the organization’s vision of ‘Working together so our communities are the healthiest in America.’
During the Tuesday virtual press conference, Joel Botler, MD, chief medical officer of Maine Medical Center, shared that the state’s largest hospital is seeing unprecedented demand. This is resulting in ongoing evaluation of, and rescheduling of some, non-emergent procedures at the hospital. Also, the MMC emergency department has been on frequent “diversion” in recent weeks, meaning that only life-threatening and other critical cases are taken in and others are directed elsewhere for care.
Cindy Wade, R.N., president of LincolnHealth in Damariscotta and Boothbay Harbor, said her rural hospital network is straining under the increased demand and the shortage of workers. She said in her hospital there is a particular challenge with patients who need care in a nursing home but can’t find a space due to the labor shortage impacting skilled nursing services.
Wade also urged people with non-life-threatening concerns to use LincolnHealth’s urgent care center in Boothbay Harbor rather than the hospital emergency department in Damariscotta. She said that even if someone has to drive a bit to get to Boothbay Harbor, they are likely to get care and be home sooner than if they sought similar care in the emergency department.
The health system leaders asked patients and communities to do their part in mitigating the capacity challenges for providers.
Mueller urged people to get vaccinated against COVID-19, noting that the sickest COVID patients are those who are not vaccinated.
The leaders also stressed the importance of seeking out the best venue for care. Across the health system, hours have been extended for walk-in care, urgent care and at doctor’s offices to help take the pressure off emergency departments.
MaineHealth is taking a number of steps in response to the capacity issues, including:
- Forming a work group specifically targeting capacity. The work group uses a “capacity dashboard” that enables them to see on a daily basis where beds are available across the health system and where patients can be appropriately transferred to receive the best possible care.
- Reducing non-emergent procedures, evaluating them day-to-day depending on capacity.
- Expansion by the MaineHealth Medical Group of outpatient access, including extending primary care, walk-in, urgent care and telehealth hours to help reduce the strain on emergency departments.
- Placing an emphasis on supply chain efforts to ensure the health system has the right equipment to keep everyone safe.
- Creating incentives to add staff, including a $61 million market adjustment to pay across the system in August and still higher increases for some of the most difficult positions to fill, making sure that wages are competitive. The system also significantly increased the employee referral bonus.
- Continued investment in training programs for critical positions, working both internally and with community partners to promote these opportunities. Longer term, the health system will be investing nearly $5 million next year in partnership with community colleges and institutions of higher learning to build a workforce pipeline into the future.
The leaders also touched on other steps that can be taken to help alleviate the capacity challenges.
Mark Fourre, MD, president of Pen Bay Medical Center and Waldo County General Hospital in Rockland and Belfast, noted there were three important priorities for the community and policy makers that would help improve the situation. One of those is reimbursements and programing for behavioral health, which is being felt today in the form of patients who are having a mental health crisis filling emergency department beds over many days. “That is a long standing problem made worse today,” said Fourre.
Fourre also noted that investment in local EMS companies and other patient transport services as well as reimbursements for long-term care services at nursing homes have also lagged, and the failure to invest in those services is making the current situation much worse.
Additionally, Mueller said the investments in supporting training and education for health care workers announced by Maine Gov. Janet Mills on Monday were positive steps forward, and he said hoped that the initiative will be followed by a permanent investment in expanding the state’s capacity for training nurses and other health care professionals.
Mueller also had one additional ask of the community on behalf of the entire MaineHealth care team, which is to continue to appreciate and respect the difficult job health care workers are doing.
“One of the other things that we need you to do is just be patient, and recognize we are all working hard to ensure we get everyone cared for in a timely manner. I can’t say it enough; we have the most amazing care team,” said Mueller. “We have true heroes on the front lines.”
Editors, reporters producers please note:
The recording of the news conference can be found here: https://vimeo.com/639191738/4cef5efbcb
Also, there were two charts presented during the news conference. One showing COVID-19 absences among MaineHealth care team members over time and another showing the number of vacancies among the MaineHealth care team over time. Copies of those charts as well as spread sheets showing the data points used to make them are available here: https://assets.mainehealth.org/share/B87C425A-BB89-4B30-AE405F6DBA362B67/
MaineHealth is a not-for-profit integrated health system consisting of nine local hospital systems, a comprehensive behavioral health care network, diagnostic services, home health agencies and nearly 1,700 employed physicians working together through the MaineHealth Medical Group. With more than 23,000 employees, MaineHealth is the largest health system in northern New England and provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire. It includes Franklin Memorial Hospital/Franklin Community Health Network in Farmington, LincolnHealth in Damariscotta and Boothbay Harbor, Maine Behavioral Healthcare in South Portland, MaineHealth Care at Home in Saco, Maine Medical Center in Portland, Memorial Hospital in North Conway, N.H., Mid Coast-Parkview Health in Brunswick, NorDx in Scarborough, Pen Bay Medical Center and Waldo County Hospital in Rockport and Belfast, Southern Maine Health Care in Biddeford and Sanford, Spring Harbor Hospital in Westbrook and Stephens Memorial Hospital/Western Maine Health Care in Norway. MaineHealth Affiliates include Maine General Health in Augusta and Waterville, New England Rehabilitation Hospital in Portland and St. Mary’s Regional Medical Center in Lewiston. It is also a significant stakeholder in the MaineHealth Accountable Care Organization in Portland.