In the wake of unprecedented staffing shortages and patient surges, Frederick Health Hospital shifted to "crisis standards of care" Monday, giving the hospital and health care system flexibility to care for patients with the highest levels of need.
This step is only taken in times of emergency, when the demand for health care exceeds the health system’s ability to provide it, Frederick Health said in a Monday news release. Making the move will allow the county’s largest health system to care for as many patients as possible with the staffing and resources it has available, according to the release.
Changes to protocol may include:
- Modifying surgical schedules consistent with Gov. Larry Hogan’s recent orders (the governor directed hospitals to suspend elective surgeries on Dec. 29)
- Expediting hospital discharges when safe and appropriate
- Transitioning to telehealth care options when applicable
- Simplifying documentation
- Re-deploying clinical and nonclinical staff members to areas with the greatest need
The shift comes as Frederick Health sees a dramatic uptick in coronavirus hospitalizations and patient levels. As of noon Monday, there were 104 people hospitalized because of the virus in the health system, down from 107 on Saturday — the highest number so far during the pandemic. Nearly 70 percent of Monday's coronavirus patient population was unvaccinated.
Frederick County overall logged 546 new cases and two more deaths on Monday, according to the local Health Department’s COVID-19 dashboard. The local positivity rate was 30.64 percent — higher than state levels, which stood at 26.87 percent. Positivity levels are calculated by dividing the number of COVID-19 positive test results by the total number of test results.
The health system's announcement also comes a day before Hogan is scheduled to announce additional emergency action in response to the pandemic. The governor has a news conference scheduled for 10 a.m. Tuesday.
Frederick Health Chief Senior Vice President Cheryl Cioffi called the shift to crisis standards of care “significant” and said it will allow the health system to best support its health care workers and other team members.
“This is a crisis, and we are doing everything within our power to bring the right resources to the table,” Cioffi, who is also Frederick Health’s chief operating officer, said in the release. “Making sure that Frederick Health is here for our community is paramount.”
According to the Maryland Institute for Emergency Medical Services Systems’ County/Hospital Alert Tracking System, Frederick Health Hospital was on yellow and red alert Monday afternoon. Under this system, red alert means hospitals have no more ECG-monitored beds available, and yellow alert means the hospital’s emergency department is temporarily requesting it receive absolutely no patients in need of urgent medical care.
Moving forward, Frederick Health leadership and clinical teams will monitor patient volumes and staffing levels daily and will re-evaluable crisis level protocols accordingly, Monday’s release read. Officials at the health system remain in touch with federal, state and community partners; and the Maryland Hospital Association to “ensure consistency and alignment across the healthcare delivery system,” according to the release.
Frederick Health Hospital is joining other health care centers in Maryland that have previously announced moves to crisis standards of care, including Johns Hopkins Bayview Medical Center, centers run by University of Maryland Capital Region Health and the University of Maryland Upper Chesapeake Medical Center.
On Thursday, Carroll Hospital issued a letter jointly with Carroll County’s Health, Public Safety and Fire/EMS departments in which it pleaded with community members to get vaccinated, take precautions and follow other steps to protect the county’s overloaded health system.
“Carroll County – this is real,” the letter read. “We are in a very difficult situation. This is not about politics or personal beliefs. This is about taking care of ourselves, each other, our first responders, our healthcare providers, and our community."
In implementing crisis standards of care, Frederick Health hopes to “manage expectations within the community about the reality of what our hospital is facing and how this may impact care,” Monday’s release read.
To reduce the burden on the hospital, the release said community members should protect themselves and others against COVID-19 by getting vaccinated, getting boosted, wearing a mask and practicing social distancing. They should also call their doctor or use urgent care for non-life-threatening issues if they aren’t feeling well, the release read.
Those who seek care at the hospital’s emergency department will be triaged by a clinician for the most appropriate care site and may be redirected to an outpatient facility if they are not experiencing a true emergency, according to the release.
During Thursday’s Board of Health meeting — in which the body ultimately voted to institute a mask mandate for public indoor spaces — Frederick Health Chief Medical Officer Dr. Kathy Weishaar shared that the health system has had patients wait for over 11 hours to be seen in its ER.
She also noted the health system is currently limited more by staffing shortages than by a shortage of beds or space. Over the last two years, Frederick Health has seen clinical staff members leave the medical field altogether due to burnout, while other employees have taken early retirements or pursued more lucrative jobs, she told the health board.
Frederick Health’s announcement Monday came after Hogan released further steps Maryland would take to suppress the surge of the virus: Masks are now required in state buildings, and state employees who receive their booster shot may request two hours of paid leave.
In the health system’s release, President and CEO Tom Kleinhanzl said Frederick Health will continue delivering the best possible care to its community.
“We will get through this crisis, as we have so many before,” he said.