Hospitals pause elective procedures
Virus admissions strain city system
Hospitals in Memphis are enacting measures to maintain capacity for patients as record-high numbers of COVID-19 patients are being admitted.
Methodist Lebonheur Healthcare officials informed employees Friday the hospital would cancel elective procedures scheduled for Monday and Tuesday, as the system endures sustained high levels of patients ill with COVID-19.
Dr. Richard Aycock, chief of staff at Methodist Le Bonheur Healthcare, said Monday the hospital system would revisit the decision to cancel elective surgeries after the two-day pause, noting that historically, hospitals experience a bump in admissions after Thanksgiving.
“It’s a decision we’re going to be in constant conversation about,” Aycock said.
As of Monday morning, the system had 219 patients admitted with virus complications, up from 213 Sunday and 191 on Saturday.
“So you can see it’s a pretty upward trajectory,” he said.
A spokesperson for Baptist Memorial Healthcare, Ayoka Pond, said elective surgeries were being delayed at Baptist Memorial Hospital-memphis, but that other hospitals in the system were continuing elective procedures. Only surgeries requiring an overnight stay will be rescheduled.
Additionally, Baptist is adjusting staffing levels in its units to accommodate the surge of patients admitted with COVID-19 complications.
As of Monday, 160 people were hospitalized with COVID-19, 37 of whom were in the intensive care unit at Baptist Memphis, according to Dr. Steve Threlkeld, co-chair of the infection control
program.
Of the 706 total licensed beds at the hospital, 446 were occupied Monday and of the 88 ICU beds, 68 were occupied, Threlkeld said.
He said at this time, the hospital had the capability to care for patients who had been scheduled for elective procedures. But he was worried at the rate at which COVID-19 hospitalizations were increasing.
“I think that’s the single most dangerous thing that we face,” he said. “If you start seeing a tripling of your cases, which we’ve seen in several weeks... when you look at those kinds of numbers, I don’t care how good your preparation is. You can be outstripped by this kind of thing.”
Regional One and Saint Francis hospitals will not be pausing elective procedures, representatives of the hospitals said.
As of Saturday evening, the latest system-wide data available, there were 447 COVID-19 positive patients hospitalized in the area and another 49 patients under investigation were hospitalized with COVID-19 symptoms.
In addition to freeing up hospital beds, putting off elective procedures gives hospitals the ability to conserve personal protective equipment and free up medical workers to serve in other capacities. While hospitals have the capability to open up more physical hospital beds, the beds can only be used if there are enough nurses to staff them.
But, while postponing or canceling elective procedures can give hospitals the ability to better control inpatient numbers, it also decreases revenues.
The cancellation of elective procedures at area hospitals in March prompted furloughs at multiple medical centers, including in the Methodist system. Methodist executives also took pay cuts due to the decreased revenues. Hospitals across the region and the country faced similar revenue declines while elective procedures were curtailed.
After the initial shutdown, Methodist hospitals began to phase elective procedures back in at the beginning of May, starting with about half of what would be considered normal volume with a focus on ambulatory surgeries.
What qualifies as ‘elective surgery’?
The question of whether to pause elective procedures is not a simple one, doctors have said. Not all elective procedures will require a hospital stay and the question of what exactly is an elective procedure is up for debate.
While some things, like cosmetic surgery, can often be postponed without health consequences. Other procedures, if delayed too long, can have serious consequences.
“Not all elective procedures are the same,” Aycock said. “Some can wait and be rescheduled at a later date with no harm to the patient, but others can’t. Cancer surgeries, surgeries to save a life or a limb... those really can’t wait.”
Aycock said Methodist, like other hospitals, individually evaluates each procedure, following a set of guidelines established by the American College of Surgeons and other national medical societies.
Throughout the pandemic, doctors and executives at Memphis-area hospital systems have said they are monitoring hospitalization numbers and regional case numbers on a daily basis to keep an eye on which hospitals are getting tight on bed space or staffing.
The number of available hospital beds fluctuates throughout the day depending not only on elective procedures, staffing and the number of COVID-19 patients but on other factors like the number of trauma patients received. Hospital censuses are often higher in the winter months, when other illnesses, like influenza, are circulating in the community.
With multiple hospitals in the region, Methodist and Baptist both take in patients from well beyond the borders of Shelby County but also have the ability to shift patients, and staff members, between hospitals as needed.
The two systems have treated the bulk of the region’s COVID-19 patients.
“Clearly, the systems are being stressed throughout the city at this point,” Aycock said. “And we need the help of the community to control this.”
Since the beginning of the pandemic, physicians like Aycock have been pleading for public buy-in on basic preventative measures. But those physicians encounter more than just fatigue around COVID-19 protocols, there’s defiance as well, Aycock noted.
“Even though we’ve developed more finesse in treatment options, and the vaccine is right around the corner... it’s going to take weeks to get the vaccine out to the community,” he said. “We really need to keep up our diligence on these preventative measures.”
Micaela Watts is a breaking news reporter for The Commercial Appeal. She accepts tips of all kinds at micaela.watts@commercialappeal.com.
Corinne Kennedy covers COVID-19’S impact on hospitals, economic development and soccer for The Commercial Appeal. She can be reached via email at Corinne.kennedy@commercialAppeal.com or at 901-297-3245.