Tulsa World

Hospitals shift toward crisis care

Strains on system not limited to COVID-19 patients

- COREY JONES Tulsa World

Oklahoma hospitals have transition­ed to some crisis standards of care as COVID-19 inundates emergency rooms and intensive care units, and the substantia­l strains on the hospital system are manifestin­g in myriad ways that aren’t limited to COVID-19 patients.

Hillcrest Hospital South in Tulsa has brought in a temporary trailer morgue. Medical tents have popped up outside Comanche County Memorial Hospital in Lawton and Stillwater Medical

Center.

Fourteen unvaccinat­ed COVID patients at McAlester Regional Health Center tapped out its ventilator capacity Friday, requiring its ethics committee to decide which COVID patients wouldn’t have access to a ventilator in the event that one or more of nine other COVID patients deteriorat­ed.

Patient wait times are extended, and hospitals are sending patients out of state — some as far as South Dakota, Idaho and Nevada.

The Oklahoma State Department of Health last week acknowledg­ed knowing of a couple of hospitals that had “short-term issues” with having enough medical-grade oxygen on hand but said they were able to replenish

the supply.

And an Oklahoma Hospital Associatio­n survey found that there are about 200 fewer nurses in Oklahoma hospitals now than in December.

“Lots of things (are) happening right now to be able to take care of our scarce hospital resources,” Dr. Jennifer Clark, an Oklahoma State University professor of health care delivery sciences, said Wednesday. “There’s a lot of shift around kind of using some of the crisis standards of care ideas to maintain ventilator resources and physical beds — but also being able to staff those beds and having the supplies that are needed.”

Clark conducts regular COVID informatio­nal sessions for Project ECHO — an effort to deliver specialize­d health care knowledge to rural areas.

Gov. Kevin Stitt has refused to reissue an emergency declaratio­n for the state, but Health Commission­er Lance Frye previously suggested that the emergency rules the governor did sign were what hospitals needed to respond to the surge.

OHA President Patti Davis said the emergency rules are “very helpful” with expanding licensed bed space flexibilit­y, but she noted that they don’t address the nursing shortage like the previous emergency order did.

“We don’t have everything back on the nursing side that we had last time,” Davis said. “There are things that we had that were broader than just hospital licensure that were in the surge before that we don’t have.”

Hospitals across Oklahoma are coping with the ongoing surge in varying ways that are becoming more visible to the public outside of their facilities.

Hillcrest HealthCare System said in a statement that increased COVID-19 rates and deaths in the community required an expansion of resources and capacity.

Hillcrest Hospital South brought in one freezer trailer in August that can hold up to seven bodies — the same trailer it used in December and January. The hospital’s morgue can hold two, and the trailer is in use.

“Hospitals work closely with funeral homes to ensure patients and families are taken care of,” Hillcrest’s statement says. “In this event, that includes expanding the size of our morgue as a service to our partners during this latest large surge.”

Stillwater Medical Center erected medical tents Friday outside its emergency room in advance of the extended holiday weekend, with Mayor Will Joyce declaring an emergency for the city.

The tents were put up to help triage and treat patients and relieve some burden from the emergency room.

Hospital spokeswoma­n Shyla Eggers said the tents were staffed from noon to midnight Saturday.

“While no patients were treated in the tents, some of the volunteers assisted with patients inside the ER,” Eggers said.

Eggers said the tents will remain in place for an undetermin­ed period of time in case a need for them arises.

Comanche County Memorial Hospital put up a tent facility on Monday to “help with the overflow of ER patients waiting to be seen or admitted to the hospital,” according to its post on Facebook.

The hospital noted that it had 61 COVID inpatients, only two shy of its record of 63 on Jan. 4.

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