With less than 30 percent of inpatient hospital beds in Arizona needed to treat COVID-19 patients, the hope among doctors and patients was that routine medical treatment would be readily available once again by year end.
But even though the Arizona Department of Health Services (ADHS) reports plenty of beds across the state for surgeries and even emergencies, as well as 65 percent of Intensive Care Units not currently in use, it appears Arizonans should expect to experience challenges in obtaining medical care for the time being due a shortage of health care workers.
According to a briefing report issued last month by the American Hospital Association (AHA), staffing pressures will persist across the health care industry, with “a critical shortage of 3.2 million health care workers by 2026.”
In Arizona, staffing concerns came to a head last week when ADHS confirmed Bisbee’s Copper Queen Community Hospital had begun operating under “crisis standards of care” protocols which required the cancellation of several scheduled surgical procedures.
The decision was prompted, according to Copper Queen’s chief medical officer, by the need to redeploy operating room nurses to care for other patients in the hospital, which has 13 general care beds and 24 emergency room beds.
The cancelled procedures were diagnostic colonoscopies used to detect gastroenterology diseases like colon cancer, Arizona Daily Independent has learned. Such procedures are generally done by a specialized doctor in a medical office setting on an outpatient basis, but Bisbee and nearby Douglas do not have any such options.
As a result, the procedures are performed at Copper Queen’s surgery center.
However, due to concerns of an upturn in COVID-19 patients hitting at the same time as the surgeries were scheduled, hospital administrators believed it was necessary to avoid a possible medical staff shortage if a worst case scenario presented itself.
Even if it meant delaying a potentially life-saving diagnosis or sending patients to medical facilities in Sierra Vista or even to Tucson.
It is a problem that will likely start to hit more Arizona hospitals and disrupt medical care for more Arizonans in the new year, according to the AHA briefing report.
The report addresses how health care workforce challenges currently threaten the ability of hospitals to care for patients 20 months after COVID-19 hit. And there is no end in sight, as the pandemic has had “a significant toll” on medical professionals in the U.S., nearly 94,000 of whom left a hospital workplace since February 2020.
Of those, more than 8,000 left between August and September of this year, coinciding with mandates which left frontline workers facing termination if not vaccinated.
“Throughout the pandemic, hospitals and health systems and their workforces have remained on the front lines mobilizing resources to ensure access to care for the patients and communities they serve,” the AHA report states. “This level of burnout coupled with ongoing COVID-19 surges, as well as other existing health care workforce pressures, has left hospitals across the country to contend with critical staffing shortages.”
And then there is the dire financial picture facing many small hospitals like Copper Queen.
According to the AHA, the credit rating agency Moody’s has forecasted a decrease in hospital margins over the next year due to a combination of wage inflation, the use of expensive contract nurse staffing firms, and the expansion of hospital worker benefits in order to retain employees.
Another credit rating agency, Fitch Ratings, forecasts that salaries and employee benefits are the largest expense category for hospitals, making up more than 50 percent of total expenses. Fitch Ratings noted that average hourly wages have risen nearly 10 percent since February 2020 “and is unlikely to subside anytime soon.”
In Arizona, one health care organization is suggesting its members think outside the box to address staffing issues.
The Arizona Hospital and Healthcare Association (AzHHA) recently noted that the current uptick of in-patient and out-patient admissions is directly related to the fact tens of thousands of Arizonans put off or could not receive medical attention since early 2020 due to a disruptions in access to non-COVID care.
But those new demands for medical treatment are coming at the same time staffing shortages are hitting every size and type of health care facility in the state. This prompted AzHHA to host a webinar for its members in mid-November about how providers big and small can utilize international health care workers to help stabilize core staffing.
The option, according to AzHHA, involves the recruitment and placement of foreign-educated registered nurses who have already been trained to meet U.S. credentialing and licensure standards.