Area hospitals ‘exchange’ patients to stave off capacity concerns as hospitalizations rise

Washington County Hospital says rising hospitalizations are becoming concerning, but it’s not the number of patients in its own rooms that’s the worry.
Published: Nov. 11, 2020 at 11:49 PM CST
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WASHINGTON, Iowa (KCRG) - As COVID cases rise in Washington County, Washington County Hospital has also seen a rise in patients over the last few weeks, both in its COVID rooms and throughout the rest of the hospital.

“But we still have capacity, and we still are able to handle all the inpatient traffic that’s been sent our way so far,” Todd Patterson, the CEO of Washington County Hospital & Clinics, said.

Patterson said while the hospital was treating multiple COVID patients as of Wednesday, its seven negative-pressure rooms designated for those patients specifically weren’t at capacity.

He said the hospital also has better knowledge and equipment to treat patients than staff did earlier in the pandemic, along with adequate PPE and testing supplies.

But Washington County Hospital doesn’t have an intensive care unit, so it transfers its sickest patients elsewhere, especially to the University of Iowa Hospitals & Clinics in Iowa City and Mercy Iowa City, using the lone ventilator it owns to make those transfers.

“Our biggest concern, I think, is if the hospitals to our north, which take a lot of our transfers, if they end up with limited capacity, that can start to back up the rural transfer systems that we depend on a lot,” Patterson said.

UIHC CEO Suresh Gunasekaran said while his hospital is experiencing record high hospitalizations this week, it has the ability to add up to 100 more ICU beds as part of its surge plan, doubling its normal intensive care capacity.

Gunasekaran said on a Nov. 5 teleconference with reporters that UIHC wasn’t close to reaching that point, but that that, it doesn’t have a plan if more ICU capacity is needed.

“I assume by the time that we have been overwhelmed, or if we get to that stage, it would be pretty dire,” he said on the Nov. 5 call. “We haven’t really thought through what that looks like. We haven’t really thought through transferring patients to other places. We are usually the place that gets the transfer, not sends the patient out.”

But that process is sort of what UIHC and Mercy Iowa City are doing right now with Washington County Hospital, through an “exchange” of patients that Patterson described.

He said his hospital will send some of its sickest patients, who may need intensive care, up to the Iowa City hospitals, which will then transfer less sick patients down to Washington.

“It’s kind of our way to try to help them maintain capacity so when we need to send people up who are really sick, they can take care of that,” Patterson said.

This swap has been used more frequently over the last few weeks, though he said it could be called into action whenever larger area hospitals are concerned about capacity or staffing.

“I think four or five patients this week, I believe, we’ve either brought down from the University or from Mercy that are either people that have geographical ties to us down here or are a particular level of care,” Patterson said.

While other area hospitals have said they are worried about not having enough staff to care for an influx of patients and have put plans in place to address that, Patterson said Washington County Hospital hasn’t had to install its contingency plan just yet.

“It would be cutting back on certain services. It could be elective cases. It could be certain types of outpatient services that we provide. It just depends on how and where pockets of the disease would show up,” Patterson said. “The only thing I know for sure is we don’t know what’s going to happen. I really hope that we don’t have to do that.”

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