Hospitals ready to perform elective surgeries

Inslee eases restrictions

Olympic Medical Center and Jefferson Healthcare hospital officials are preparing for an influx of patients following Gov. Jay Inslee’s clarification on restrictions for hospitals performing non-urgent, or elective, surgeries and procedures.

They also are hoping that Inslee’s new parameters for who decides when harm would occur if the procedure is delayed, making the patient’s physician a key player in the decision, will hasten surgeries and procedures for patients in pain as well as boost revenues.

At tax-district hospitals in Port Angeles, Port Townsend and Forks, income has plummeted by 40 percent to 52 percent since the restrictive surgery rules were imposed almost two months ago, OMC, Jefferson Healthcare and Forks Community Hospital administrators said in recent interviews.

“We have a huge backlog of surgery,” Olympic Medical Center CEO Eric Lewis told hospital commissioners at their meeting Wednesday, which also was National Nurses Day.

The pileup is about to shrink.

As of Monday, the use of 2½ OMC surgery rooms will be expanded. In normal times, the hospital has four operating rooms in use Monday through Friday.

“We will be able to do a lot more surgeries starting Monday,” Lewis promised.

Some non-urgent procedures that could not be conducted under Inslee’s original March proclamation include orthopedic, urological, obstetric-gynecological and general surgeries, he said.

Patients who need hip replacement surgery, for example, are in pain and can’t sleep, although whether they could get the procedure was left up in the air until Inslee’s clarification.

“They need that surgery,” he told the commissioners.

“It’s not an option.”

Jefferson Healthcare is contacting patients whose surgeries have been delayed, spokeswoman Amy Yaley said Friday.

All three North Olympic Peninsula hospitals have seen a precipitous drop in patients, not only those who haven’t been able to get elective surgeries but also in the emergency rooms and for routine appointments, administrators said.

“Our concern right now is to get to the patients whose care has been delayed and back in, so if they need lab work and they’ve been putting it off, making sure they are coming back in now,” Yaley said.

“If their surgeries have been delayed, we are getting them back in to set things up to do that.”

Paul Babcock, Forks Community Hospital chief financial officer, said hospital revenue has dropped 40 percent, emergency room visits have declined by 25 percent-30 percent, and clinic visits and outpatient procedures have gone down.

The March edict, which also covered dental procedures, had limited “healthcare services, procedures, and surgeries that, if delayed, are not anticipated to cause harm to the patient within the next three months,” according to the proclamation (https://tinyurl.com/PDN-ElectiveSurgery).

It was based on the severe disruption of the supply chain for personal protective equipment and the need to protect health care workers.

Lewis said Friday that OMC has 60,000 masks available for visitors and, like Jefferson Healthcare hospital, last week began requiring the public to wear masks in public areas of the facility. OMC will review its policy by June 30.

Examples of delayed procedures in the March proclamation included “most joint replacements, most cataract and lens surgeries, non-urgent cardiac procedures, cosmetic procedures, some endoscopy and some international radiology services.”

Inslee originally did not define “harm,” a key point he clarified April 29 by leaving the assessment up to a patient’s doctor and admitting the definition was lacking in its original form.

Under both versions, it is a gross misdemeanor to violate the restrictions under Inslee’s state-of-emergency powers, meaning physicians could go to jail if they misapplied whatever harm meant, Lewis said.

“Surgeons were nervous,” he added.

“To clarify, the Governor leaves assessment of harm up to the individual clinician,” the amended proclamation said (https://tinyurl.com/PDN-InsleeClarifies).

“In order to assess harm, clinicians should consider if a patient’s illness or injury is: causing significant pain, significant dysfunction in their daily life or work, or is either progressing, or at risk to progress,” it said, listing nine criteria, including “overall health.”

“Additionally, clinicians should assess the risk of harm that could be experienced by a patient as a result of undertaking the surgery or procedure during the COVID-19 pandemic.”

Lewis welcomed Inslee’s revised order, but was training his attention on May 18, when the restrictions expire.

“We still don’t know what happens May 19,” Lewis said.

“We like to think months ahead of time.”

Mike Faulk, an Inslee spokesman, said Monday that the restrictions will be eased gradually.

“The expectation following May 18 is we would move into a phased approach of allowing more elective procedures and services,” Faulk said in an email.

The added patient traffic won’t come soon enough for the hospitals’ bottom lines.

“We have taken an incredible hit and are currently running anywhere from 47 percent-52 percent of budget,” Yaley said in an email.

She urged patients who need non-urgent surgeries to contact their health care providers to decide together if procedures are warranted.

“If they think delaying their surgery is causing them harm, they should talk to their physician,” Lewis said.

Jefferson Healthcare CEO Mike Glenn said in an email the hospital had operating losses of $2.4 million for February and March and projects a $4.5 million loss for April.

The facility received a $2.67 million Coronavirus Aid, Relief, & Economic Security Act grant in April and is applying for additional CARES Act funding,” he said.

“Jefferson Healthcare currently has cash reserves to help us weather this storm,” Glenn added.

“However, absent of additional federal funding, the net result of all of this will no doubt leave a noticeable and lasting impact on the healthcare delivery system for east Jefferson County.”

OMC and Forks Community Hospital are also hoping for additional federal funding.

“We are here for the community; we’re not here to make money,” Babcock said.

“The stimulus packages have been a lifeline, and it’s good they are doing it.

“They need to continue doing it as long as this crisis goes on.”

Lewis said surgeries are down 75 percent.

Revenues are down 40 percent in April, or about $7 million a month, he said, adding that the inpatient census in the hospital is 35-40 inpatients daily at the 80-bed acute-care facility.

Emergency room visits are down 40 percent as well, in keeping with a statewide trend, Lewis said.

OMC did receive $5.9 million in federal aid about two weeks ago.

And still, no layoffs have been imposed, Lewis added.

Forks Community Hospital has received $3.8 million in federal funding, is seeking Federal Emergency Management Agency money, and will have to pay back loans.

“We are basically applying for everything we can,” Babcock said.

The loss in patient traffic has been seen across the Peninsula.

“We’ve seen a very precipitous drop in folks coming into the (Forks Community) hospital due to the stay-at-home orders,” Babcock said.

“We’ve done everything we could to encourage them if they are sick and need help, you need to come in.

“I think people have stayed away, just in general.”

________

Senior Staff Writer Paul Gottlieb can be reached at 360-452-2345, ext. 55650, or at [email protected].

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