Crisis care standards now active for 20 healthcare facilities across Alaska

After weeks of rising COVID-19 cases and a wave of hospitalizations that have strained state hospitals, 20 healthcare facilities in Alaska are now operating to crisis care standards.

Shifting to crisis standards, which provide a framework for providers to make difficult decisions about patient care and prioritization when resources are limited, is often viewed by providers as the worst-case scenario. The standards also provide liability protection for healthcare workers who work with limited resources.

According to a statement released Saturday afternoon by the state health department, the 20 affected facilities include:

• Alaska Native Medical Center

• Alaska Regional Hospital

• Bartlett Regional Hospital

• Bristol Bay Area Health Corp. / Kanakanak Hospital

• Central Peninsula Hospital

• Cordoba Community Medical Center

• Fairbanks Memorial Hospital

• Maniilaq Health Center

• Mat-Su Regional Medical Center

• Norton Sound Health Corp.

• St. Petersburg Medical Center

• Providence Alaska Medical Center

• Providence Kodiak Island Medical Center

• Providence Seward Medical Center

• Providence Valdez Medical Center

• SEARHC / Mt. Edgecumbe

• Southern Peninsula Hospital

• Elias specialized hospital

• Wrangell Medical Center

• Yukon Kuskokwim Health Corporation.

“I want to stress that our healthcare facilities in Alaska remain open and able to care for patients. Alaskans in need of medical care should seek it soon, even in these difficult times, ”DHSS Commissioner Adam Crum said in the statement.

[Are Alaska’s hospitals short-staffed over COVID-19 vaccination mandates? Not yet.]

Several of these health facilities had already adopted their own facility-specific crisis care standards.

Providence Alaska Medical Center moved up to crisis standards early last month. This week, the Alaska Native Medical Center and hospitals in Bethel, Kodiak and Fairbanks also made the switch.

Enforcement of crisis care standards varies widely from facility to facility, health officials said this week.

In Providence, “crisis care” has meant occasional rationing of treatment and the use of state guidelines and an in-house triage team to make difficult care decisions if necessary. At the Alaska Native Medical Center, the decision to switch to crisis standards was primarily made to allow more flexibility for providers.

Alaska hospitals have been operating under high stress levels for months. Some impacts on care included limited renal dialysis therapy, a shortage of oxygen supply, staff shortages, and difficulties in transferring patients from rural communities.

Earlier this month, the state activated crisis standards in an addendum to the emergency public health ordinance and Bill 76.

“Today’s action recognizes that Alaska has an interconnected and interdependent health system, requiring the activation of the state’s decision-making framework,” the Department of Health and Human Services said. Alaska in a press release.

The crisis care standards “will remain in effect until there are sufficient resources to provide the usual standard of care to all patients,” the state health department said.

To deal with staffing shortages at many Alaskan hospitals, the state signed a federal contract to bring in about 470 health care workers from outside. They started arriving this week.

[Alaska reports over 1,000 COVID cases Friday as ANMC shifts care standards, gets help from Outside workers]

A “critical lack of resources” in Fairbanks

Foundation Health Partners, which operates Fairbanks Memorial Hospital, said on Friday it had activated crisis care standards due to a “critical lack of resources,” including staff, available beds and options for transferring to d other establishments.

“Switching to crisis care standards is not something we take lightly,” said Dr. Angelique Ramirez, chief medical officer of Foundation Health Partners, which also operates the Tanana Valley Clinic and the Denali Center. “This is in response to a very serious wave of COVID in our community. “

Health organization Fairbanks also referred to a shortage of monoclonal antibody therapy, which health officials say is a very effective treatment for people at high risk with COVID-19 early in their illness. although they stressed that it does not replace vaccination. .

Other factors involved in the decision, according to Ramirez, include “community spread driven by low vaccination rates and low use of masks,” a high number of patients and the acuity of hospital patients.

About one in three patients hospitalized at Fairbanks Memorial Hospital on Friday tested positive for COVID.

[’Watching themselves die’: Fairbanks nurse describes panic and ‘air hunger’ among COVID patients in video encouraging vaccination]

The move to crisis standards “has an impact on all patient care, those with broken bones, trauma, heart attacks, strokes, COVID, anyone in need of medical attention could be affected,” Ramirez said. “The care we are able to provide is very fluid and can change from day to day and even hour to hour depending on the availability of resources within our system and statewide.”

Yet she urged people not to delay medical care, saying, “You will always receive the best and most compassionate care we can provide at the time.”

The borough of Fairbanks North Star is one of the least vaccinated areas in Alaska, with 51.8% of residents fully vaccinated, according to data from the state’s health department.

This week, the Chancellor of the University of Alaska Fairbanks asked the head of the university system to consider approving a vaccine requirement for staff and in-person students at UAF sites in Fairbanks, said AU interim president Pat Pitney in a letter to the university community on Friday. . This demand was based on multiple factors, including demands from staff and students; spread of the community virus; the number of in-person programs offered; and the residential nature of the UAF campus, Pitney said, adding that an update would be released within two weeks.

Health officials continue to encourage people to wear masks in public, get vaccinated if possible, and get tested if symptoms of COVID-19 develop.

This is a developing story. Check back for updates.

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