Harborview Medical Center is once again taking and treating all types of patients, after a lack of bed space recently forced the hospital to temporarily divert care to nearby health care facilities.
The hospital diverted care for about seven days, sending less sick patients to other area hospitals earlier this month so that Harborview could rebalance its patient loads. Harborview mainly attributed the decision to overwhelming staff and bed shortages due to delays in discharging certain patients — particularly those who are medically stable and waiting to be discharged to a long-term care facility, like a skilled nursing clinic or adult family home.
Because widespread staff shortages have also crippled long-term care facilities and limited their capacity, however, these patients are often stuck at the hospital, creating a bottleneck for bed space.
When Harborview CEO Sommer Kleweno Walley announced the temporary change on Aug. 11, she said the hospital had reached an “unprecedented census level.”
For the week, most of the hospital’s lower-acuity patients were instead taken to Providence Swedish’s and Virginia Mason Franciscan Health’s facilities in the downtown Seattle area, said Mark Taylor, senior associate administrator at Harborview.
For the past couple years, Taylor has also been in charge of operations for the Washington Medical Coordinating Center — a center housed at Harborview that balances placement of COVID-19 patients requiring acute hospital care throughout the region.
“I feel very lucky,” Taylor said. “I was, as we all were, very worried about the impact of that and still am, to be honest. The hospitals and hospital systems in the area are still at very high occupancy. … But (during the week of diverting care) we were able to catch a week where we had relatively low call volumes.”
No numbers are yet available for how many patients Harborview diverted, but Taylor noted there “was not a huge volume.”
“Considering what it could have been, I think the hospitals in the local area did a magnificent job of coordination,” said Renee Rassilyer-Bomers, chief nursing officer of Providence Swedish’s central Puget Sound region.
She noted that at Providence Swedish, staffers placed just “a handful” of extra patients in hospital beds.
“The impact wasn’t felt too strongly,” Rassilyer-Bomers said.
At Virginia Mason Franciscan Health, more patients had to wait in the emergency room for hospital beds than usual, but for the most part diverting care went fairly smoothly, said Matt Metsker, the health care system’s director of mission control command services.
He lauded Virginia Mason Franciscan Health’s efforts to centralize many of its functions so hospital leaders can see real-time data on staffing, beds and resources for all their facilities. That work helped the hospital system more quickly balance patients, Metsker said.
“We’ve had to partner with other health care systems more than we’ve ever had to,” he added.
Before Harborview reopened services to all types of patients on Aug. 18, Taylor said the hospital was able to move some of its existing patients to its other campuses, including UW Medical Center Northwest, UW Medical Center Montlake and Valley Medical Center in Renton.
The hospital also suspended or postponed some planned procedures, he said.
Over the week, Harborview was able to move about 60 to 70 patients, which “helped us get back to a place where we felt we’d be able to handle some type of large event” that might send multiple patients to Harborview’s emergency room, Taylor said.
Even though Harborview is again taking lesser-acute patients, the hospital still remains at about 20% over capacity and continues to battle discharging delays, he said.
“We haven’t really resolved the primary problem, and we’re doing everything we can to avoid it,” Taylor said. “Without a little bit of luck, I don’t know that we can say (similar disruptions) won’t happen again.”
Hospital leaders say the temporary divert could be a brief look into what’s to come this fall.
“It’s a little flare of a warning” to let Washingtonians know these options could be used again in coming months, Rassilyer-Bomers said. “What we want to do now is prevent them from becoming more frequent.”