Under-staffed, some capital region emergency care facilities cut hours or close


ALBANY – Several emergency care facilities in the capital region have curtailed their operations and hospitals are considering cutting their own spending to meet a staff shortage.

The situation, which some refer to as a crisis, has been simmering for years but has worsened during a physically and emotionally draining 19-month pandemic that has increased the rate of burnout among healthcare providers.

The next shoe came off at midnight Monday, when a state deadline for COVID vaccination arrived and New York caregivers who had refused to vaccinate were suspended from work.

Late Monday evening, Governor Kathy Hochul signed an executive order making it easier to replace these unvaccinated healthcare workers and creating a 24-hour-staffed Ministry of Health operations center to troubleshoot and resolve any staffing crisis. acute condition that can occur in individual establishments.

On Tuesday, Hochul provided a hopeful update that a significant number of refractories were receiving late vaccinations.

The percentages are low – only 4.9% of hospital staff, 5.7% of nursing home staff and 6.6% of adult care facility staff who are medically eligible for vaccination still refuse to be vaccinated. do Tuesday.

But that’s out of a combined workforce of 692,000. Those small percentages add up to more than 35,000 people refusing to be vaccinated, plus more than 10,000 more who say they plan to be vaccinated but have not yet. made.

Albany Medical Center CEO Dr Dennis McKenna said his hospital and the capital region as a whole were doing much better than average, but not enough.

“It really is a crisis, there are no two ways about it,” he said.

INITIAL CUTS

Here is an example of the impact in the region:

  • Albany Med has temporarily closed its emergency care facilities in Guilderland and Mechanicville and moved staff to the main hospital to relieve pressure on the emergency department.
  • WellNow has temporarily suspended emergency care at its clinics in Cobleskill, Glenville, Latham, North Greenbush and Rotterdam; COVID tests remain available on these sites.
  • Nathan Littauer Hospital has temporarily closed its primary care clinics in Broadalbin-Perth and the City of Johnstown to retain support staff; it is also preparing for longer wait times and greater difficulty in transferring patients to other hospitals.
  • St. Mary’s Healthcare has temporarily suspended emergency care at its Charlton clinic, which is in the process of moving to a primary care facility.
  • Community Care Physicians provides temporary reductions in hours in one or two practices.
  • Priority 1 emergency care in Guilderland interrupted emergency care for part of Tuesday.
  • Hudson Headwaters is advising the public that wait times may be longer than normal at its emergency care sites in Glens Falls and Warrensburg.

PROBLEM IN PROGRESS

The flip side is that the vast majority of medical facilities in the region remain open. But there are normal fluctuations in patient volume from hour to hour, and sometimes there are too few staff to deal with peak patient loads quickly. Thus, patients may find themselves waiting longer.

Ellis Medicine in Schenectady, for example, showed a five-minute wait to be seen at its Mohawk Harbor emergency care clinic and a 29-minute wait at its Clifton Park medical center at 2 p.m. Tuesday. By 5:00 p.m., the wait times had dropped to 58 and 114 minutes, respectively.

Ellis on Monday afternoon envisioned a loss of up to 100 unvaccinated employees, and potentially more if a court overturns the religious exemption that 69 employees have obtained. The state is pushing for this in the courts.

Meanwhile, Ellis is offering hiring bonuses of up to $ 20,000 for nurses and $ 25,000 for medical technologists, trying to gain an edge in the super tight job market for medical professionals. qualified.

And it will host a job fair with on-site interviews for many support staff job titles from noon to 4 p.m. Wednesday at its headquarters at 1101 Nott St.

On Tuesday, spokesperson Philip Schwartz said Ellis did not have to cut hours or services, but he is aware he might need to. For some time now, managers have been organizing tabletop exercises on what to do if the departure of employees prevents them from continuing to provide comprehensive patient services.

So far none of the scenarios have come true, but they are a tongue-in-cheek repetition of exercises managers had much earlier in the pandemic, trying to decide what to do if an increase in the number of patients was so large that the hospital might not take care of them all.

COMPLEX SITUATION

McKenna, the CEO of Albany Med, on Tuesday described a situation with multiple causes.

The vaccination mandate, which Albany Med strongly supports, is only part of it, he said. The pandemic itself, an unprecedented crisis for a century, is the cause of many departures of healthcare workers.

“A lot of people have worked hard and are tired,” McKenna said. “We totally understand that. “

Add an aging population that needs more health care, not less, and an insufficient number of young people replacing retired health workers, and a fuller picture of the workforce crisis emerges.

“We need to inspire a new generation to follow in the footsteps of these exemplary caregivers who are here today,” McKenna said.

Albany Med has additional complicating factors: It is the designated trauma center for 22 counties and some of its facilities and care options are not offered elsewhere in this part of the state.

It accepts approximately 16,000 transfers per year from patients who need different or more advanced care than that available at the hospital that first admitted them.

Albany Med must maintain the services that only it can provide, McKenna said, so the staff shortage could force it to limit elective surgeries, limit inbound transfers, and limit hours at satellite facilities such as its urgent care clinics.

“We knew this was going to happen years ago,” McKenna said of the personnel crisis that is now materializing. But Albany Med is unable to exactly quantify the crisis, as some of its 204 employees who have refused to be vaccinated may change their minds before being made redundant; the 29 employees who claimed religious exemptions may lose them; and the facility can obtain reinforcements in the form of retired, out-of-state or military medical personnel that Hochul is preparing to mobilize.

“We probably won’t feel the full impact of what’s going on with the vaccines mandate until next week… It’s a fluid number and it will take us a few days to sort through that number,” McKenna said.

Contact John Cropley at [email protected], 518-395-3104 or @cropjohn on Twitter.

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