CENTREVILLE — Hospitals across the Eastern Shore and Chesapeake Bay region, and particularly those utilized in Queen Anne’s County emergencies, are showing signs of stress and limitations in the months leading up to the winter season, when hospitalizations historically rise.
According to the County/Hospital Alert Tracking System (CHATS), a monitoring system that reports emergency department occupancy and capability at five status levels, the University of Maryland Shore Medical Center at Easton was on alert over 220 hours between Aug. 15 and Aug. 21. Though there are only 168 hours in a week, hospitals can be on multiple alerts simultaneously.
“I’ve never seen over 200 hours [on alert] at a hospital on the Eastern Shore,” Queen Anne’s Commissioner Steve Wilson said in an interview. While all of the commissioners receive weekly updates from the Department of Emergency Services, Wilson introduced CHATS data to the board as a point of concern during their Aug. 24 meeting.
Of the Easton hospital’s 222.25 recorded hours on alert, 57.19 percent were under red alert, meaning that the hospital had no electrocardiogram (ECG) monitored beds available. ECG units monitor a patient’s heartbeat and often, when used in hospital rooms, will notify healthcare staff if any irregularities occur.
Another 39.75 percent found Easton on yellow alert – a temporary request by the hospital to hold off bringing patients in need of urgent medical care – and for nearly seven hours, the Easton medical center was on ReRoute alert, which warns incoming ambulances to redirect a patient to a different hospital.
Throughout the month of August, several of the emergency facilities within University of Maryland Shore Regional Health (UMSRH) – which also include locations in Chestertown, Dorchester, and Queenstown – showed similar signs of fatigue. According to CHATS data, the University of Maryland Shore Medical Center at Dorchester totaled over 550 hours on alert, over 90 percent of which were spent on red alert.
When compared to July, the strain on all of the Eastern Shore medical care locations increased dramatically in August. For instance, the UMSRH emergency center in Queenstown, between July and August, experienced over a 400 percent increase in time on alert; while their Chestertown medical center saw more than a 1,550 percent jump between the two months, going from 11 hours on alert in July to over 180 in August.
These trends are not isolated to the Eastern Shore, however. The Luminis Health Anne Arundel Medical Center (LHAAMC) in Annapolis, which also serves as a destination during Queen Anne’s County emergencies, totaled over 470 hours on alert in August, 183 of which were on ReRoute. Their month-to-month numbers have remained mostly consistent. Between 416.82 hours in July and 472.15 in August, the facility experienced about a 13 percent increase.
During an “already busy” time for the Anne Arundel medical center, Chief Nursing Officer Barbara Jacobs cited a “sharp increase” in COVID-19 hospitalizations as one of the reasons for its high runtimes on alert. Though Jacobs stated the hospital had administered over 100,000 vaccinations in its coverage area, Jacobs also said that the majority of the facility’s recent hospitalizations were unvaccinated patients.
“Decreasing the number of hospitalized patients with COVID positive test results will have the biggest effect of all in reducing the crowding in the hospitals and emergency departments,” Jacobs said.
“Unfortunately, temporary ambulance diversions (Yellow Alerts) are not uncommon across the State due to a variety of factors,” said Trena Williamson, a UMSRH spokesperson, “Including increasing volumes and more patients seeking emergency care post-COVID.”
With 345 positive cases in August, COVID cases in Queen Anne’s County reached their highest point since April. As of Sept. 8, out of the county’s total cases, including 99 so far this month, eight are currently hospitalized, according to the QA Department of Health.
In a related interview with the Star Democrat, Williamson said early on in the pandemic, temporary triage tents were set up to accommodate a possible surge in cases at all four Shore Regional Health emergency centers. In mid-August, the larger of the tents at the Easton location was taken down. Williamson said, despite several case spikes, the Easton hospital never reached a volume of COVID-19 patients to necessitate using the larger of the two tents.
Beyond the general stress of the pandemic, however, both the Anne Arundel facility and UMSRH acknowledged that staffing issues have also factored into their capacity challenges.
“Like most hospitals in the country, LHAAMC has faced staffing challenges during the pandemic and are working diligently to retain and recruit staff,” Justin McLeod, a spokesperson from the hospital said. “Right now, our hospital units are staffed to maintain all services and give our patients the best care.”
Nursing shortages – spurred by a variety of COVID-based factors, including exhaustion, disproportionate wages, and vaccine requirements – have greatly impacted the operations of hospitals nationwide.
Gov. Larry Hogan announced Aug. 18, that Maryland would join the growing number of states that would require all nursing home and hospital employees to either get a vaccination or submit to regular coronavirus testing. The first dose of the vaccine was due Sept. 1 for all healthcare workers.
When asked what plans there were to address their emergency alert numbers, Jacobs said that the Anne Arundel hospital opened “several additional beds” in response to the increased volume of their emergency department. She also said that LHAAMC is also working with the state to find alternative care sites for COVID-positive patients.
“LHAAMC is ensuring we are discharging patients safely back to their homes as quickly as possible,” Jacobs said.
When asked the same question, Williamson said that Shore Regional Health was working on “several strategies” to improve flow through their emergency departments, including alterations to their staffing models and the criteria for inpatient admission. She also said that UMSRH officials meet quarterly with local Emergency Management leaders and the Maryland Institute for Emergency Medical Services Systems to discuss areas for improvement, saying that “changes to the current alert system have been discussed and are ongoing.”
“As fall and colder months approach, we will continue to monitor ED levels and utilize staffing resources from the University of Maryland Medical System as needed,” Williamson said.
Luke Parker is a journalist and award-winning film critic covering government, schools, crime, and business. To send a tip or question, email email@example.com. For updates, follow him on Twitter: @lparkernews