Presbyterians, UNMH enact “Disaster Administration Requirements” in Albuquerque hospitals

ALBUQUERQUE, NM (KRQE) – Executives from Presbyterian Healthcare Services and the University of New Mexico Hospital are addressing a newly enacted Crisis Standards of Care (CSC) status for their Albuquerque hospital facilities as New Mexico continues to enjoy high numbers has been fighting new COVID-19 cases. The new status from Thursday in part means that “non-medically necessary” procedures in the facilities under siege will be delayed by 30 to 90 days.

“This (COVID-19 pandemic) has been going on for a very long time, and the scale of it has reached a point where we now need to take the next step in our nationwide response,” said Dr. Michael Richards from the UNM Health System. “At the moment, at UNM we are now working at around 140% of our normal operating capacity and we have had moments when we have approached 150%.”

The new CSC status for the two Albuquerque hospitals comes almost a month after the New Mexico Department of Health opened up the opportunity to every hospital in the state to make the statement in mid-October. The status allows several changes in relation to patient care.

Hospitals will have a “standardized, fair process for deciding who receives medical care”. This means that in certain situations, immediate, non-life-threatening medical treatment may be delayed for some patients because staff may not be able to help a patient.

Dr. Jason Mitchell, Presbyterian’s chief medical officer, outlined what it means to make a “CSC” decision, stressing Thursday that hospital systems are not “suspending care” or “suspending and denying care.” Dr. Mitchell says at the moment that part of the CSC status is more about moving patients in Albuquerque to other hospitals in rural New Mexico or the Southwestern region.

“So the decision is not going to be to take someone off a ventilator, that’s not what we’re doing,” said Dr. Mitchell. “The decision could be: ‘We don’t have any beds in our hospitals, who else can take this patient in?’ And it can mean a patient comes to a regional hospital with sufficient capacity and to different hospitals in Albuquerque.

Dr. Mitchell of the Presbyterian says CSC decisions could mean patients from New Mexico will have to move to surrounding states like Texas, Arizona or Colorado. Meanwhile, hospitals say they are currently browsing their schedules to see which patients with non-medically necessary procedures may receive delayed medical care.

“It’s not big numbers anymore, people have long postponed their operations and they have become medically necessary,” said Dr. Mitchell. “However, it is regrettable that so many have already had to wait for operations that most of them are now medically necessary.”

Dr. Mitchell said while the delay in medically necessary procedures will bring some relief to the Presbyterian’s facilities, the hospital system will likely need to consider other measures. “It’s not that big of a lever, so we have to focus on other levers, such as how we might build standing beds in other hospitals.”

According to UNMH, delays for non-medically necessary procedures start at 90 days, but could be reduced as needed. “It’s really a matter of deciding whether it has to be done today or whether it can be postponed,” said Dr. Richards from UNMH.

The capacities in hospitals are not only being increased by COVID-19 patients. The hospital systems announced on Wednesday that the average length of stay in their facilities will be extended. Dr. Presbyterian’s Mitchell said Thursday that the biggest challenge facing intensive care units recently is getting patients out of the hospital.

“Our (emergency departments) are overcrowded because patients cannot come to the hospital, because the patients are so sick, and we have no place to accommodate them,” said Dr. Mitchell. “At the moment it is not necessarily the case that we do not have enough ventilators, but that the overall demand in the hospitals exceeds capacity.”

At UNMH, Dr. Michael Richards stated that while COVID-19 cases are a driver, a high proportion of non-COVID patients also remain in hospitals. “It’s not about whether we create the capacity in the intensive care unit for the COVID patient or not, but that we also need the intensive care units for other types of patients available.”

As of Thursday, the UNMH had around 70 COVID-19 patients, which is around 17% of its capacity. Presbyterian said Thursday that around 20% of its patients are COVID-19 while the hospital is running around 120% of normal capacity.

“The people who don’t have COVID are much sicker and therefore stay longer,” said Dr. Mitchell of the Presbyterian. “Even at 120% capacity, things are worse because people have to stay longer, because they are much sicker, and that supports the whole system.”

UNMH and Presbyterian are joining the San Juan Regional Medical Center in Farmington as the second and third hospital system, which made a CSC statement last month.

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