The start of 2022 will be a grim one for hospitals.
Surging COVID-19 cases — mostly among the unvaccinated — and pent-up demand from patients with worsening conditions who previously delayed care filled hospitals during the fourth quarter.
The rising patient volumes since the summer further stressed hospitals that were already coping with acute staffing shortages that worsened during the pandemic. The crisis is driving up staff burnout that’s caused workers to move to another care setting that’s less stressful, leave the profession for new fields, or to retire early.
“We’re a victim of the ‘Great Resignation’ like everybody else,” said Rob Casalou, CEO of Trinity Health Michigan, the Livonia-based parent company of Mercy Health Saint Mary’s in Grand Rapids and Mercy Health Muskegon. “We’ve had a lot of staff just say, ‘I can’t do it anymore,’ or, ‘I’m going to go make money doing something else.’”
Staff shortages and the pandemic’s effects on the ability of care providers to keep up remain “front and center” as 2022 approaches, Casalou said. He describes the situation as a “double hurricane, in a sense, where you still have the pandemic raging at a time when you don’t have the resources to get it done.”
“I never thought that COVID would ever completely disappear from our lives, but I really felt it would become one of those chronic, manageable situations. As we’re moving into 2022, that’s top of mind,” Casalou said. “How we manage our business, how we manage all of the other work we’re doing, in the context of this pandemic, I think is going to be our reality for the foreseeable future.”
The pressure on hospitals also has led to delays in care, surgeries, and admitting patients from emergency rooms, as well as in patient transfers from one hospital to another for specialty care.
The present crisis poses an issue that care providers, including long-term care centers, will need to continue to manage in the new year and beyond.
“The resulting health care worker burnout, which is the second pandemic that’s affecting this community, will have a negative impact for years to come,” Dr. Aaron Lane-Davies, pediatric hospitalist at Bronson Children’s Hospital and chief of quality for Bronson Medical Group, said during a recent media briefing.
Pent-up demand and a rise in patients who previously delayed care are contributing to the situation that care providers face heading into 2022. That includes, for instance, not getting regular health screenings such as a colonoscopy or mammogram.
As the pent-up demand exploded this fall, care providers are finding some patients now have conditions that have advanced further and require a higher level of treatment or a longer hospital stay.
The stress of the pandemic and a general decline in how well people took care of themselves adds to the problem, Casalou said.
“One of the reasons we’re having a particularly bad time right now on this (COVID) surge is because all of the delayed care that’s finally arrived at our emergency rooms. COVID by itself is bad enough, but then add all of the other care we have and it’s just kind of an overwhelming situation for all of the hospitals,” Casalou said. “People’s general health and wellbeing didn’t do well during the pandemic. There’s research coming out on weight gain, lack of exercise, depression, and mental health issues. All of those culminate into people showing up then with heart attacks, strokes, diabetes, and other really heavy-duty health conditions that are the result of basically almost a couple years now of neglect.”
In an effort to address the staffing crisis, many hospitals have raised pay and implemented retention and attraction bonuses to keep and attract clinical staff.
Grand Rapids-based Spectrum Health, for example, toward the end of this year allocated $117 million for staff retention and sign-on bonuses and pay raises. University of Michigan Health-West (formerly Metro Health) has been paying bonuses of up to $10,000 for critical clinical positions.
Trinity Health in 2021 put $34 million toward bonuses for clinical staff at its eight hospitals in Michigan, Casalou said. Still, the turnover rate at the Catholic health system’s hospitals in the state that was once “closer to single digits” has been ranging from 17 percent to 20 percent for nurses and other clinical positions, he said.
The health system has more than 3,100 positions open in Michigan as 2021 closes, Casalou said. Trinity Health Michigan, which employs 28,000 people, typically has less than 1,000 open positions, he said.
Staff vacancy rates at hospitals statewide average 14.3 percent, with nearly 21,000 open positions, Adam Carlson, senior vice president for advocacy at the Michigan Health and Hospital Association, told state lawmakers this month in testimony to the House Appropriations Committee.
Health care providers have been urging state lawmakers to allocate federal pandemic relief funds to help address the problem.
“Each month more health care workers exit the workforce than what hospitals are able to replace in the state of Michigan,” said Carlson, who described the situation as “dire.”
“Maintaining the existing workforce while growing the pool of health care workers will be the key to solving the shortage, but help is needed now,” he said. “Support from the state or federal government is vital as staffing costs continue to far exceed budget expectations with no signs of slowing down.”
State lawmakers last week approved more than $1.2 billion in a supplemental funding bill that includes support for health care providers overburdened by the current COVID-19 surge and other patients.
The supplemental funding also includes $300 million for a health care recruitment and retention fund to begin addressing the acute worker shortage.
As he looks ahead to 2022, Casalou hopes the health care industry can improve out of the crisis. Diversifying supply chains, better segregating patients without shutting down other operations, and better support staff resiliency and recruiting are among the lessons learned in the nearly two years since the pandemic began.
“Those are the things I think about going forward,” Casalou said. “The pandemic exposed the weaknesses in a frail system … everything from supply chains to the readiness to handle a legitimate pandemic, to the issue of politics that entered into the health care space. All of this was all new to us.”