The ‘Boarder’ Crisis
July 18, 2022
Hospitals throughout Washington state are facing unprecedented capacity challenges and those challenges have made their way to Whidbey Island.
Hospitals are operating above their capacity, impacting their ability to provide timely care to all people who urgently need it. As larger urban hospitals reach capacity, smaller rural hospitals are caring for more complex patients that normally would be transferred. The downstream effect is reduced access to OUR Emergency Department and acute inpatient care.
The biggest factor impacting capacity is patients awaiting discharge to nursing homes, behavioral health facilities or other similar settings. Statewide, between 10 and 20% of hospital beds are occupied by patients who are awaiting discharge to one of these settings. In July, WhidbeyHealth has averaged 8 patients per day, without options for safe discharge to an appropriate care setting. Many for days, weeks, and in some cases, a month.
WhidbeyHealth’s Emergency Department has 13 patient rooms. Earlier this week, our ED had 10 patients “boarding” while awaiting discharge to another facility. With the ED operating with only 3 rooms – only 3 patients could be seen at a time, including anyone brought in by ambulance. When patients are held in our ED, it causes delays for patients seeking emergency treatment. WhidbeyHealth is not alone in this struggle.
“There are no easy answers for this challenge. Answers will come through improved guardianship rules, state funding for more psychiatric beds, and additional utilization of our Walk-In clinics.” Mike Layfield, WhidbeyHealth CEO continues, “Washington has the lowest number of hospital beds per capita in the US. This position is untenable for staff and the patients we care for. It’s increasingly challenging for our patients, many of which only have WhidbeyHealth as an option for care.”
How can we fix this on our island and across the state?
Patients are stuck in hospital beds due to inadequate state funding and slow state approval of long-term care placement – all while hospitals and health systems in Washington are struggling financially.
- The last federal COVID dollars were provided before the Delta and Omicron COVID surge.
- Costs for supplies and staff have skyrocketed while reimbursement remains stagnant.
- Most hospitals in Washington have not had a Medicaid rate increase in 20 years.
- There continues to be a staffing shortage across the health care industry and in hospitals.
- Hospital staff have also been hit hard by the most recent wave of COVID, with staff who test positive unable to work for 5-10 days.
Rural hospitals like ours are the first line of care for heart attacks, strokes, trauma, and other emergency and acute care needs. People are now waiting longer for care, putting them at higher risk.
WhidbeyHealth is working with our partners in Olympia to enact change:
- End discriminatory practices towards Medicaid patients by requiring unnecessary guardianships.
- Fund bed readiness programs at acute care hospitals.
- Maintain and expand programs to stabilize long-term care facilities and behavioral health.
- Expand child and adult respite capacity to prevent inappropriate hospitalization of children and adults with developmental disabilities.
WhidbeyHealth is fighting every day for our community’s health. We appreciate the grace and understanding that you have all shown as we navigate the current health care climate.