Hospitals Confront the Pandemic: Let The Stats Speak

J.Adderton, BSN, MSN

The Office of Inspector General (OIG) recently conducted a “pulse survey” to get an inside look at the ability of U.S. hospitals to care for patients and staff during the pandemic. The results were published in the brief Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery and an article in Becker’s Hospital Review compiled a snapshot of the more eye opening statistics in the report. Let’s take a look at how well hospitals held up while fighting the pandemic.

Survey Details

As part of the survey, The OIG interviewed hospital administrators from February 22-26, 2021. The interview questions focused on these 3 questions:

What are your most difficult challenges in responding to the COVID-19 pandemic right now, and what strategies have you been using to address the challenges?
What are your organization's greatest concerns going forward?
How can the government best support hospitals?

Administrators from 320 hospitals in 45 states, the District of Columbia and Puerto Rico participated in the “pulse survey”. Participating hospitals represented a wide variety of institutional sizes and characteristics.

The Stats

The survey gives us a front row seat to the most significant obstacles hospitals encountered in responding to COVID-19. Let’s take a look at the statistics pertaining to staffing, care delivery, vaccinations, supplies and finances.

Care delivery

Forty hospitals reported over 90% inpatient occupancy in the Feb. 22-26th timeframe and 90% of ICU beds were being used at 56 hospitals.
Patients experienced longer hospital stays as a result of ICU and emergency department bottlenecks. One hospital reported 13 of its 17 ED beds were occupied from Feb. 22 to 26th by COVID-19 patients waiting on an inpatient bed.

Staffing

Higher than normal staff turnover was experienced in many hospitals, with 36 hospitals reporting they faced a critical staffing shortage as recent as 1 week prior to the survey.
Higher turnover rates among nurses were reported. A Texas hospital serving a high-poverty and socially vulnerable community reported an increase in their annual nurse turnover rate from 2% before the pandemic to 20% in 2020.
One CEO stated their cost for using agency nurses was between $60 and $70 hourly before the pandemic. The hospital is now paying up to $200 per hour.
One teaching hospital typically hires students that trained at the hospital once they become nurses. At survey time, the hospital had 200 open positions and only 100 students set to graduate this year.

Vaccinations

A significant amount of staff time was spent on running vaccination clinics. For example, one administrator said it took 25 staff members working an 8 hour shift to give 600 vaccinations.
Frustration was reported over underused distribution capacity because vaccination supply was unpredictable. One hospital reported having the resources to vaccinate 5,000 people a week, but only received 2,000 weekly doses.

Supplies

Even though availability of PPE had improved since the beginning of the pandemic, some hospitals still didn’t have a dependable supply source. Even in February 2021, 19 hospitals reported still being unable to order N95 masks.

Finances

Some hospitals experienced a dip in revenue related to a decrease in patient visits. One administrator reported a 25% reduction in revenue.

Other Key Takeaways

Not interested in reading the OIG’s full report? Here are a few additional “takeaways” from the pulse survey.

Patient care has been affected by staffing shortages which has led to staff exhaustion and trauma.
Hospitals having difficulty balancing resources between high acuity COVID-19 patients and those needed for routine hospital care.
Hesitancy among hospital employees and the community toward self vaccination.
Exacerbation of disparities in access to healthcare and health outcomes.
Financial instability related to the cost of caring for COVID-19 patients, which is more severe in rural hospitals.

The Road Ahead

Hospitals, Federal, State and Tribal agencies have been working alongside the U.S. Department of Health and Human Services to address the challenges faced when providing patient care over the past year. Here are a few steps that have been taken within the collaboration to minimize barriers:

Addressing staff shortages, burn-out and trauma
Increasing knowledge and guidance on the prevention of treatment of COVID-19
Supporting vaccination efforts
Assisting hospitals in maintaining financial security, especially for underserved areas

The pandemic has also shed more light on long-standing systemic problems within the U.S. healthcare structure.

Let's Hear From You

Are there any challenges you experienced in your practice that are not touched on here?