Are 'available' ICU beds actually... available?

Hospital Generic
Posted at 5:29 PM, Dec 09, 2020
and last updated 2020-12-10 22:03:42-05

PHOENIX — Throughout this pandemic, health officials have routinely pointed out there is a difference at hospitals between a bed and a staffed bed, and it's unclear how many of the latter are actually available around the state.

Case in point, as of Wednesday morning, Valleywise Health Chief Medical Officer Dr. Michael White said their ICU was 98% full, with only one available staffed ICU bed. He noted they had 10 unstaffed ICU beds.

"If we had more staff, we would be able to have additional ICU capacity," Dr. White said.

As of Wednesday, the state's coronavirus dashboard showed 10% - or 178 - ICU beds remain available statewide. It is unclear where those beds are located.

ABC15 reached out to the Department of Health Services to ask if those are just beds, or beds with the requisite staff to be put into use. A spokesperson for the department told ABC15 hospitals are instructed to report only staffed beds to the state, which posts the inpatient and ICU bed availability online. That person also noted additional beds that were identified to meet the 50% capacity increase required by an executive order are not reflected in the numbers shown on the dashboard.

ABC15 has also heard from doctors and nurses around the state who say ICU space is slim and in some cases even less than that.

Finding additional staff for the current COVID-19 surge is a challenge for health systems across the state. Winter is typically a busier time of year in the hospitals, and there are fewer travel nurses available to come to Arizona than in the Summer, as coronavirus cases surge across the country.

In an update Wednesday, Banner Health Chief Clinical Officer Dr. Marjorie Bessel said in hiring additional staff, 2,036 people have been hired and Banner is looking to fill an additional 406 positions, which include critical care nurses and respiratory therapists.

"What we do forecast is we are in a significant surge and it is going to get a lot worse before it gets better," Dr. Bessel said.

Dr. Bessel said Banner Health could hit 100% licensed bed capacity on December 15.

"We expect to get significantly strained in the healthcare system, which will mean more difficulty taking care of these very ill COVID patients," Dr. Bessel said. "As well as more difficulty caring for other individuals who have heart attacks, strokes, infections, and the like."

ABC15 asked Dr. Bessel about ICU availability in the Phoenix area.

"At this time we are participating with the Arizona Surge Line, which is helping to load balance the entire state," she said. "At this time, we are able to accommodate ICU patients in the Phoenix area that require that level of service."

ABC15 also asked about the potential to have to enact crisis standards of care, a sensitive subject within the healthcare community that essentially means a lower quality of care, that could lead to doctors having to make tough choices.

"It is very likely, very, very probable that we will go into some aspects of crisis standards of care," Dr. Bessel said. "Crisis standards of care can mean some of the following; things like increasing nursing ratios, increasing the number of individuals that a physician has to see. Doing other things so that we can take care of the most number of patients possible."

Dr. Bessel said they are working to avoid the most undesirable of situations.

"We will do everything that we can to avoid triage," she said.