Are Iowa Hospitals ‘Full’? A Chief Medical Officer Explains

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Iowans seeking out emergency care are increasingly showing up at their local hospital only to be met with long waiting lines for open beds or a scramble to find an available ICU unit elsewhere.

However, if you look at the state’s COVID data dashboard, you might come away thinking there is plenty of beds free and waiting for you if you suddenly face a medical emergency. As of this afternoon, the state’s data shows 161 COVID patients in the ICU, with 182 ICU beds listed as still available.

So, what’s the real situation?

According to Dr. Michael McCoy, the chief medical officer for Southeast Iowa Regional Medical Center in West Burlington, the state’s official numbers don’t reflect the reality they and their patients are dealing with on the ground.

“When you look at the state, you would think we’re fine, we have plenty of beds. And if you look only at that, we do. So it’s not the issue of the number of beds we have. It’s the number of staffed beds,” he said. “I think a lot of the public doesn’t realize the gravity of the situation.”

McCoy described seven people waiting in the emergency department for hours because the hospital’s staffed beds are full and staff has to reach out to other hospitals beyond the region.

Burlington is in the fifth Regional Medical Coordination Center, which also includes hospitals in both Mount Pleasant and Fort Madison.

As of this afternoon, the state’s COVID dashboard says this region of the state has 247 inpatient beds available (down to about 13% of the total) and 30 ICU beds available.

RMCC Region 5 data, Sept. 22

“The data on the state site probably makes it look better than the data we’re dealing with in each of our hospitals,” McCoy said.

The reason for that, he explained, is a misunderstanding about what hospital capacity really means.

“We could put you in a bed, but we have no one to take care of you, so that’s not really giving you the care you need. That’s the valid data.”

The more critical a patient’s condition is, the more care they need. So, on the general floor, McCoy explained, a single nurse could care for four or five people. But in the ICU, because of the level of care required, oftentimes one nurse takes care of one patient. Maybe two, McCoy said.

Getting people admitted involves looking at the available staff and determining who can be taken care of safely.

“We’re stretching thin sometimes the staff we have,” he said. “And oftentimes they’re doing things a little past comfort zone. So what they would like to do or what they’re used to doing because of the need.”

When stretched beyond capacity, McCoy said they’re sending patients wherever they can find an open bed.

“We’ve had our docs in the emergency department calling Chicago, Des Moines, down to St. Louis, over to Peoria. I mean, all over,” he said.

The problem of limited beds has led to another one: patients being boarded in the emergency department. McCoy said that isn’t an ideal location because ERs aren’t designed to care for patients long-term. They’re meant to assess patients and either treat and discharge them, or admit them.

But without open beds, they can’t be admitted.

As of Wednesday, state data shows 638 Iowans hospitalized with COVID-19 as either a primary or secondary diagnosis.

McCoy said the Burlington hospital consistently has between 22 and 24 patients with COVID, and the number hasn’t declined.

And COVID-19 isn’t the only reason people need hospitals.

Cedar Rapids hospitals and Blank Children’s hospital have suspended non-emergency surgeries because some require staying in the hospital to recover.

McCoy encourages people to seek out the level of care that most applies to them. So instead of going to the hospital for a test or vaccine, people should reach out to their primary care provider and get advice from them.

Getting everyone vaccinated, McCoy said, is the way to bring the crisis of bed capacity under control.

“We’ve got to get ourselves vaccinated so we have the majority of us being immune to this or that the illnesses we get are very mild,” he said.

“In Iowa and in our region there’s a real health care crisis because you have patients coming in that need a level of care that we cannot provide in a timely fashion or we’re happy to try to provide it in a setting that’s not a normal setting.”

 

by Nikoel Hytrek
9/22/21

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