Baker-Polito Administration issue hospital guidance to reduce elective services, procedures, due to staffing shortages

Boston – Today, the Baker-Polito Administration, in collaboration with the Massachusetts Health & Hospital Association, announced updated hospital guidance to conserve inpatient hospital capacity and to protect patients and the healthcare workforce in response to several challenges impacting the Commonwealth’s hospitals.

The Department of Public Health released updated guidance to hospitals to reduce certain non-essential, elective services and procedures via a COVID-19 Public Health Emergency Order. Effective November 29, 2021, any hospital or hospital system that has limited capacity must begin to reduce non-essential, non-urgent scheduled procedures to ensure adequate hospital capacity for immediate healthcare needs.

This guidance, jointly developed by MHA and the Administration, was agreed upon based on several contributing factors. There is a critical staffing shortage across the healthcare system, largely due to staff shortages stemming from the pandemic. This staffing shortage has also contributed to the loss of approximately 500 medical/surgical and ICU hospital beds across the Commonwealth. These factors, coupled with the current high census level and annual increases in hospitalization commonly seen during the period post-Thanksgiving through January, require this concerted effort to preserve inpatient capacity.

“The current strain on hospital capacity is due to longer than average hospital stays and significant workforce shortages, separate and apart from the challenges brought on by COVID,” said Secretary of Health and Human Services Marylou Sudders. “COVID hospitalizations in Massachusetts remain lower than almost every other state in the nation, but the challenges the healthcare system face remain, and this order will ensure hospitals can serve all residents, including those who require treatment for COVID-19.”

DPH defines non-essential, non-urgent scheduled procedures as procedures that are scheduled in advance because the procedure is not a medical emergency and where delay will not result in adverse outcomes to the patient’s health. This reduction will not impact urgent and essential procedures.

“Our healthcare system and state leaders have done heroic work to mitigate this public health crisis over the past 20 months. But we are now seeing significant strain on hospital capacity due largely to workforce shortages and an influx of non-COVID-19 patients who deferred care and now need complex medical care,” Steve Walsh, President and CEO of the Massachusetts Health & Hospital Association. “To address these challenges, MHA worked closely with the Administration to develop a solution that is patient-focused and can ensure that safe, high-quality care remains available to everyone in need in the weeks ahead. We are grateful for the Baker-Polito Administration’s leadership on behalf of our providers and caregivers, and for the collaboration that has enabled us to continue to offer world-renowned care through every turn of this crisis.”

“While we recognize that delaying some prescheduled surgeries may present a significant hardship for patients, we believe it is a necessary step to assure that all of the Commonwealth’s hospitals can continue to meet the needs of patients requiring emergency care,” said Eric Dickson, MD, MHA Board Chair and president and CEO of UMass Memorial Health. “Working together with the Executive Office of Health and Human Services, the Massachusetts Health & Hospital Association, all hospital leaders from across the state developed these guidelines with the goal of minimizing the negative impact it would have on patients. As we go into the holidays when pre-COVID, we traditionally see higher hospitalizations, our state’s collective health system is preparing for the convergence of unprecedented inpatient levels due to deferred care across all hospitals and the impact of a severe staffing shortage that hinders our ability to care for patients.”

“Hospitals and health systems across Massachusetts are contending with unprecedented capacity pressures,” said Kevin Tabb, MD, President & CEO of Beth Israel Lahey Health. “Although COVID-related hospitalizations are far from what they were at their peak, we are now caring for an unusually high number of patients with other health problems – many of whom were hesitant to seek treatment during the height of the pandemic and whose health issues have become more serious over time. We are grateful to the state for working constructively with all of us in health care to help address the complex issues that are making hospitals busier than ever, and we will continue to do everything we can to care for everyone who needs us.”

In addition to these direct efforts to conserve inpatient capacity, the Executive Office of Health and Human Services, in partnership with the Massachusetts Health & Hospital Association, has pursued multiple strategies throughout the pandemic concerning the constraints hospitals are facing. Most recently, working closely with MHA, EOHHS has adopted flexibilities to improve administrative burden for hospitals and hospital providers; extended temporary licensure for healthcare workers and expedited licensing processes; improved services to support hospitals in discharging patients; expanded coverage for telehealth and hospital-at-home programs to improve hospital capacity; expanded inpatient psychiatry services and capacity to address the ongoing crisis in behavioral health; extended coverage for skilled nursing facilities; and, increased funding and capacity for EMS transport services to ensure adequate transportation for patients throughout the Commonwealth.