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Two of New Mexico’s largest hospitals on Thursday announced that they would be focusing on patients who need care the most, meaning non-medically necessary procedures will likely have to be delayed.
While most patients are not dealing with coronavirus infections, officials at Presbyterian Healthcare Services and University of New Mexico Healt say the ability to grow the capacity that was built over the last year due to the pandemic is now limited by space and the availability of healthcare workers.
The two hospitals announced they were activating crisis standards of care, noting that it’s not really a shift in policy but rather a continuation of how they have been managing the crush of patients since last winter.
“It’s really important to recognize we are not deallocating care. That is not part of this. We are not triaging and denying care,” said Dr. Jason Mitchell, Presbyterian’s chief medical officer. “At this point we are trying to make sure that every patient has care in a bed across our state and even in surrounding states.”
He explained that the decision will not be to take a patient off a ventilator for example, but rather finding other hospitals within New Mexico or in neighboring states that can take patients or directing patients with less severe issues to urgent care clinics or other providers.
Even before the pandemic, New Mexico had ranked near the bottom when compared to other states for hospital capacity. That capacity has been expanded over the past year by finding new space for hospital beds and bringing in additional staff. At University of New Mexico Health, more than 500 additional nurses were brought in, allowing the provider to open up an additional 100 hospital beds.
“We’re operating at about 140% of our normal operating capacity and we’ve had moments where we’ve approached 150%. This really is unsustainable,” said Dr. Michael Richards, senior vice president for clinical affairs for the UNM Health System.
New Mexico in October cleared the way for hospitals to ration care if necessary with a public health order. HHS Secretary Dr. David Scrase said at the time that hospitals have been juggling patients with fewer resources since the pandemic began, and the order he signed sets up an “equitable procedure” for making tough decisions.
In northwestern New Mexico, hospitals have been rationing care amid a surge in coronavirus cases that has left only a handful of intensive care beds available. COVID-19 patients accounted for 90 out of 169 patients at San Juan Regional Medical Center in Farmington on Wednesday, with 15 patients sustained by breathing machines.
In Albuquerque, coronavirus patients make up about one-fifth of patients at Presbyterian and UNM Health.
Officials said Thursday that the more preexisting conditions a patient has, the more likely that person could be hospitalized due to a coronavirus infection. Still, they acknowledged that they have seen younger healthier people end up in the hospital and in some cases die.
Mitchell and Richards both stressed the importance of basic habits such as hand-washing, mask-wearing and social distancing as spread of COVID-19 remains high in New Mexico.
State data shows about 73% of adults are fully vaccinated, and officials are urging people to get their booster shots as immunity wanes. More than 28% of cases confirmed over the last four weeks are among those who were vaccinated and nearly one-quarter of hospitalizations were the vaccinated.
The data also shows that unvaccinated people make up 95% of deaths recorded over the last month.
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