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In response to the local effects of a national staffing shortage, Summa Health is reducing its inpatient bed capacity by 22% and taking a series of other steps to align its inpatient hospital capacity with current levels of available staffing.
By Oct. 24, the Akron healthcare system will adjust the combined inpatient bed capacity on its Akron and Barberton campuses from 551 to 430.
“As of today, we are going to begin making changes to better align our inpatient hospital capacity to our current levels of available staffing to support our clinical teams in providing the highest quality care that our community expects from Summa and to allow us to continue to maintain a full array of healthcare services and avoid long-term service closures,” according to a Monday, Sept. 27, memo to Summa Health employees, physicians, boards and committees from its leadership. “We are no longer able to maintain the current level of capacity in our hospitals and we must make adjustments to align with the current level of clinical staff.”
Summa also will reduce the number of surgeries that would require a bed stay in a hospital by phasing down over the next several days to performing only emergent, urgent and cancer-related cases. That will continue for weeks until the system gets through the anticipated surge of COVID-19 cases and addresses the ongoing capacity issues it has had, said Dr. David E. Custodio, president of Summa Health System – Akron and St. Thomas campuses. The Akron campus will drop from 439 beds to about 350, while St. Thomas campus won’t see a change.
In August, Summa announced it would require employees to get a COVID-19 vaccine by this fall, a move that Custodio said he doesn’t believe to be a major factor in the staffing challenges. National conversations around vaccine mandates for healthcare workers have continued and more health systems, including MetroHealth, have implemented requirements since then.
Though COVID has exacerbated some of the staffing and capacity issues, it is only a piece of the problem, said Dr. Michael Hughes, president of Summa Health System – Barberton Campus, where inpatient beds will change from 112 to about 80.
“We had a large influx of patients that predated this most recent surge of COVID,” Hughes said. “Here at Barberton, we’ve had highest volumes that I’ve ever seen in the last five years throughout the summer that pre-dated this latest COVID surge. We only had seven COVID patients in the entire organization in July. And we were still having these capacity issues, although the recent surge has really exacerbated despite us trying to do some small steps leading up to this larger plan that we just put forth today.”
Work already is underway to implement several measures to improve throughput in both emergency departments and in hospitals.
In emergency departments, according to the memo, the system plans to embed specialists, primary care physicians and/or hospitalists in the EDs on the Akron and Barberton campuses to initiate care more efficiently, as well as work with skilled nursing facilities to enhance patient navigation. Summa will also optimize monoclonal antibody treatments to improve efficiency and potentially eliminate or reduce hospital stays, according to the memo.
In order to improve throughput in hospitals, the system will adjust its new available capacity over the next few weeks by temporarily stopping some elective procedures in surgery, cardiology and interventional radiology without impacting cancer-related procedures or emergency services, including those to preserve life or limb, according to the memo, which notes that ambulatory surgery sites will remain open.
Summa plans to reassess the reduction to urgent, emergent and cancer procedures after a few weeks, Custodio said.
Additionally, the system will schedule surgeries seven days a week in order to help moderate daily case volumes. Summa also will develop a Standby Patient Program to accommodate elective surgery cases and a remote monitoring home care solution to allow patients to recover at home when appropriate.
These moves are not cost-cutting measures, and the system will continue to hire, Custodio said.
These steps of course will not change the number of people seeking care, leadership acknowledges in the memo, stating it will treat as many patients as possible, but will divert or transfer to other facilities when necessary. Custodio noted that Summa’s collaboration with other hospitals in the area and across the state has only increased during the pandemic.
“In the event the community has no beds available, we will do everything possible to minimize the amount of time we need to board patients in the emergency department waiting for one to become available,” according to the memo. “We also plan to work closely with the health department for surge planning and with our community partners to help manage patient volumes, all in the best interests of protecting our employees and patients.”
The memo was signed by Dr. Cliff Deveny, Summa president and CEO; Custodio; Hughes; Dr. Lydia Cook, president of Summa Health Medical Group; Ben Sutton, Summa’s chief strategy officer and president of ambulatory care and clinical service lines; Bill Epling, president of SummaCare; and Kathy Blake, president of Summa’s accountable care organization, NewHealth Collaborative.
In the memo, leadership also recognized there’s no quick fix to the current situation, and it will take “considerable time” to build back up to full capacity, but the steps are necessary and in the best interests of staff and the community.
What “full capacity” is will depend on the impact of some of the changes that are implemented, Hughes said. It may not be that full 551 inpatient beds combined across Summa’s Barberton and Akron campuses.
It’s going to be a “new world” three months from now in how physicians, their offices, urgent care centers and beyond are operating, he said.
“So we don’t really know the total impact over that as we come out of this latest surge,” Hughes said. “It’s really a moving target, but sufficed to say, we don’t have enough nurses, and we’ve gotta hire as many as we can, and the ones that we can’t hire, we need to change the way that they’re functioning in the team model.”
The system expects disruption during the next three to four weeks as it implements this plan.
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