Some Banner Health hospitals are now at 100% capacity — and crisis standards loom
Banner Health has reached its highest inpatient levels since the pandemic began, and several of its hospitals now operate above 100% capacity.
With few intensive care unit beds available statewide, the system may soon reach a long-feared tipping point.
"Crisis standards of care is defined at the state level, and we evaluate every day whether or not we are in that level of care," said Banner Health Chief Clinical Officer Dr. Marjorie Bessel.
Banner Health now operates under contingency standards, which stretch and repurpose staff and resources but continue necessary individual care.
"We have made a change in our primary care clinics to prioritize sick visits for established patients. As a result, patients may experience an increased wait for nonurgent PCP appointments that can safely be delayed, such as routine follow-ups, well visits and new patient visits," said Bessel.
But, based on pre-omicron forecasts, that soon could change, Bessel says their models project cases and utilization rates will rise into mid-January.
“If the forecasted trends continue, we will soon be unable to meet the healthcare demands of Arizonans,” she said.
That could trigger crisis standards of care, which prioritize overall health and, in the worst cases, can entail making tough decisions about who to treat and when.
As a July 28, 2020, National Academies of Science Engineering & Medicine working group report put it, "When crisis conditions exist, the goal is to 'gracefully degrade' services to the minimum degree needed to meet the demands, maintaining the maximum patient and provider safety."
Banner currently employs more than 2,600 travel workers, but it still cannot staff all of its beds due to nationwide personnel shortages, even as burnout drives local staff to leave the front lines.
"We are experiencing the impact of this shortage in our hospitals, with many core team members who have decided to retire or exit the healthcare industry or transition to non-bedside roles because of prior surges and the enormous physical and mental impact the pandemic has had on them," said Bessel.
Although staffed beds, ICU beds and ventilators are at peak usage levels, only around one-third are occupied by patients with COVID-19, 85-100% of which are unvaccinated.
But Bessel said many of the remaining beds are occupied by people whose treatment was delayed because of the coronavirus.
"Some of them delayed preventative care; some of them are presenting after having symptoms for a protracted period of time and presenting late in the course of their disease or illness," she said.
Bessel called on Arizonans to mask up, get vaccinations and boosters and use emergency departments for life-threatening matters only.