Hospitals Manage Their Own Elective Procedures Amid Staffing Shortage, Rising COVID Patient Numbers

Aug 24, 2021

What plans are hospitals in Tulsa following for elective surgeries now during COVID-19?  

Ascension St. John has publicly announced its services “may require” adjustments, while media reports say the hospital has internally communicated cancellations. Hillcrest Hospital and Saint Francis Hospital say they’re evaluating electives on a patient-by-patient basis. 

“We assess for every surgery that’s scheduled,” said Saint Francis spokeswoman Lauren Landwerlin on Friday. 

Landwerlin said Saint Francis, when deciding on whether to go ahead with an elective, looks at the clinical condition of the patient first and foremost. She stressed that the hospital uses the term “scheduled” instead of “elective” since sometimes these surgeries are not what most people would consider choices. A scheduled surgery could entail something like the removal of a tumor. 

Rachel Smith, communications manager for Hillcrest, said the hospital has delayed some surgeries requiring ICU beds.  

“Outpatient elective surgeries are not impacted at this time,” Smith wrote in an email. 

Previously, elective surgeries were regulated by an April 2020 emergency order from Gov. Kevin Stitt. After those regulations expired, OSDH published a hospital surge plan last updated Oct. 2020. 

The surge plan has guidelines for what hospitals in a region should do when the percent of COVID patients in that region hits certain levels, including when electives should be limited. Together with capacity numbers published by OSDH, it was possible to get an idea of what could or should be going on in hospitals according to the state.  

Now, with COVID hospitalizations climbing and hospital staffing falling, the picture is muddier. OSDH has not regularly published capacity data since May, and the surge plan is optional.  

“The hospital surge plan as a whole has always been guidance for hospitals and was not mandated by previous emergency orders,” said OSDH Deputy Commissioner Keith Reed in a written statement to KWGS. 

According to Aug. 19 data released by OSDH, 22% of hospital beds statewide are taken up by COVID patients. Though the state’s hospital plan was meant to assess needs by regions, 22% would put a given region at tier 3 on the plan. When a region is at tier 3, hospitals should implement surgical cancellation protocols. The governor also has the option of ordering a reduction of elective procedures by 50%. 

In the past week, Saint Francis has steadily seen around 25% of its beds taken by COVID patients. At Saint Francis Hospital South on Friday, 40% of beds were taken by COVID patients.  

Dr. Cliff Robertson, CEO of Saint Francis Health System, spoke Monday at a weekly press conference.

“What we learned the first go around was stopping surgery didn’t create as much capacity as we thought, and more importantly delayed a lot of care,” said Robertson.

Hillcrest did not report on its general numbers, and Ascension St. John did not respond to a request for clarification on its elective policies. 

Meanwhile, a hospital staffing shortage in the state is worsening. The CDC updates a state profile on Oklahoma every week. As of Aug. 11, using data from the Department of Health and Human Services, the CDC reported that 33% of hospitals statewide are lacking staff. That's a 7% increase from the week before.