With the load of coronavirus patients rising and some hospitals reaching capacity, Maryland officials plan to ramp up a program that makes it easier to move patients among hospitals.
Hospitals already had been moving patients among their own systems, but typically only refer a patient to an outside hospital when they do not have the expertise for a specific treatment.
“Currently, individual hospitals need to go critical care ‘bed-shopping.’ That usually takes place within their own medical system, ignoring beds that maybe exist actually relatively close to them,” said Dr. Thomas Scalea, physician-in-chief of the University of Maryland Medical Center’s Shock Trauma Center in Baltimore.
Most hospitals belong to medical systems, such as the University of Maryland, Johns Hopkins, LifeBridge or MedStar.
“Now, a single phone call will give them access to the appropriate level of critical care services,” Scalea said Tuesday during a State House news conference.
“This will help alleviate the overcrowded hospitals in some areas of our state and place patients in hospitals where beds and medical staff are needed and where they can receive adequate care,” Republican Gov. Larry Hogan said at the news conference.
The effort will focus on intensive care beds and will be coordinated by a state agency unique to Maryland, the Maryland Institute for Emergency Medical Services Systems. MIEMSS already coordinates care for certain patients.
“It will bring a level of visibility for hospitals in need of transferring patients,” said Dr. Theodore R. Delbridge, the executive director of MIEMSS. “When a hospital becomes more saturated with patients, they typically wouldn’t know a hospital that is their peer has an intensive care bed.”
MIEMSS will “match-make” between hospitals, he said.
The coordination could involve the transfer of patients needing treatment for COVID-19, or those who need other medical care. The goal is to ensure hospitals don’t get into situations where they can’t care well for their patients.
Coronavirus hospitalizations have more than quadrupled in the past two months, after hitting a pandemic low of 281 on Sept. 20. On Wednesday, 1,144 people were hospitalized with COVID-19 as the state had more than 1,000 hospitalizations for the second day in a row for the first time since June.
Of those hospitalized on Wednesday, 270 were in intensive care.
In Howard County, for example, Howard County General Hospital’s acute care beds are 90% filled and ICU beds are 77% filled, according to the county’s data. The county had 25 coronavirus patients in acute care and 12 in intensive care Tuesday.
Howard County Executive Calvin Ball said he’s watching the hospital capacity closely.
“I am alarmed by the state’s dramatic increase in COVID cases and rates of infections,” said Ball, a Democrat. “As the recent spike in cases poses a threat to our hospital capacity, we look forward to continued dialogue with the state and governor on addressing this critical issue.”
Hogan on Tuesday highlighted concern about Western Maryland hospitals that are nearing capacity, but Delbridge said on a given day, any hospital could fill to capacity.
Per an order from Hogan, the hospitals all have extra beds in their facilities and in specially made tents, some staffed and others ready if needed. There also are beds at the ready in makeshift hospitals, including at the Baltimore Convention Center and at the former Laurel Hospital Center.
“Our goal is not to fill them up with people, but they are currently still available and ready to handle that,” the governor said. “And it’s certainly looking more likely that we may need to.”
The Maryland Department of Health also has issued guidance to hospitals to stop nonemergency procedures to keep bed space free. It’s more narrowly tailored than guidance given to hospitals during the first wave of the virus in the spring.
“We do not want Marylanders to put off lifesaving treatments or surgeries, but our highest priority right now is preserving capacity at our hospitals,” Hogan said.
Delbridge said the guidance is an important step in keeping intensive care beds available in a system that, if working at top efficiency, doesn’t have many to spare.
Maryland hospitals have about 800 open beds that are staffed and available to take patients — 600 acute care beds and 200 intensive care beds, Delbridge said. There are normally about 7,800 staffed beds in Maryland hospitals, plus some additional beds in use for COVID-19 patients. There are 2,500 more beds ready but unstaffed if needed and there’s space for an additional 2,400.
Hospitals plan to continue cooperating throughout the pandemic, said Bob Atlas, president and CEO of the Maryland Hospital Association.
“They review patient needs daily and are ready to transfer or accept patients as they are able,” he said Tuesday. “One of today’s orders is specifically intended to give hospitals more flexibility, particularly regarding transfers to the alternate care sites such as the Baltimore Convention Center field hospital.”
Atlas also said the hospitals appreciated that Hogan understood that patients with a variety of conditions need access to hospital care.
“Our hospitals are balancing the medical necessity of care with the preservation of resources,” he said. “We continue to ask all Marylanders to help stop the spread so hospitals do not become overwhelmed.”
Baltimore Sun Media `reporter Ana Faguy contributed to this article.