Hospital leaders sounded an alarm Wednesday about the workforce challenges plaguing them as they continue to grapple with the COVID-19 pandemic's effects.
"I get that people fully want to go back to some semblance of normal, but our health care organizations don't have that option," Steve Walsh, president and CEO of the Massachusetts Health & Hospital Association, said during a meeting of the Health Policy Commission's advisory council.
During the meeting, hospital and health care officials said they are facing labor shortages and capacity constraints as they treat a patient population that includes both those who have contracted COVID-19 and those who have become sicker as they delayed treatment for other conditions during the pandemic.
"It's a very, very serious situation and anything that you can do from a policy standpoint to get access to us to workforce needs -- it's not just nurses, it's transporters, it's across the board vacancies that are making it very challenging," Lawrence General Hospital President and CEO Deborah Wilson said.
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Though hospitals have been imposing COVID-19 vaccine mandates for their workers as a public health measure, those policies have the potential to add another layer to the challenges if some staffers quit their jobs rather than comply with the policies.
Wilson said Lawrence General, which has a mandate in place, is so far at about 90 percent vaccination.
"Even if we make tremendous headway we're going to lose some of our workforce at a time when there's a need for all hands on deck," she said.
Emerson Hospital's Christine Schuster said she also expected vaccine mandates to make staffing more difficult, but said requiring the shots is nonetheless the right thing to do. She said another obstacle for hospitals is a lack of "regulation on staffing agencies," which can offer higher pay to workers like traveling nurses.
"What happens in that case is that a nurse who will be working for us for a certain dollar rate will get two and a half or three times that, and could show up in your hospital as a traveler," Schuster said. "She might have been an employee three weeks ago, [but is now] making a lot more side-by-side with your regular, loyal staff."
Walsh said hospitals are "still very much feeling this ongoing impact of the pandemic," which is now coupled with "an intense new set of issues."
"It's really bad, and one of the reasons we can't get relief is because it's bad all across the country," he said. "We are seeing capacity challenges that are more than they were in the height of COVID."
Last week, there were 643 patients boarding in emergency departments, Walsh said, part of what he called a "behavioral health boarding crisis." Boarding refers to holding patients in emergency departments while they wait for an inpatient bed to open up.
Schuster, of Emerson Hospital, said the shortage of behavioral health beds is particularly acute at the pediatric and adolescent levels.
"As of today, I have three adolescents in my emergency department that have been there for more than four days, which as you know, it's not the greatest place when you have mental health issues to be in a short-stay, acute environment," she said.
Massachusetts Association of Behavioral Health Systems executive director David Matteodo said inpatient behavioral health facilities "really would like" and "really feel compelled" to meet the demand, but are also hampered by staffing issues.
"We're trying to meet the demand. We're adding new beds," he said. "Ironically, we're adding 300 new beds by the end of the calendar year. I keep asking, 'Where are we going to get the people?' So, we're pushing with the Legislature, we're pushing everywhere, working very closely with Mass. Hospital Association, doing all we can to address this but it's pretty bad right now."