St. Charles hospitals filled to capacity

Hospitals in Pacific Northwest hit hard by flu

By Markian Hawryluk / The Bulletin / @markianhawryluk

Published Jan 10, 2014 at 12:01AM

The four St. Charles hospitals are experiencing extremely high patient volumes this week, leaving hospital officials scrambling to accommodate all of the region’s critical care patients.

St. Charles Bend canceled several elective surgeries scheduled for Wednesday morning to avoid adding patients to an already full intensive care unit, and prepared other areas in the hospital with the proper staffing and technology needed to take care of sicker patients.

Pam Steinke, chief nursing executive at St. Charles, said the moves are being made in order to care for patients in their communities. If demand surges further, the hospitals would have to send patients as far as Seattle, Boise, Idaho, or Reno, Nev., for care.

“Right now, we’re reaching out past our normal referral patterns,” she said. “The entire Northwest is being hit with a lot of capacity issues.”

While many of the other hospitals in Oregon are being stressed by an early and particularly harsh flu season, Steinke said the volumes at St. Charles are due to other factors.

“It’s not flu, it’s not ice storms, it’s not trauma,” she said. “It’s a little bit of everything.”

St. Charles would normally look to Portland hospitals to take patients who couldn’t be accommodated locally, but many of their usual referral sites are also bulging at the seams. Oregon Health & Science University has been at capacity all week, both in the ICU and in their regular hospital wards.

“We’re sort of in this vicious cycle now,” said Dr. Jeffrey Gold, an ICU physician at the 500-bed hospital. “I actually have patients that can leave the ICU to go to the wards, but there’s no room in the wards, so we can’t get any new patients into the ICU.”

Gold said most patients have come to OHSU’s ICU due to the flu or complications from the flu. The hospital has fielded calls from other hospitals including facilities in other states seeking to send critical care patients to OHSU.

“We don’t have beds,” Gold tells them.

Flu patients can particularly stress hospital capacity because they are generally isolated in order to protect other patients. OHSU has now run out of single-bed rooms to place those patients, and the hospital can’t place a second patient into a double room with them.

Legacy Emmanuel Hospital in Portland is also nearing its 400-bed capacity.

“We are quite full,” said Dr. Lori Morgan, the chief administrative officer at the hospital. “This is a very ugly flu season, and it has started very early.”

The hospital has seen a surge in flu cases since the start of December, and is taking in patients from as far away as Washington and Nevada as hospitals there struggle with capacity.

“We can’t answer the phones fast enough from people who are looking for extra resources to care for patients who are profoundly ill,” she said. “We really started to feel it more around the beginning of December and we are still drinking from a fire hose.”

A Salem Hospital spokesman said the facility has also seen a surge in patients, although like St. Charles, not as many flu cases. Hospitals in Boise and Seattle are seeing increased volumes, primarily due to the flu.

Oregon public health officials say the flood of flu cases over the last past three weeks has been the worst since the 2009 H1N1 pandemic.

“This is a pretty big spike,” said Dr. Ann Thomas, a flu expert with the state epidemiologist’s office. The state has been conducting a project with the Centers for Disease Control and Prevention to track flu hospitalizations in a three-county area around Portland. The project has only twice recorded 500 hospitalizations in a single flu season, in 2009 and 2013. As of Dec. 28, it has already recorded 179 hospitalizations.

The vast majority of those affected, 84 percent, have been below the age of 65. That’s unusual for the flu, which tends to hit the elderly and the very young much harder.

“This year is really behaving much more similar to the pandemic year,” she said.

Thomas said that unlike 2009 when the H1N1 vaccine wasn’t available until after the initial surge of cases, the current flu shot does contain the H1N1 strain.

With months to go in the flu season, there is still time to get a flu shot, she said. Individuals can also help prevent the spread with frequent hand-washing and staying home from work, perhaps telecommuting, if sick.

Late Wednesday, St. Charles was able to discharge some patients from the Bend and Redmond hospitals, easing a bit of the bed crunch. At last report, the hospital did not plan to cancel any surgeries today.

“Some families may be impacted if we have to short-term house a patient in an overflow area, because it’s not going to be as comfortable as a regular patient room,” Steinke said. “But we’re committed to making sure we have the resources, the technologies, the skill sets and the caregivers to take care of those patients.”

— Reporter: 541-617-7814, mhawryluk@bendbulletin.com

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