Brumsted: Taking action on patient access at the UVM Health Network - Vermont Biz

by Dr John Brumsted, The University of Vermont Health Network These are unprecedented times for the UVM Health Network. After months of testing for, treating and vaccinating against COVID-19, we are seeing a new surge of cases from the highly contagious delta variant. In recent weeks, we’ve also experienced intense pressures related to abnormally high patient volumes and intense patient needs. Our patients come to us when they need us most, and long wait times for certain kinds of care are an added stress.

This ‘perfect storm’ has also placed a heavy burden on our health system’s dedicated physicians, providers and staff. Hospitals across the country are experiencing the same challenges. Despite these contributing factors, the current situation is unacceptable to me on behalf of our patients and on behalf of our people, who continue to provide expert care while responding to every challenge.

Nationally, the pressures on health care providers are attributable to a couple of factors. Many patients delayed care during the pandemic, resulting in health problems becoming more serious.

Also, there are acute shortages of doctors, nurses and technicians, a problem worsened by fatigue from working through the pandemic. Other factors are at work in our region, notably a long-standing need for additional mental health treatment capacity and a serious shortage of outpatient operating room capacity, exacerbated by the closure of the Fanny Allen OR last year due to air-quality issues.

We are taking a number of actions to respond to these national and regional issues:

• Intensifying efforts to recruit.  We’re adding Human Resources support to accelerate hiring for front-line vacancies. We’ve also added temporary staff as part of our short-term strategy, and we’re working hard to develop innovative solutions to retain our people and fill critical needs. However, despite monthly hiring averages that are double their normal volumes throughout the summer, many of our teams continue to experience vacancies at twice the normal rate.
• Partnering with the State of Vermont to increase psychiatric care.  We are working with the State and other providers to make sure all Vermont’s existing inpatient beds are fully staffed and fully operational. We’ve also proposed a new facility at Central Vermont Medical Center to serve high-need psychiatric patients.
• Proposing to install new equipment to meet patient needs.  For example, we have requested state permission to install a new 3T Magnetic Resonance Imaging (MRI) device at UVM Medical Center. Our current equipment is being used 17 hours per day, and patients still are waiting too long for access.
• Proposing new or upgraded facilities to meet our communities’ needs.  We’ve proposed a modern space for outpatient surgery to meet a pressing need in our area. Additionally, we’ve let the Green Mountain Care Board know we are restarting planning efforts for other high-priority projects:

·         expanding UVM Medical Center’s Emergency Department;

·         updating UVM Medical Center’s Neonatal Intensive Care Unit;

·         and relocation of the UVM Medical Center ophthalmology and dermatology clinics.

• Partnering with long-term care facilities.  We are working with Birchwood Terrace Rehab and Healthcare in Burlington to help them staff additional beds so we can improve the flow of patients at UVM Medical Center.
• Expanding telehealth. We continue to add telemedicine opportunities, including in the Emergency Department at UVM Medical Center and e-consults between primary care providers and specialists.

I hope some of the current pressures will abate, but some will not. The recent census shows significant growth in and around Chittenden County since 2010, and growth is projected for the next 20 years. Also, the population in our area is aging, with the Medicare-eligible populations expected to double by 2040. With aging comes greater health care needs.

As an integrated academic health care system, we can coordinate and deploy expertise and resources whenever and wherever they are needed most. A recent example is our Patient Access Service Center, developed as a pilot and now being rolled out to additional service lines. This service allows us to operate more efficiently and offer patients appointments throughout our Network to reduce wait times.

I hope this conveys the urgency we are feeling and some of the actions we are taking to address the current crisis. But we also need to set realistic expectations. Many of these interventions will take time to work, and many require the approval of state regulators before we can proceed. Our focus, as always, is on providing the high-quality care our patients deserve and expect.

John R. Brumsted, MD, is the president and CEO of The University of Vermont Health Network. UVMHealth.org/MedCenter

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