HHS study highlights COVID challenges faced by hospitals

A report from the Office of the Inspector General of the Department of Health and Human Services highlights the myriad challenges facing hospitals during the COVID-19 pandemic.

The report is based on interviews from March 23 through March 27.

According to study, hospitals reported that their most significant challenges centered on testing and caring for patients with COVID-19 and keeping staff safe. Severe shortages of testing supplies and extended waits for test results limited their ability to monitor the health of patients and staff. They also reported that widespread shortages of personal protective equipment (PPE) put staff and patients at risk. In addition, maintaining adequate staffing levels was not always possible.

The report also stated that hospitals saw substantial challenges to maintaining and expanding capacity to care for patients. Capacity concerns emerged as hospitals anticipated being overwhelmed if they experience a surge of patients, who would need specialty beds and isolated areas for effective treatment. The shortages of critical supplies, materials, and logistic support that accompany more beds affected their ability to care for patients. A pending challenge to care was the anticipated shortages of ventilators, and increasing costs and decreasing revenues as a threat to their financial viability. Changing and sometimes inconsistent guidance from federal, state, and local authorities posed challenges and confused hospitals and the public.

To secure the necessary PPE, equipment (including ventilators), and supplies for their staff, hospital administrators reported turning to new, sometimes un-vetted, and non-traditional sources of supplies and medical equipment. To ensure adequate staffing to treat patients with COVID-19, hospitals were training medical staff like anesthesiologists, hospitalists, and nursing staff to help care for patients on ventilators.

Some hospitals reported providing services such as childcare, laundry, grocery services, and hotel accommodations that promote separation from elderly family members in order to support staff members. Some hospitals reported providing ambulatory care for patients with less severe symptoms, telehealth services when possible, and setting up alternate facilities at locations such as fairgrounds, and non-operating college dorms and closed correctional facilities as additional space for patient care.

At the time of the interviews for the report, hospitals reported pressing needs for government assistance to help meet COVID-19 response challenges. The needs fall into five categories:

• assistance with testing, supplies, and equipment (e.g., PPE)

• assistance with workforce allocation

• assistance with capacity of facilities

• financial assistance

• communication and public information

The report is based on brief telephone interviews conducted with hospital administrators from 323 hospitals across 46 States, the District of Columbia, and Puerto Rico, that were part of a random sample.