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WA hospitals over capacity due to patient discharging woes

Swedish Hospital on Broadway in Seattle is among the campuses affected by the impending strike.
Joe Mabel
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FILE - Swedish Hospital on Broadway in Seattle. On Monday, July 18, 2022, Washington State Hospital Association leaders said that many health care facilities are 120% to 130% full. That's leading to long emergency department wait times, declining patient care and ambulance service disruptions throughout the state.

SEATTLE (AP) — Washington’s hospitals are again “dramatically over capacity,” as challenges discharging patients worsen and staff shortages continue, the state’s health care leaders said Monday.

In a news briefing, leaders from the Washington State Hospital Association said many health care facilities are 120% to 130% full, leading to long wait times in emergency departments, declining patient care and disruptions in ambulance services throughout the state, The Seattle Times reported. The high patient loads aren’t directly because of COVID-19 cases, although they are increasing, but due to delayed procedures and difficulties discharging hospital patients.

“We are doing our best, but many of our hospitals — especially in the west side of our state in the populated areas of King, Pierce and Snohomish counties — are more strained today than really at any other point since the pandemic began,” said Dr. Steve Mitchell, medical director of Harborview Medical Center’s emergency department and the Washington Medical Coordination Center.

Some patients remaining in hospitals are better suited to continue recovering at post-acute care facilities, like skilled nursing homes, Mitchell said. Those types of facilities, however, are experiencing staffing shortages and are often unable to take more patients.

As a result, some of these post-acute patients stay in the hospital for months, Carrington said.

And while COVID-19 has had less of direct impact on hospital capacity recently, infections and hospitalizations keep rising as the highly transmissible BA.5 variant continues to spread. COVID patients make up about 12% of the state’s hospital beds, a jump from about 3.5% in early April, according to the state’s COVID-19 data dashboard.

Washington state’s guardianship laws also complicate discharges, barring a family member or close friend from consenting on a patient’s behalf (if the patient is incapacitated or unable to consent) to move them from a hospital to another facility. If the patient hasn’t appointed a decision maker in a power of attorney document, state law requires a court-appointed guardian, which is a lengthy process, said WSHA vice president Taya Briley.

Hospital leaders have long asked state officials to address discharge and staffing issues with measures like reconsidering interpretation of the state’s guardianship laws, but change has been slow-moving, Briley said.

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