Like other hospitals around the state taking in more and more pandemic patients, Denver Health, the region's go-to hospital for people with little or no insurance, faces a dual-threat: a shortage of workers and a rise in coronavirus cases that could spike after Thanksgiving.
The good news is, compared to the first wave, in the spring, a smaller percentage of Denver Health patients need the intensive care unit this time around, said Thomas Mackenzie, a doctor and chief quality officer at Denver Health. That could change, Mackenzie said, if the virus keeps spreading at its current clip.
A little more good news: Denver Health, which frames itself as the area's top "safety net" hospital, expanded the number of beds and equipment for adult patients by 12 percent -- 28 beds -- to prepare for the second and third waves of the pandemic. And although they were full as of Friday afternoon, they've been that way all week and haven't overflowed as Mackenzie expected -- yet.
"Given the numbers in the community going up as they are, and the positivity rate going up as it has, our concern was that we would start to see more and more patients as the week went on," Mackenzie said. "But that has not materialized. I think it could still happen over the next week or 10 days."
The next step in the hospital's "surge plan" is to start doubling up, or putting two beds in one room, which makes room for more beds elsewhere. The hospital has enough beds and equipment; what they don't have is enough staff to attend to the patients in them in an efficient way.
For instance, the next 12 beds the hospital adds will require 50 more staff members it doesn't have, Mackenzie said. That would represent the first phase in its surge plan which Mackenize thinks can be achieved by December 1. Nurses, therapists, case managers, pharmacists, radiology techs, food services workers all become in higher demand.
If COVID cases keep proliferating, Denver Health will keep leveling up its beds, meaning those staffing needs grow exponentially. The following phase of the surge plan would require 57 more staffers it doesn't have and the next would require 110.
"These are really big numbers to try to manage this surge. And quite honestly, that's our biggest pain point right now is trying to figure out how we would recruit, hire, find sufficient staff members to take care of these patients safely," Mackenzie said.
Those numbers don't include frontline workers who fall victim to the virus, which Mackenzie said has sidelined staffers at the same rate as the general public.
Many people have left the healthcare field because of burnout, among other reasons, as government initiatives and the general public have failed to slow COVID's spread. The hospital is offering staffers more money to work extra hours, training administrative workers for clinical roles, and recruiting like crazy. Mackenzie said Denver Health is even "making pleas" to health professionals who have recently left the organization to return.
All the while, the hospital is attempting to provide "psychological first aid" for its workers, most of whom are probably facing an unprecedented demand for their physical and mental energy. It has counselors on-call, for instance.
"This is one of the most stressful events any of us have ever experienced," Mackenzie said.
Denver Health, like other hospitals in the state, has submitted its surge plan to the governor's office for review. Hospitals could see a boost from a stimulus expected from the special legislative session called by Governor Jared Polis. Mackenzie said he'd like to see a cooperative approach among hospitals that shifts workers in less affected areas to hospitals in hotspots. He said he welcomes "all creative ideas."
