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Luminis Health Moves to Crisis Standards of Care

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by Luminis Health

January 4, 2022
General - Tier 3 Section
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Due to a significant increase in COVID-19 hospitalizations, Luminis Health is taking the unprecedented step of declaring a crisis at both its hospitals – Luminis Health Anne Arundel Medical Center and Luminis Health Doctors Community Medical Center.

Since November 1, the healthcare system has seen a 320 percent increase in admitted patients with COVID-19, with more than 205 COVID-19 patients in its hospitals as of this date. This rise in hospitalizations, combined with ongoing staffing shortages, has made it necessary for the health system to implement crisis standards of care in order to continue providing safe and effective care to its patients.

“The decision to declare crisis standards of care was made following careful consideration and discussion,” said Tori Bayless, CEO Luminis Health. “We are following our emergency operations plans. Decisions will be guided by a focus on maximizing our resources to care for our patients. These crisis protocols allow us to quickly pivot to help meet the overwhelming demand for hospital services. We are all in this together and never more have we needed the support of our communities as we fight through this most challenging time.”

The health care crisis in Maryland is impacting many other Maryland hospitals, who have already implemented crisis standards of care protocols. At the same time we are escalating to crisis status, Maryland Gov. Larry Hogan has declared Maryland is in a catastrophic healthcare emergency.

Crisis standards of care are used only in times of emergency, when the demand for healthcare exceeds the ability of the health system to provide it through normal means. The modified protocols allow healthcare leaders to change staffing, adjust or delay surgeries, and when necessary, deploy non-clinical staff to assist with patient care. Though rarely used, these protocols have been prepared and approved in advance for just this type of situation and are based on best practices and guided by ethical principles.

“More than 70% of our hospitalized patients are not vaccinated,” said Dr. Stephen Selinger, chief medical officer for Luminis Health Anne Arundel Medical Center. “With Omicron spreading rapidly, it is critical our community get the vaccine and the booster as soon as possible and continue masking in public to help minimize COVID-19 symptoms and severity. This has an important impact on reducing hospitalizations and emergency room overcrowding.”

The crisis caused by the increase in COVID-19 infections is also leading to increased wait times in the health system’s emergency departments. Adding to the crowding are people inappropriately seeking tests for COVID-19 at the emergency department, rather than going to one of the many test sites around the region, including one led by the Maryland Department of Health at Luminis Health Anne Arundel Medical Center.

“While we are always here for serious illness and injuries, we are asking the community to avoid the Emergency Department for non-life-threatening issues,” said Dr. Sunil Madan, chief medical officer at Luminis Health Doctors Community Medical Center. “For COVID-19 tests and less severe illnesses and injuries, patients should visit their primary care provider or go to an urgent care center.”

There are a number of ways the community can help, including:

  • In addition to getting vaccinated and boosted, practice the 3W’s to stop the spread. Wear your mask, watch your distance, and wash your hands.
  • Use the emergency room for true medical emergencies, not for minor injuries or COVID testing.
  • If you have COVID-19 and are experiencing minor symptoms, please stay at home and contact your primary care physician if you have questions.

 

Frequently Asked Questions

What does crisis standards of care mean?

Crisis standards of care protocols are put into place when there is a need to extend the availability of key resources, while also minimizing the impact of shortages on clinical care. These protocols have been prepared and approved in advance so that we can quickly implement them in times of crisis. This is the first time in the history of Luminis Health that we have implemented these plans.

What changes for patients?

It’s important to note that patients with serious illness and injury should continue to access needed care at Luminis Health. Our focus will be on care for the sickest patients who truly require inpatient hospital treatment. Those with less serious conditions should avoid the emergency departments and seek care from their primary care provider or an urgent care center. Patients can expect longer wait times for all services and increased limitations on visitors and communication with loved ones. We plan to increase the use of telemedicine to triage the need for in-person clinic appointments.

What does it mean for staff?

During this period, staff may be redeployed or asked to change regular protocols in order to better care for the sickest patients. These changes may include the frequency of imaging studies, expedited transfer and discharge processing, streamlined documentation, and the use of telemedicine to triage patients before scheduling inpatient clinic appointments. Surgeries will be limited to urgent cases that cannot otherwise be managed with more conservative measures, and the emergency department will be reserved for those with life-threatening illnesses and injuries.

Can someone still go to Luminis Health when they need care?

We are always here for those with serious illnesses and injuries. During this time, we ask those with less serious needs to go to their primary care doctor or an urgent care center. Because we are caring for so many with COVID-19, we have fewer staff and fewer beds available for those with other needs, so surgeries may be postponed. We are working diligently to get back to normal care protocols as soon as possible.

How long will the crisis protocols be in place?

It is difficult to know when the need for crisis standards of care will abate. Gov. Hogan has stated that the next four to six weeks could be a very difficult time for the state of Maryland, and the pandemic models we are seeing form the CDC and other trusted sources support this. The Incident Command teams at Luminis Health are closely monitoring the evolving situation and making decisions accordingly.

What can the community do to help?

The most important things the community can do is to take care of themselves. Get vaccinated and boosted. Practice the 3Ws – wear a mask, watch your distance and wash your hands. During this crisis, we ask those with less serious needs to go to their primary care doctor or an urgent care center rather than the emergency departments. Patients within the emergency department should understand that our staff is working at peak capacity, and there may be longer wait times or differences in care experience. All Luminis Health care teams are focused on being able to provide the highest quality, safe care to those who need it the most.

 

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