What to know…

• In response to the critical situation we’re in, Emergency Management is standing up Incident Command again. (Incident Command is the leadership structure enacted in a time of crisis or emergency response.) Chief Shared Services Officer, Clint Brooks has asked Dr. Ramirez (Chief Medical Officer) to take the lead as Incident Commander. Incident Command will begin meeting next week. Meeting invites will be sent to the response team soon.

• AS of 6am today, FMH had 11 patients receiving care for COVID-19. There are an additional two patients who meet the criteria for having COVID, but whose tests came back negative. Age ranges of these patients are; months, teens, 20s, 30s, 40s, 50s, 60s, and 70s. (The highest number of COVID positive inpatients that we’ve had throughout the pandemic is 15, and this unfortunate milestone has been reached twice.)

• Caring for a COVID patients takes significantly longer than care for a non-COVID patient. This is notable because it creates delays in a staff member’s ability to respond to the needs of other patients. (This delay can be even greater due to staffing shortages.)

• Because of staffing shortages, new care models are being considered – this includes increasing staff-patient ratios. This is notable because it creates additional stress on staff and can create delays in response times to patients. 

• A process to evaluate surgeries that require hospital admission has been established. Surgeries are being evaluated daily as to whether we have a bed or staffing support to provide the care. This is notable because some surgeries will need be cancelled when we don’t have staffing to provide care for an additional patient. 

• Surge plans are being reviewed, updated, and implemented as needed.  Examples include nursing support models, identifying alternate spaces within the building where patient care can be provided, and alternate staffing models -  all are being explored.

• Providence Hospital and Alaska Regional Hospital are both on divert, which means they cannot take our transfer patients. This is significant because if a patient comes to us for care and can’t be accommodated (due to needing a higher level of care or us not having capacity to provide the care needed) they have to be transferred out of state for that care. This is worrisome for several reasons; it delays the patient’s care, which could lead to undesirable outcomes. It’s expensive for the patient. It removes the patient from familiar surroundings and from their support network. 

• The Emergency Department is experiencing higher volumes of patients. The standard wait time is now 2-3 hours and sometimes up to six hours. This is significant because it delays necessary care, it takes an emotional and physical toll on the patient and his/her family, it creates additional emotional and physical stress on staff. 

• TVC’s 1^st Care Clinic is experiencing  higher volumes of patients – about 1/3 with respiratory issues. Higher volumes and staffing shortages are creating longer wait times. Sometimes people get frustrated, leave, and in doing so delay their care. This can make their symptoms worsen, which makes them sicker when they are seen. This is notable because it can be dangerous to the patient’s health. In addition, care provided to a sicker individual takes longer, which creates additional delays for other patients needing care. 

• Due to staffing challenges and the specialty of the care being provided, we are unable to provide dialysis treatments right now. 

• We are currently recruiting for almost 200 positions and application traffic is still down. In addition we are losing staff every week who seek employment in other industries and trades due to the current challenges and hardships of health care. 

STAFFING UPDATES: What to know…

• We continue to heavily recruit for employees.
• We rolled out an employee referral program; the program pays a referring employee $500 if the new hire is still employed at 6 months. 
• We are paying $1000 retention bonuses to key positions that have high turnover.
• We are working with multiple agencies to fill critical roles while recruitment for permanent replacements continue. 
•  We have increased traveler pay, in some areas double and triple the normal rate. (Hospitals nationwide are experiencing staffing shortages and are in fierce competition with each other for nurses and other clinical positions. Fairbanks is a hard location to recruit for heading into winter. So in order to remain competitive, we’ve had to increase our traveler pay.)

• We have implemented critical shift pay in several key areas to encourage staff to pick up extra shifts.

• Exempt staffing, extra shift incentive: We are working on a unique pay model that would allow exempt staff to pick up extra clinical shifts (i.e. exempt RN can pick up a clinical shift and get paid for it).  This practice is being reviewed by our labor attorney to ensure we’re not breaching any FLSA. If approved this could launch next week.

EMPLOYEE VACCINATIONS: What to  know…

• 77% of FHP employees are vaccinated. 

• On August 18, CMS and CDC announced that they are developing regulations that would require employees in long term care facilities to be vaccinated or risk losing CMS funding. Learn more here. 

HELP IS NEEDED: What to know…

1. Be an advocate for FHP with your family and friends. Give an overview of our challenges and explain staff are working double time to keep services open. Due to staffing shortages, high COVID numbers, high volumes and acuity of care needed, there are long wait times and unavoidable delays.

• Help those outside of health care understand that everyone is impacted by COVID, even when they don’t think they are. COVID numbers are high which requires additional staffing and resources. This creates delays for other patients to receive care. Some services may have to be eliminated. Some departments may have to close temporarily – this means that those in our community may need to go without necessary care. We are losing employees to less stressful industries – this contributes to delayed care and extended wait times.
• Patients, visitors, and family members are understandably frustrated ( we work in an emotionally charged environment). Unfortunately, this frustration is being taken out on FHP employees who are working in a stressful environment and are experiencing their own fears, frustrations, delays and life challenges both at work and at home. This is contributing to burnout and resignations. 
• This is our first pandemic. We’re experiencing challenges we’ve never seen before and considering operational changes that have never had to be considered before. 

• MASKING IN PUBLIC: The CDC recommends that everyone, regardless of vaccination status, wear masks in public indoor spaces in communities with high COVID-19 transmission. Fairbanks is in high alert, along with almost the entire state. Please mask up in public.

INCREASED TRANSMISSION: 

• U.S.: Cases are up 23%, deaths are up 111%, and hospitalizations are up 32% over 14 days. The 7-day average of new cases has been trending up since July 5.  There are 7,829,286 active cases in the United States and the US remains #1 in new cases – more than three times the #2 country.
•  Alaska:  620 new cases | 11 deaths | 130 hospitalizations | Statewide alert level: high | 54% of Alaskans 12+ vaccinated. Juneau has the highest vaccination rate at 77% and Mat-Su has the lowest at 38%. The current statewide alert level – based on the reported number of cases per 100,000 people over the past 7 days – is high (red) at 447.4. For boroughs and census areas: 26 areas are at the high alert level (>100 cases), 2 areas are at the substantial alert level (50-99.99), 0 areas are at the moderate alert level (>10-49.99) and 0 areas are at the low alert level (0-9.99). Alert levels for individual boroughs and census areas using the alert levels map on the cases dashboard here.
•  Fairbanks: Community vaccination rate remain below national and state averages. Of 11 regions in Alaska, Fairbanks has one of the lowest vaccination rates at 47.7%.

KEY TAKEAWAYS: 

• The pandemic is not over. It’s getting worse. 
• The Delta variant is different. It’s making people sicker and its making younger people sick. 
• Vaccinations are the most effective tool for ending the pandemic and the best defense against new strains. Vaccines are our best long term strategy.
• Mask up, vaccinated or not. Masking interrupts the spread of the virus and is the best short term strategy to avoid additional strain on the hospital. 

If you have questions, comments, concerns or suggestions please send them to EmployeeFeedback@Foundationhealth.org 

COVID continues to evolve. And, as long as it does, so too will the recommendations that are geared toward keeping everyone safe and alive. 

This is a Foundation Health Partners employee communication, but can be shared with anyone who has an interest in learning more about COVID-19.