Safeguarding long-term care means hospitals can’t serve patients


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Sommer Kleweno Walley

Sommer Kleweno Walley

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Our health care system in Washington State is in crisis, with hospitals caring for large numbers of patients who no longer medically require hospitalization. The reason? Hospitals are unable to transfer these patients to qualified nursing and long-term care facilities, which cannot accommodate them.

The lack of space in these facilities has many causes, including staffing and reimbursement issues that limit the beds available for patients ready to be discharged from our hospitals.

As residents of Washington, we depend on Harborview Medical Center in Seattle to be there for anyone who needs care at our state’s only Level I adult and pediatric trauma and burn center.

With its highly specialized clinical teams and staff, Harborview is open 24 hours a day to provide lifesaving care to the most seriously ill or injured patients. It is also ready to provide emergency care at any time in the event of a major disaster or mass casualty event.

On August 11, Harborview “diverted” by dispatching ambulances with less complex patients to other hospitals to preserve our ability to provide trauma care and disaster response. Although licensed for 413 beds, Harborview routinely cared for more than 520 patients each day and recently peaked at 562 patients. Harborview stopped diverting patients on Thursday, after reducing the number of patients to around 500.

A major contributor to the high count is that we have regularly had over 100 patients who no longer need to be in hospital but cannot be discharged due to difficulty in finding placements in care facilities skilled nursing and long-term care.

During the diversion, Harborview remains open to all trauma and critically ill patients in our state. These are patients who typically come through Medic One for treatment of burns, car accidents, gunshot wounds, falls from ladders, and other traumatic injuries. Those who are less seriously injured or ill are now referred to hospitals in the region equipped to take care of their care. We are very grateful for the partnerships with other hospitals and their assistance in caring for these additional patients, allowing Harborview to continue to provide its unique services.

Going on a diversion is a difficult decision. We understand the strain this puts on our entire health care system in the state, as it disrupts patients, emergency medical services and other hospitals. This is also only a short term solution. This will give us time to reduce the Harborview hospital count to a more manageable number and ensure that every patient continues to receive high-quality care in a safe environment.

Washington’s healthcare system is in crisis. Harborview is not alone in having many patients who cannot be discharged from the hospital to qualified nursing and long-term care facilities.

In response, Harborview is taking the initiative to fund beds in select skilled nursing facilities. We are also working to develop long-term solutions with local and state governments and public health agencies. We appreciate their commitment to meeting our exit challenges, but additional efforts are needed to support and increase the capacity of our state’s qualified nursing and long-term care facilities.

Members of our community depend on our hospitals to be there when they need medical care. We must continue to work with our local and state partners, as well as other hospitals, to address this public health emergency.

Sommer Kleweno Walley is the CEO of Harborview Medical Center in Seattle. Dr. Timothy H. Dellit is the acting CEO of UW Medicine as well as the acting executive vice president for medical affairs and acting dean of the University of Washington School of Medicine.


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