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UVM Health Network chief says system under ‘intense pressure’ following reports of monthslong wait times

  • Dr. John Brumsted, President and CEO of the University of Vermont Medical Center in Burlington on Thursday, November 21, 2019. File photo by Glenn Russell/VTDigger GLENN RUSSELL

Published: 9/2/2021 9:38:17 PM
Modified: 9/2/2021 9:38:25 PM

Vermont’s largest health system is in the midst of a “perfect storm” as a deluge of patients seek inpatient and specialty care from the University of Vermont Health Network, CEO John Brumsted said in a statement Wednesday.

The pressure comes as the network is “seeing a new surge in cases from the highly contagious delta variant” of COVID-19, Brumsted said, calling the situation “unacceptable.”

The statement follows a Seven Days investigation revealing that some patients of the Burlington-based UVM Medical Center, the largest hospital in the network, have been waiting for outpatient specialist appointments for months. After the piece was published Wednesday, the state Agency of Human Services said it would investigate wait times for medical appointments, though it did not mention the medical center by name.

“We want to understand the challenges and ways to remove the barriers that leave some Vermonters waiting for months for appointments,” Mike Smith, the agency’s secretary, said in a statement Wednesday.

Brumsted vowed to work with health leaders to reduce wait times but cautioned that nationwide staffing shortages and the state’s ongoing psychiatric bed shortage are out of the health network’s control. His administration welcomes the state’s investigation, he added.

“There are multiple pressures on the system right now,” Brumsted told VtDigger on Wednesday afternoon. “(But patients) can be assured that if they have an emergent problem and come to our emergency room or have a crisis that we are there to take care of them. What I can’t do is say that everybody’s expectations of when they can get to see a specialist will be met.”

Staffing has long been in short supply in health care, but the arrival of the delta variant has exacerbated these issues. Dartmouth-Hitchcock Health, based in Lebanon, is facing similar staffing challenges, chief clinical officer Edward Merrens said in a video statement on Wednesday.

“A year ago we had to reduce elective admissions because of protective equipment (shortages),” he said. ”Right now, we’re having to close ORs and beds because of staffing.”

The delays at the UVM Health Network stem from across-the-board vacancies as demand for mental health services and other critical care grow. Though Vermont has seen relatively few hospitalizations as a result of the highly contagious delta variant, many of the 29 people who are currently hospitalized for COVID-19 are quite sick and require more care.

Taken together, these factors have threatened to overwhelm the network, whose flagship hospital is Vermont’s only Level 1 trauma center.

“I want to be very clear, these are not excuses,” Brumsted said. “We are very focused on making sure that we have access, to the best of our ability, for everybody who needs our services, but we do have these obstacles to overcome.”

UVM’s staffing shortages affect nearly every corner of the six-hospital system, according to Brumsted. As of Wednesday, the system is short roughly 75 physicians, including specialist and primary care providers. University of Vermont Medical Center — the 620 licensed-bed regional referral hub — has 180 unfilled nursing positions and has openings for 90 technicians, Peg Gagne, the medical center’s chief nursing officer, said last week. The hospital’s imaging department is also short on staff, resulting in significant delays.

According to data provided by the health network Wednesday, the wait for a routine colonoscopy averages two to three months. Urgent colonoscopies may take two to four weeks. In mid-June roughly 6,200 patients were waiting for a colonoscopy. By July, that number dropped to 2,800.

As with other health systems across the state and the country, UVM Health Network relies on temporary staff to fill some — but not all — of the gaps. Roughly 250 travel nurses work at the Burlington hospital. However, the cost of hiring these professionals is much higher than that of a full-time, permanent employee, according to Gagne.

A higher-than-expected influx of patients has also filled the medical center nearly to capacity, causing longer wait times at the emergency department and leading to sporadic rescheduling of elective surgeries.

Brumsted on Wednesday outlined some measures his leadership plans to take to alleviate the shortage, including salary increases and more concerted workforce recruiting and retention efforts. He also highlighted long-term proposals to add one MRI machine and make facility renovations to expand capacity.

The exact timeline for these interventions isn’t set yet, Brumsted said, but many of the physician vacancies would likely be filled in the coming weeks. He said other limiting factors may take longer to address and may require input from the state.

“The more folks with expertise (that) look at this very complex issue of access, the more likely (it is) that there will be (an option) to find creative solutions,” he said.

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