Aurora Cuts Back Electives, Redeploys Staff

Dr. Robert Citronberg, Advocate Aurora Health Care‘s Executive Medical Director of Infectious Disease and Prevention, believes COVID-19 will be in the rearview mirror in November 2021.

But the healthcare system, which operates in Wisconsin and Illinois, is strained now and preparing to deal with what could be a difficult few months. It is treating a record number of COVID-19 patients, scaling back elective procedures and implementing staffing changes.

“Staffing has been and will continue to be one of our most significant challenges,” said Mary Beth Kingston, Advocate Aurora’s Chief Nursing Officer, during a press briefing Monday morning.

She said the system has requested traveling nurses, redeployed staff, brought back retired nurses and reached out to students.

“We are safely, very safely, redeploying staff,” said Kingston. The system announced last week it was “pausing” some of its community testing sites to reassign personnel, a decision that Milwaukee Mayor Tom Barrett has criticized.

“Certainly we are feeling the challenge, but we are not at capacity and we have contingency plans to expand,” said Kingston.

But the healthcare provider has sent seven patients from its facilities to the Alternate Care Facility in West Allis.

St. Luke’s Medical Center on Milwaukee’s South Side has 137 COVID-19 patients currently, the highest number of patients of any of the system’s Wisconsin hospitals.

Dr. Jeff Bahr, Chief Aurora Medical Group Officer, said it was important to understand that not every facility is the same size or has the same resources. The Wisconsin facility with the fewest number of patients, its Washington County medical center, has nine patients, but only 35 total beds. St. Luke’s has 983.

Kingston said plans developed early in the pandemic to expand capacity, reschedule electives and protect staff are being implemented.

“What we are really trying to do is encourage people to give one more big push to get through the winter,” said Citronberg of a request to restrict travel and avoid gathering in a press briefing Monday morning.

There is concern that behavior could change with positive vaccine news. “That is a big concern,” he said. “The first thing people do when they see news about a vaccine is they want to book a trip somewhere.”

Citronberg said people were “lulled into complacency” over the summer and must be vigilant about their behavior, including wearing a mask to protect others.

The officials said the quality of COVID-19 care is improving, even as the number of patients surges to record levels.

“We have learned so much during the past few months about therapeutics,” said Citronberg. He said better information on steroids, ventilation and other care options is reducing COVID-19 fatalities at hospitals. “In some ways it is easier to take care of the patients or get better results now that we have all these tools available that we didn’t have back in March.”

Bahr said the system would be making system-wide decisions on elective care in the coming days. Facilities currently are postponing procedures on a case-by-case basis. He said a software system helps make those decisions based on resources and the likelihood of an extended hospital stay following the procedure.

Emergency care continues even as electives are being postponed. “Anything related to the diagnosis or treatment of cancer will not be delayed,” said Bahr. A plan to ethically treat patients when care must be rationed, developed early in the pandemic, has not been used.