Massachusetts governor releases emergency orders to ease strain on the healthcare system

Photo: AlenaPaulus/Getty Images

In response to ongoing staffing shortages across the healthcare industry, Massachusetts Governor Charlie Baker has directed the commonwealth's Department of Public Health to release a number of emergency orders meant to ease strain on the healthcare system, including letting qualified physician assistants to practice independently.

The Massachusetts healthcare system has been facing a critical staffing shortage, according to the Baker administration, and this has contributed to the loss of about 700 medical/surgical and ICU hospital beds since the beginning of 2021. Hospitals are also seeing many more patients than usual, the majority due to non-COVID-19-related reasons.

One order allows physician assistants to practice independently without physician supervision – provided they are employed within a provider setting where PAs work together with physicians to provide patient care, and the PA is qualified and practicing within their scope of practice and experience.

Another order calls for curtailing unnecessary emergency department visits for non-emergency services. As in all other healthcare systems, emergency departments across Massachusetts are experiencing significant staff shortages and long wait times for care. 

In order to ensure resources are available for those who are having a medical emergency, the governor's office advised that people should not seek ED care for routine healthcare needs, COVID-19 testing or COVID-19 vaccination. For nonurgent, routine healthcare, individuals should contact their primary care providers.

A third order is meant to provide greater staffing flexibility for dialysis units. The idea is to enable out-of-hospital dialysis providers, including hospitals with outpatient dialysis centers, to relax staffing requirement levels while maintaining safe patient care by following DPH guidance that otherwise ensures that sufficient direct care staff, who are trained in dialysis care, will be available to meet the needs of patients undergoing dialysis.

Baker also called for foreign-trained physicians to qualify for licensure more easily. This order enables an expedited licensure of foreign-trained physicians by allowing those with at least two years of post-graduate training, but who do not have a Massachusetts limited license, to qualify for licensure.

WHAT'S THE IMPACT?

Healthcare staffing shortages have become a pervasive issue across the country, with hospitals besieged by two conflicting trends: Burnt-out employees leaving the profession altogether, combined with wave after wave of resource-sucking COVID-19 hospitalizations.

These labor shortages, combined with ongoing supply chain challenges, have become a rising threat to profit margins for U.S. healthcare and pharmaceutical companies, according to a November report from Fitch Ratings.

Multiple factors are contributing to labor pressures, including staff burnouts caused by the enduring COVID-19 pandemic and an overall shortage of qualified help, which has resulted in higher costs to hire temporary staff, as well as wage inflation.
 
Further, the report noted that lack of staff is forcing some in-patient behavioral health and senior housing operators to lower admission rates.

Insufficient staffing in some regions of the U.S. has spread beyond clinical staff – such as nurses, respiratory therapists and technicians – to nonclinical workers such as dietary and environmental services staff. This has led to hospitals suspending elective overnight surgeries.

In addition, the shortage of hospital workers has hampered recruitment and retention and driven up wages – which an October Moody's Investors Service report predicted will continue into this year. This will lead to a further decline in profit margins.

THE LARGER TREND

Staffing shortages are expected to remain a top issue for hospitals and other providers throughout this year. They've cost health systems money in both lost revenue and in hiring traveling nurses at a higher price. In his plan to combat the Omicron variant spreading nationwide, on December 21 President Biden released a plan to use the military to beef up hospital staffing. 

In December, due to ongoing staffing issues, Massachusetts ordered hospitals with limited capacity to cut nonurgent procedures by 50%. Hospitals lose revenue in foregoing nonurgent procedures. 

Beyond the cost, physicians, nurses and other staff are burned out by a pandemic that's still raging almost two years in. Numerous staff have left hospitals and practices for jobs that are not on the front lines of pandemic care.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com