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October 27, 2021

Citing 'unprecedented' demand for medical care, MaineHealth aims to ramp up capacity

chart with numbers Courtesy / MaineHealth The number of open positions throughout the MaineHealth system has grown from about 1,200 at the start of the pandemic to nearly 2,900 today.

Facing its highest hospitalization rates during the pandemic and a chronic labor shortage in health care, MaineHealth on Tuesday said it is taking steps meet the new demand and to build a bigger workforce pipeline.

With 22,000 employees and 12 hospitals, the Portland-based health care network is northern New England’s largest. The number of open positions throughout the system has more than doubled — from about 1,200 at the start of the pandemic to nearly 2,900 today.

At a virtual press conference, MaineHealth CEO Dr. Andrew Mueller said investments in training and education for health care workers announced the previous day by Gov. Janet Mills were positive steps forward.

He added that he hoped the initiative will be followed by a permanent investment in expanding the state’s capacity for training nurses and other health care professionals.

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COURTESY / MAINEHEALTH
Dr. Andrew Mueller

Leaders with the organization said they expect capacity challenges for the region’s health care industry to persist in the months ahead and asked for understanding from patients and support from the community and policy makers.

Workforce lag

Mueller said much of the challenge can be traced to a workforce shortage that has been building over time. Training for more clinical professionals is needed.

Other factors are making it harder for health care providers to keep up with demand, he added. 

“We’re seeing the largest numbers of hospitalized patients since the pandemic began, right now,” said Mueller.

In addition, many patients who delayed care are now arriving at MaineHealth hospitals much sicker, putting greater demand on the organization’s care team. 

Mueller noted the labor shortage is not just affecting MaineHealth, but health care organizations across the region. That in turn is making it hard to transition patients out of the hospital to skilled nursing facilities and to behavioral health facilities.

Some of the health care workers are leaving their jobs due to the state’s requirement for them to be vaccinated against COVID-19. Those departures will have some impact in the short term, but the overall labor challenges will remain for the long term, he said.

Rescheduling, diversions

Dr. Joel Botler, chief medical officer of Maine Medical Center, said the hospital — the state’s largest, with 637 licensed beds — is seeing unprecedented demand. It's resulted in ongoing evaluation of nonemergency procedures, and rescheduling of some.

The hospital’s emergency department has been on frequent “diversion” in recent weeks, meaning that only life-threatening and other critical cases are taken in and others are directed elsewhere for care, he added.

Cindy Wade, president of LincolnHealth in Damariscotta and Boothbay Harbor, said her rural hospital network is straining under increased demand and the shortage of workers. She said in her hospital there is a particular challenge with patients who need care in a nursing home but can’t find space due to the labor shortage impacting skilled nursing services.

Wade urged people with concerns that aren't life-threatening to use LincolnHealth’s urgent care center in Boothbay Harbor rather than the hospital emergency department in Damariscotta. 

Action plan

MaineHealth is taking a number of steps in response to the capacity issues, including:

• Forming a work group specifically targeting capacity. The work group uses a “capacity dashboard” that enables them to see on a daily basis where beds are available across the health system and where patients can be appropriately transferred to receive the best possible care.

• Reducing nonemergent procedures, evaluating them day-to-day depending on capacity.

• Expansion by the MaineHealth Medical Group of outpatient access, including extending primary care, walk-in, urgent care and telehealth hours to help reduce the strain on Emergency Departments.

• Placing an emphasis on supply chain efforts to ensure the health system has the right equipment to keep everyone safe. 

• Creating incentives to add staff, including a $61 million market adjustment to pay across the system in August and still higher increases for some of the most difficult positions to fill, making sure that wages are competitive. The system also significantly increased the employee referral bonus.

• Continued investment in training programs for critical positions, working both internally and with community partners to promote these opportunities. Longer term, the health system will be investing nearly $5 million next year in partnership with community colleges and institutions of higher learning to build a workforce pipeline into the future.

The health care system leaders asked patients and communities to do their part in mitigating capacity challenges for providers, including getting vaccinated and seeking an appropriate venue for care. Across the system, hours have been extended for walk-in care, urgent care and at doctors' offices to help take the pressure off emergency departments.

“One of the other things that we need you to do is just be patient, and recognize we are all working hard to ensure we get everyone cared for in a timely manner,” said Mueller.

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