Advocate Aurora to scale back elective procedures

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Advocate Aurora Health will scale back its elective procedures by 50% as COVID-19 cases continue to surge and prompt hospital capacity concerns.

Leaders with the Milwaukee- and Downers Grove, Illinois-based health system said Monday that it will be reducing admissions for elective procedures that would result in a hospital stay across its system’s facilities beginning later this week.

This comes amid an “absolutely abysmal” second wave of the pandemic, in which the health system is seeing numbers that “were not even imaginable just a few weeks ago,” said Robert Citronberg, director of the division of infectious disease at Advocate Lutheran General Hospital in Park Ridge, Illinois.

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Advocate Aurora currently has 1,118 hospitalized COVID patients, the highest of any point of the pandemic. That total includes 489 inpatients in its Wisconsin facilities and 629 in Illinois facilities. Hospitals with the highest caseloads include Advocate Christ Medical Center in Oak Lawn, Illinois, which has 162 inpatients, and Aurora St. Luke’s Medical Center in Milwaukee, which has 137 inpatients, according Dr. Jeff Bahr, chief Aurora Medical Group officer.

Advocate Aurora, like health systems across the country, suspended elective procedures for the first few months of the pandemic to preserve bed space for COVID patients. Those measures were in line with CDC guidelines, but devastated health systems’ revenues throughout the spring. Advocate Aurora later resumed its halted services beginning in May, and its level of elective admissions has been dependent on COVID patient numbers since then, Bahr said.

The system is opening “additional units and sites” within its hospitals to care for the growing number of COVID-positive patients and non-COVID patients, but it is not at capacity, said Mary Beth Kingston, chief nursing officer for Advocate Aurora.

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About 1.5% of Advocate Aurora’s frontline employees are off work because of a need to quarantine from exposure or sickness, which Bahr said is a “pretty controlled pace.”

Still, rising cases have put an “immense pressure” on the system’s inpatient care teams, and the system has plans to redeploy staff across facilities based on demand.

“Our scale does give us some advantage to better account for the people who need our help in our ICUs and our medical and surgical beds,” Bahr said.

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In the spring, some Advocate Aurora nurses from the network’s Wisconsin facilities were sent to its Illinois hospitals in response to higher COVID-19 patient volumes there.

The system is also relying on student nurses and recently retired nurses to help provide some support services, such as screenings, Kingston said.

Unlike during the first wave of the pandemic, Advocate Aurora now has a robust supply of personal protective equipment for its employees, Citronberg said.

“Right now the supply looks really good,” he said. “Of all the things we have to worry about right now, PPE is not one of them.”

Advocate Aurora leaders urged people to cancel Thanksgiving gatherings that involve people outside of their home, saying they have the potential to be super-spreader events that would cause hospitals to become overwhelmed.

“The numbers are devastating right now. Our health care system cannot absorb doubling or tripling of those numbers as might happen if we have many super-spreader events arising out of Thanksgiving,” Citronberg said.

The positive early results from two potential COVID vaccines, produced by Moderna and Pfizer, give reason for some optimism, Citronberg said. The progress of those two, along with several others in development, could mean there will be as many as seven available vaccines by mid-2021, he said.

“The next two to three months are going to be very difficult, no matter what,” Citronberg said. “But there clearly is light at the end of the tunnel, that light is the vaccine news. It is very likely that by this time next year we will be looking at COVID-19, at least the pandemic, in the rearview mirror. And that is fantastic news.’

Still, he cautioned that vaccines are useless unless people are willing to get immunized.

“We’ll be having a big push to recommend these vaccines for our team members,” he said.
“That’s the way to end the pandemic.”

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