More than 12 months spent operating in "survival mode" has led to new and different challenges for hospitals during the COVID-19 pandemic, according to a hospital survey conducted by HHS' Office of Inspector General.
The survey highlights hospital perspectives on their capacity to care for patients, staff and communities. Results stem from interviews the office conducted with 320 hospitals in the U.S. from Feb. 22-26.
Ten statistics from the survey that show the strain hospitals have faced during the pandemic:
Care delivery
1. Forty hospitals reported over 90 percent inpatient occupancy at the time of the survey, and 90 percent of intensive care unit beds were occupied at 56 of the hospitals.
2. Bottlenecks in the ICU and emergency departments have led to longer stays at some hospitals, with one reporting at the time of the survey that 13 of its 17 emergency treatment rooms were occupied by COVID-19 patients waiting for admission.
Staffing
3. Hospitals have been seeing higher-than-normal staff turnover, with 38 hospitals reporting to HHS Protect that they faced a critical staffing shortage during the week before the survey.
4. Turnover was especially high among nurses. One Texas hospital in a high-poverty and socially vulnerable community reported its annual average for nurse turnover increased from 2 percent before the pandemic to 20 percent in 2020.
5. A hospital CEO responding to the survey said their cost for agency nurses has risen from between $60 and $70 an hour to $200 per hour.
6. The administrator from a teaching hospital that typically recruits nurses after their training at the hospital said it had 200 open nursing positions; however, only 100 nurses are set to graduate this year.
Vaccinations
7. Considerable staff time has been spent operating vaccination clinics, with one administrator saying to distribute 600 vaccines, it took 25 staff members working an eight-hour shift.
8. Many administrators said they were frustrated about underused distribution capacity because of inconsistent vaccine supply. One hospital said it has the capacity to vaccinate 5,000 people a week, but only received 2,000 doses a week. The Office of Inspector General noted since the time of the study, the FDA has issued an emergency use authorization for the Johnson & Johnson vaccine.
Supplies
9. While hospitals said they weren't experiencing the same supply and personal protective equipment shortages that plagued the beginning of the pandemic, some still lacked dependable and predictable supply chains for PPE. In the week before the survey, 19 hospitals told HHS Protect they couldn't order and obtain N95 masks.
Finances
10. A decline in patient visits is still affecting some hospitals. One administrator said their hospital was operating at a 25 percent reduction in revenue.
Read the full report here.