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Health Report: Foundation Health Partners holds press conference regarding crisis standards of care

Published: Oct. 5, 2021 at 4:21 PM AKDT
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FAIRBANKS, Alaska (KTVF) - Foundation Health Partners (FHP) in Fairbanks held a press conference Monday in which they addressed questions and concerns regarding the decision to move to crisis standards of care at their facilities.

According to Dr. Angelique Ramirez, Chief Medical Officer for Foundation Health Partners, the decision was made with a focus on community health as a whole.

“This is not something that we have typically done in medicine,” Dr. Ramirez explained. “Medicine is usually practiced at the individual doctor-patient relationship level in terms of what’s the best care for that individual patient. In crisis care, the circumstances are such that the focus transitions [to] how to deliver the best care for the community as a whole in the setting of a scarce resource.”

There are three major factors that ultimately led to the decision by FHP to enter crisis standards of care.

“The basis for our decision - and it was a challenging decision - was three fold,” Dr. Ramirez elaborated. “One is the continuing challenge with our inability to transfer patients to other hospitals, requiring our clinicians and our facility to consistently stretch our skills beyond our routine scope of services, and because we are keeping patients here that we usually don’t keep.”

The other factors in the decision were the lack of capacity of various facilities due to COVID-19 cases in the area, along with a shortage of monoclonal antibody treatments.

“Number two, the fact that we are at capacity across the organization as a whole this past week,” Dr. Ramirez continued, “forcing us to make decisions on a routine basis as to how best to utilize our OR time, our inpatient beds, [and] our ICU space. Our current COVID percentage is sitting at 37% - not quite double our hospital census but getting there - of routine patients. We have COVID patients in our ICU, on 2 South, our behavioral health unit, women’s center, pediatrics, and NICU, and we are currently treating our youngest COVID patient to date, who is 14 days of age, and our first with pulmonary disease.”

Dr. Ramirez continued, “The third reason is the restriction that we had to recently place on the monoclonal antibody. This is a therapeutic treatment that we have found to be very beneficial for our patient population. But because we did not have enough to give to everybody who wanted it and who met the EUA (Emergency Use Authorization) requirements, we had to limit its use to those patients whom it’d most benefit.”

Despite the implementation of crisis standards of care, Dr. Ramirez said FHP will continue to provide the best care possible for all patients despite the changes.

“For many of you, care will look no different,” Dr. Ramirez said. “You’ll see the same doctors, same great staff - all of us, all of them, committed to providing high quality care at all times. You may not see a difference. In the case of the patients who were previously eligible for the monoclonal antibody, it means you’re only able to get it if you’re at high risk for serious illness, hospitalization, or death. Two weeks ago, you would’ve been able to get it even if you were at low risk, and we would have recommended it for you because that was the best that we could do for you as an individual patient. In other cases, we may have to defer your procedure, or your surgery.”

FHP also announced the arrival of federal aid in the form of clinical support provided by the Federal Emergency Management Agency (FEMA).

Nicole Welch, Chief Human Resource Officer for Foundation Health Partners explained, “While we continue to actively recruit and hire, we are very excited to receive the additional emergency resources that the state has contracted to supply. Today, seven individuals arrived at FHP to begin supporting the care at Foundation Health Partners. We’ve received three medical staff RNs, two emergency department RNs, and two respiratory therapists. We are expecting 13 other individuals to filter into the organization over the next couple of weeks.”

The additional clinical help is expected to last for the next few months with potential extensions depending on the situation.

“The state has formed the contract for 90 days, with a possible 90 day extension, but at this point it is 90 days,” Welch continued. “The individual clinicians however only sign a contract for 30 days, and then they have the option to continue for another 30 or another 30. We are obviously trying to welcome them in a way that they’re going to want to continue to stay here locally. Waves will continue to come in over the next couple of weeks. I think as we get closer to that 90 day mark, they’ll be evaluating the continuation of the need.”

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