DHS identifies new healthcare criteria for reopening economy
The Department of Health Services identified additional healthcare-related measures for a gradual reopening of the state’s economy on Tuesday.
The measures are on top of the three benchmarks launched more than two weeks ago, which are downward trajectories in flu-like illnesses, COVID-19-like syndromic cases and percent of positive tests out of total tests within a 14-day period.
The new criteria announced Tuesday include 95 percent of hospitals affirming they can treat all patients without crisis care, 95 percent of all hospitals affirming they have arranged for testing for all symptomatic clinical staff treating patients and a downward trend of COVID-19 cases among healthcare workers.
So far, the state has met the downward trend in cases among healthcare workers and flu-like illnesses. It’s not met the downward trend in syndromic cases and percent in positive cases out of total tests. And it’ll start reporting data on the two hospital-related measures Friday.
“The Badger Bounce Back plan is our road map to turning the dial in Wisconsin,” DHS Secretary-designee Andrea Palm said in a statement. “Ensuring we do not overwhelm our hospital capacity is integral to that plan, and having this hospital gating criteria in place makes that a more attainable goal.”
One of the hospital metrics deals with “crisis care,” characterized by the Institute of Medicine as “extreme operating conditions,” according to the DHS statement.
Under the agency’s measurement, hospitals will be considered as being in crisis if they report for three days or more that the facility is damaged, unsafe or using non-patient care areas for patient care; that trained staff are unavailable or unable to adequately care for the number of patients; and that critical supplies are lacking, leading to the allocation of life-sustaining resources or extreme operating conditions.
On the testing requirement, the hospital has to have arranged testing for all symptomatic clinical staff treating patients at the facility during the past week. The metric will be monitored weekly.
The agency will use data from the Wisconsin Electronic Disease Surveillance System to determine the weekly trend of COVID-19 cases among healthcare workers.
DHS consulted with the Wisconsin Hospital Association and Rural Wisconsin Health Cooperative on the measurements.
WHA CEO Eric Borgerding called the measures “balanced and reasonable” for affirming that Wisconsin hospitals are not in a crisis mode as a result of COVID-19. He said they think it’ll be simple to collect and report the data.
“Once it’s posted, I think the data will likely show that our hospitals are handling the impact of COVID-19 quite well,” he said. “We’re confident that no hospitals have reached those sort of extreme operating conditions, and that’s really what the metric is intended to gauge.”
Borgerding said they’ve spent time weighing an appropriate way to define and measure what a crisis is. He said there’s been some talk about intensive care unit capacity, which isn’t the best measure of whether or not a hospital is in crisis because units are typically managed to be at a high capacity.
He feels the three-day element for the crisis metric is important because if a hospital is in a crisis situation for a day or so there would be assistance from other hospitals, the state or their health system, to help the situation.
“Hospitals are not islands,” he said.
He noted that the metrics can serve as a warning sign if things are changing and could help play a role in identifying the next steps for any type of COVID-19 strategy that may move forward.
Tim Size, Rural Wisconsin Health Cooperative executive director, said they worked closely with WHA and signed off on the metric after “much discussion.” He wrote in an email that the cooperative believes that “strong consideration needs to be given to regions having the opportunity to go through the gates as these metrics are met.”
DHS reported an increase of 330 confirmed cases, bringing the total number in the state to 8,566 positive cases. There were 353 deaths, 13 more than on Monday.
The department also said Tuesday that it’s trained 401 additional contact tracers over the last two months. The Badger Bounce Back plan calls for adding additional 1,000 contact tracers to address the pandemic.
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