State ICU call center could ease rural health care gap, Yukon-Kuskokwim health officials say

A man wearing a blue coat and white gloves looks at a computer.
When a critical care patient arrives in the Bethel hospital, an attending physician can spend hours reaching out to other hospitals in the state to secure an ICU bed. (Katie Basile/KYUK)

The Yukon-Kuskokwim Health Corporation is urging the state health department to change how hospitals connect patients to intensive care beds across Alaska.

YKHC wants the Alaska Department of Health and Social Services to implement an ICU call center. The health corporation said a call center would help its doctors transfer critical care patients to ICU beds across the state, and ease the burden on rural hospitals during the pandemic, as ICU beds become more scarce.

Many rural hospitals don’t have their own ICUs. So, for example, when a critical care patient arrives at the hospital in Bethel, it’s up to the attending physician to reach out to other hospitals to find an ICU bed. YKHC Chief of Staff Dr. Ellen Hodges said that the process can take hours and it’s taking even longer as a statewide surge in COVID-19 cases means most ICU departments are at or near capacity.

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Last week, Hodges spoke to state leaders about a YKHC physician trying to find an ICU bed for a critically ill patient the weekend prior. The patient did not have COVID-19.

“My physician had to reach out to each and every hospital in Alaska to ask if they had an ICU bed for this person,” she said. “All the while, the physician had to provide ongoing medical care at the bedside of this desperately ill person who was deteriorating as precious time was being spent securing an ICU bed.”

Hodges said the doctor couldn’t find a bed for the patient, but the patient recovered.

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A centralized call center would have helped, she said. It would mean ER doctors would only have to make one call, and the person in the call center would organize the transfer details. The call center would help solve another problem too, she said: the issue of getting rural patients the same level of care as urban patients.

Hodges said that YKHC is calling for a round-robin-like system where hospitals with ICU departments would have to take turns accepting patients. She said that would make care more equitable for rural patients who don’t have the same access to advanced care as urban patients.

“It’s not fair, if you live in Anchorage, that you should be able to get an ICU bed without a problem,” she said. “I think some type of a coordination at a statewide level is needed to make it safe and fair for everyone. I think rural Alaska gets overlooked.”

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Hodges said that she and YKHC officials have been in contact with the state health department, and she hopes that they will agree to implement the ICU call center.

The health department did not respond to a request for comment for this story.

Hodges said the best way the public can avoid overburdening the health care system is to get vaccinated and wear a mask.

YKHC has been calling on the state to implement a variety of measures in response to the spike in COVID-19 cases and hospitalizations, including urging the governor to mandate masks and vaccines for state employees, and to use stronger language to encourage vaccines for all Alaska residents age 12 and older.

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