Nebraska Gov. Pete Ricketts on Friday said the state has issued a new health measure suspending some inpatient and outpatient surgeries at the Nebraska Medical Center in Omaha, a day after Nebraska Medicine began operating under its crisis plan.
The directed health measure suspends pre-scheduled, nonemergency surgeries — what are known as Class C, D and E inpatient and outpatient surgeries — at the medical center, effective at 5 p.m. Friday. The measure is expected to remain in place through Feb. 13.
Nebraska Medicine officials said Thursday that they were activating the crisis plan, known as crisis standards of care, for the first time in the health system’s history in the face of a growing demand for health care and a shortage of staff to provide it. The health system is in the first stage of that plan. They said the governor’s order would not disrupt needed care.
“Hospitals that decide to operate under a crisis standard of care should not be performing non-emergency surgeries,” Ricketts said in a statement. “Today’s DHM makes sure the Nebraska Medical Center remains focused on prioritizing care for patients with the most urgent medical needs.”
Nebraska Medicine officials said in a statement Friday that the operational changes they announced Thursday are consistent with the directed health measure.
“The actions we are taking ensure we are prioritizing care for patients with the most urgent medical needs,” officials said. “As outlined in the directed health measure, our medical providers will continue to make case-by-case determinations on surgeries and procedures that must be done to preserve the patient’s life or physical health.”
Health system officials said that because current operations are consistent with the health measure, any necessary care will not be delayed. “Patients should continue to access care as they’ve planned unless they hear from their physician,” they said in the statement.
Nebraska Medicine officials said patients still can receive care at the health system’s facilities. The goal behind activating the crisis plan, they said, was to provide flexibility in operations and staffing and to ensure the safety of patients and staff. The health system, they said, also enacted the plan to prepare for an anticipated further surge in COVID-19 cases caused by the omicron variant and the need for additional health care expected to come with it.
Nebraska Medicine, a private, nonprofit business that operates the Nebraska Medical Center, is the clinical partner of the University of Nebraska Medical Center.
The new health measure comes as Douglas County on Friday reported 1,866 new cases of COVID-19, the highest one-day total since the beginning of the pandemic. In addition, 403 COVID patients were hospitalized in the Omaha metro area, a figure approaching the pandemic peak of 445, recorded in November 2020. Some 671 COVID patients were hospitalized across Nebraska.
The health measure cites state law and administrative code as giving the Nebraska Department of Health and Human Services the authority to order health measures to prevent the spread of communicable disease and illness.
The measure says that the state health department finds that the “current hospital capacity and healthcare resources at the Nebraska Medical Center are reaching near capacity as noted in the activation of the NMC Crisis Standards of Care plan, and that the immediate implementation of the following Directed Health Measure is necessary to preserve sufficient hospital capacity and health care resources to ensure public health needs can be met.”
The health measure further states that “surgeries or procedures that must be done to preserve the patient’s life or physical health, but do not need to be performed immediately, are allowed on a case-by-case determination of the medical provider.”
A number of health systems across the country are enacting crisis plans as they face the dual challenges of rising case counts fueled by the omicron COVID variant and a growing number of health care workers sidelined by their own or their relatives’ infections.
No other hospital was named in the health measure. Many of the large hospitals in the state have been limiting surgeries and procedures that can wait for months as they have responded to increased demand for care of all types, including a high number of patients with COVID-19.
Nebraska Medicine, Methodist and Lincoln’s Bryan Health have been limiting elective procedures and surgeries requiring overnight stays since August. CHI Health also has been delaying cases that can safely wait. Bryan Health officials said Thursday that many of the elements in its crisis plan are in place and have been for some time, including redeploying staff and repurposing some clinical areas.
Class D and E surgeries typically can wait for some weeks. But Class C procedures can include cancer surgeries.