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Portland Metro Hospitals implement crisis standards of care for adults

This step helps ensure both adult and pediatric patients get the best possible care as RSV, Flu and COVID hospitalizations increase
Aerial Tram at OHSU Marquam Hill
In the Portland Metro area, Kaiser Permanente, Legacy Health, OHSU Health and Providence have declared staffing crisis standards of care in response to the high volume of adult and pediatric patients with respiratory viruses – including COVID, influenza and RSV – in addition to the care they provide every day. (OHSU/Christine Torres Hicks)

Recognizing the extreme strain on hospital resources statewide and in the Portland Metro area, and in alignment with guidance from the Oregon Health Authority, Kaiser Permanente, Legacy Health, OHSU Health and Providence have declared staffing crisis standards of care in response to the high volume of adult and pediatric patients with respiratory viruses including COVID, influenza and RSV  in addition to the care they provide every day. 

Pediatric crisis standards were implemented beginning Nov. 21, 2022.

Regional hospitals will work together as a team to provide beds where they are available to patients in need of care. Some surgeries will be postponed to create more patient capacity. This will support the regional approach to distributing patients between hospitals who can accept critical care patients. 

Declaring crisis standards of care gives hospitals the flexibility to be nimble and maximize resources. This is what will ensure community access and save lives, not just patients in Portland-metro area, but the patients in our small and rural communities needing transfer. 

According to the Oregon Health Authority, crisis standards of care are activated when patient care resources are severely limited; the number of patients presenting for care exceeds capacity; and there is no option to transfer patients to other acute or critical care facilities. The Portland Metro area health systems have met those criteria.  

The formal definition of crisis standards of care has been defined by the OHA and includes a tool to help hospitals equitably allocate scarce resources and ensure hospitals are ready if a wave of patients make it impossible to provide lifesaving care to all who need it. We recognize and have planned for the possibility that patients could overwhelm Oregon hospitals, forcing decisions about available resources for care. At this time, we are not making triage decisions, but we are entering crisis standards of care in order to optimize all resources, including bed capacity and staffing.

For our frontline health care teams, providing compassionate, high-quality care is their calling; they show up every day to help heal people, and every single life is valued. The needs of every individual patient is always at the center of their thinking and decision-making.  

As more people become hospitalized, we ask the community to practice all the measures that were emphasized during the pandemic: wear masks in indoor settings, avoid contact with those who are sick, wash hands frequently, clean and disinfect surfaces and stay up to date on all routine vaccinations, including flu shots and COVID-19 boosters. It’s also helpful to limit infants’ exposure to frequent visitors and crowds, especially if they are at risk for severe illness and/or younger than 12 weeks of age. 

Because of the high volume of patients requiring emergency services at this time, caregivers and families, unfortunately, may experience long wait times in our emergency departments and urgent care facilities. Additionally, appointments for urgent, immediate and primary care may take longer to schedule. Except when emergency care is needed, we urge families and caregivers with concerns to first call their primary care provider. 

Kaiser Permanente, Legacy Health, OHSU Health and Providence thank the community for its support and patience as we continue to collaborate with the state and other hospitals and health systems around Oregon to respond to these challenges and help ensure patients have access to the care they need. We also want to express appreciation for the additional support and flexibility the state is providing through Governor Brown’s executive order extending the state of emergency. 

Eric Roth, M.D., Chief of Hospital Operations, Kaiser Permanente Northwest

Kathryn Vandewalle, J.D., M.B.A., B.S.N., RNC, CENP, NE-BC, Chief Nurse Executive, Kaiser Permanente Sunnyside Medical Center

Matthew Freeman, M.B.A., B.S.N., RN, NE-BC, Chief Nurse Executive, Kaiser Permanente Westside Medical Center

Melinda Muller, M.D., Interim Senior Vice President and Chief Medical Officer, Legacy Health

Kecia Kelly, D.N.P., RN, NEA-BC, FACHE, Senior Vice President and Chief Nursing Officer, Legacy Health

Renee Edwards, M.D., M.B.A., Chief Medical Officer and Senior Vice President, OHSU Health

Dana Bjarnason, Ph.D., RN, NE-BC, Chief Nursing Executive and Vice President, OHSU Health

Elizabeth Ransom, M.D., FACS, Chief Medical Officer, Providence Oregon/Central Division

Jennifer Gentry, M.S.N., RN, NEA-BC, Chief Nursing Officer- Central Division, Providence St. Joseph Health 

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