Opinion: AMC hospital’s closing will further stretch already-tight workforce

Sustainable solutions will require support from governmental and civic partners.

The past two years have come with unprecedented challenges for our state’s health care infrastructure. This fall and winter, developments in metro Atlanta will test those systems like never before.

For decades, the metro Atlanta region has relied on multiple hospitals and health care professionals to meet the needs of our community. The breadth, collaboration and stability of these providers has helped our city, region and state meet the demands of patients needing acute hospital care. As we now navigate the impact of Wellstar’s surprise decision to close the Atlanta Medical Center (AMC), we must leverage these partnerships and the support of local, state and federal leaders to develop sustainable short- and long-term solutions that put our community first.

By the numbers, AMC historically saw approximately 50,000 emergency room visits each year with roughly 10% of those visits requiring hospital admission. AMC provides care for about 200 hospitalized patients each day, with about 1 in 5 bed days being in critical care. The vast majority of inpatient admissions at AMC are patients who first go to the emergency room, highlighting the critical role AMC has played in emergency and trauma care.

Credit: contributed

Credit: contributed

With AMC’s ER now closed and all remaining hospital services shutting down in just a few weeks, those patients in our community requiring hospital care will need to go to another hospital. Hospitals across Atlanta are already challenged with volumes and workforce challenges resulting from the past several years of battling COVID-19. With an influx of additional volumes on already-strained systems, we all can expect wait times and delays in emergency care to increase. Hospital diversion for ambulance access will increase. The strain on our physicians, nurses and other staff will increase and risk further exacerbating healthcare workforce challenges. These are the realities Atlanta hospitals and our community need to be prepared to face as we enter the fall and winter.

Credit: contributed

Credit: contributed

At Emory Healthcare, these are realities that we are already living. Since the closure of the AMC South facility last May, we have seen an increase of more than 13% in emergency department outpatient visits in our hospitals most proximate to AMC South. Total emergency department visits, inclusive of admitted patients, have increased 11% over the same time period. We are projecting further increases after the closure of AMC. Emory Healthcare is the market leader for healthcare systems serving metro Atlanta, including the area traditionally served by AMC. Based upon historical services, patient flow and market share, we anticipate that roughly one-third of ER patients and inpatient admissions once served by AMC will present to an Emory hospital, as this patient population is distributed across the metro Atlanta health care ecosystem.

These increases will necessitate the hiring of more travel nurses to support care – a challenging task given current workforce shortages – as well as the critical expansions of emergency and hospital beds. These realities are just the beginning of what we can expect in the coming weeks.

We are working with healthcare systems and local, state and federal leaders to pursue sustainable short- and long-term solutions focused on the care of our community. For more than a century, Emory and Grady have collaborated to provide care to thousands of patients passing through Grady each year and to train the next generation of physicians. Nearly 900 Emory faculty have a clinical footprint at Grady. For 400 of those faculty, and an equal number of fellows and residents from the Emory University School of Medicine, Grady is the professional home from where they drive clinical excellence, innovative research and progressive medical education to the benefit of our city, region, and state.

Throughout the pandemic, we similarly partnered with healthcare systems across metro Atlanta and the state to disseminate the latest research and care protocols for patients with COVID-19.

Sustainable solutions will require support from governmental and civic partners. We are grateful for Gov. Brian Kemp’s provision of funding to Grady as an initial step to support long-term solutions. We are equally grateful to DeKalb County CEO Michael Thurmond and the DeKalb County Board of Commissioners for recognizing our emerging challenges and committing to addressing them. These are critical initial investments to stabilize healthcare in our community and we look forward to continuing to partner with governmental and civic leaders on further necessary investments.

Make no mistake, there will be difficult times ahead and we will need your help while we partner to identify solutions. As we work with leaders across our city, region and state to identify and deliver solutions, we ask for your support. As we move quickly to accommodate the dramatic increase in patients seeking care, we ask for your patience. As we continue to champion the physicians, nurses and caregivers who serve on the front lines of these challenges, we ask for your grace.

David Stephens, M.D., is interim executive vice president for health affairs at Emory University. Dane Peterson is interim CEO, president and COO of Emory Healthcare.