Duluth hospital diversions cause concern for Cloquet residents
The Cloquet Area Fire District recently saw a drastic rise in long-distance patient transfers, according to CAFD Chief Matthew Ashmore.
Hospital diverting in Duluth is taking a toll on Cloquet emergency medical services, as well as the community, Cloquet Area Fire District officials said last month.
Diverting occurs when a hospital is no longer able to offer the highest quality of care to a particular group of patients at a particular time, according to Duluth hospital officials. Going on divert doesn’t mean a hospital is not accepting patients, but rather that patients with certain needs are sent to other facilities when possible. For CAFD, that means paramedics have to transport patients to whatever facility is available, including hospitals in the Twin Cities.
“It doesn't necessarily mean our beds are full … it’s just that we need additional resources to care for the community,” said Melissa Simonson, section chair of the Duluth Hospitalist Department at Essentia Health-St. Mary's Hospital.
Hospitals may go on full divert or partial divert, depending on the situation, but they will always take patients when absolutely necessary, such as if someone is suffering from a heart attack or stroke.
Long-distance transfers, which are transfers outside of Duluth, doubled for CAFD in July, according to CAFD Chief Matthew Ashmore. The department saw 8-10 long distance transfers from July 1 to July 21, whereas a normal month consists of 2-4.
While Ashmore said they are still working to understand the scope of the situation, officials believe the rise in long distance runs is due to Duluth hospital diversions forcing more patient transfers to the Twin Cities area.
What’s happening in Cloquet
Community Memorial Hospital Chief Executive Officer Rick Breuer said he's noticed an uptick, as well.
“It’s definitely increased,” he said. “Our options are … more challenged right now.”
Often, CMH providers are able to take care of patients' needs, but when they can’t, outside transfers are necessary, Breuer explained.
Because CMH is located in Cloquet, hospital officials will often send patients who require extensive care to either Essentia Health-St. Mary’s Medical Center or St. Luke’s Hospital in Duluth. However, recent diverting has resulted in more patients being transferred to hospitals in the Twin Cities.
Breuer does not blame the hospitals, but rather expressed concern for everyone involved.
“It stretches the community resources beyond what is healthy for any of us,” he said. “It’s a really big deal for all of us.”
A call to action
Ashmore, along with CAFD board member and Ward 2 Cloquet City Councilor Sheila Lamb, is in the midst of drafting a letter to lawmakers on the topic. They hope to have the letter signed by officials from local governments, agencies and organizations. It will then be sent to state representatives and Gov. Tim Walz.
The idea for the letter came about in late July after Lamb raised the alarm on hospital diverting following the long-distance transfer of her husband.
“This is a potential health care crisis,” Lamb said at the July 21 CAFD board meeting. “This affects every community member.”
Not only do long-distance transfers cause additional stress for patients and their families, but they also strain the fire district, Lamb said.
Going the extra miles results in wear and tear on ambulances that could still be costly to taxpayers despite insurance reimbursements, Ashmore and Lamb pointed out. It also means an EMS unit is unavailable for a longer period of time.
Although there is not a clear intention for the letter right now, Lamb’s main idea centers around a task force, which would consist of people from different backgrounds throughout the state working together to brainstorm solutions.
The current situation
Diverting is a complex issue with many contributing factors, hospital officials said, and it is not unique to the Northland or even to the state of Minnesota.
Simonson has worked as a physician at Essentia Health-St. Mary’s Medical Center for eight years and shared that she has consistently seen diverting times ebb and flow. The current situation is no different than past increases, she explained. It just seems like it’s a lot because it hasn’t happened in recent months.
“The challenge for many health care systems across the country right now is not a bricks and mortar or bed issue, it is a workforce issue,” Essentia Health's East Market President John Pryor said. “Plus more care is needed for an aging population with their corresponding complex health care issues, as well as increased needs for COVID care.”
Staffing shortages and increased patient needs are in fact the reasons behind a recent rise in divert time at St. Luke's Hospital in Duluth, St. Luke’s Co-President and CEO Nick Van Deelen said.
A number of St. Luke’s hospital staff members either took leave or an early retirement following the initial year of the COVID-19 pandemic, according to Van Deelen.
“There’s an unprecedented challenge related to staffing,” he said. “Health care workers have been just such incredible heroes throughout this pandemic, but it’s been very difficult work.”
Simonson doesn’t credit staffing as the reason behind recent diverting at Essentia Health-St. Mary’s Medical Center. Instead, she said changes in patients are likely the main reason.
While Essentia Health has seen some early retirements, according to Pryor, they have also seen health care workers extend their career time in order to help with the pandemic.
“I think the main difference is the patients are sicker,” Simonson said. “We’re full, and we’re taking care of really sick patients at baseline.”
Patients delaying routine health care appointments during the pandemic are likely a main factor behind the influx of sick patients, Van Deelen and Simonson said. Adding these patients to the normal mix of summer traumas, COVID-19 and everyday patients results in a high volume of hospital patients.
The health care providers the Pine Journal spoke to for this article said they will continue to serve the community and provide the best possible care. There are systems in place to help treat patients during periods of increased diversion and hospitals will collaborate to ensure needs are met.
If diverting continues to rise, Van Deelen said the hospitals will work together to make room for patients.
“If everybody’s on divert, then it’s like everybody’s off divert,” Van Deelen said.