In response to continuing staffing shortages across the healthcare industry, the Baker-Polito Administration announced several measures intended to ensure acute hospitals can serve those in need of acute care. The Commonwealth’s healthcare system has been facing a critical staffing shortage which has contributed to the loss of approximately 700 medical/surgical and ICU hospital beds since the beginning of 2021. Hospitals are also seeing many more patients than usual, the majority due to non-COVID-19-related reasons.
To assist hospitals amid the staff shortage, the Department of Public Health (DPH) issued orders to:
• Curtail unnecessary Emergency Department visits for non-emergency services
• Allow qualified physician assistants to practice independently
• Provide greater staffing flexibility for dialysis units
• Allow foreign-trained physicians to qualify for licensure more easily
“Our healthcare system continues to experience significant workforce and capacity constraints due to longer than average hospital stays, separate and apart from the challenges brought on by COVID,†said Secretary of Health and Human Services Marylou Sudders. “Working closely with our hospital leaders, these additional actions by DPH will allow for flexibility to preserve our hospital capacity in the coming weeks.â€
DPH has previously updated public health orders and issued advisories to hospitals and other healthcare facilities to alleviate staffing shortages and enhance the capacity of the health care system. These new actions include:
Advisory Curtailing Unnecessary Emergency Department Visits
Emergency Departments across the Commonwealth, like all other healthcare systems, are experiencing significant staff shortages and long wait times for care. In order to ensure critical resources are available for those who are having a medical emergency, individuals should not seek ED care for routine healthcare needs, COVID-19 testing or COVID-19 vaccination. For non-urgent, routine healthcare needs, individuals should contact their primary care providers.
Physician Assistants
Physician Assistants (PA) may practice independently without physician supervision, provided they are employed within a provider setting where PAs work together with physicians to provide patient care and the PA is qualified and practicing within their scope of practice, experience, and training.
Moonlighting for Resident Flexibility
Resident physicians can engage in “internal moonlighting,†which will allow flexibility to provide patient care outside of their specialized training program so that they may be redeployed to parts of the health care system with the highest staffing demands.
Credentialing: Interfacility Staff Transfer Flexibilities
Requires DPH-licensed facilities to expedite credentialing and to facilitate staff transfers across and between hospitals and provider systems to best meet patient care and capacity needs.
Out-of-Hospital Dialysis Center Staffing Flexibilities
Enables out-of-hospital dialysis providers, including hospitals with outpatient dialysis centers, to relax staffing requirement levels while maintaining safe patient care by following DPH guidance that otherwise ensures that sufficient direct care staff, who are trained in dialysis care, will be available to meet the needs of patients undergoing dialysis.
Foreign-Trained Physician Order
Enables an expedited licensure of foreign-trained physicians by allowing those with at least 2 years of post-graduate training, but who do not have a Massachusetts limited license, to qualify for licensure.
These actions align with or expand upon emergency public health orders issued since March 2020 to preserve the healthcare system while still providing quality care.
Residents can help these efforts by getting a vaccine and booster, which remains the best way to protect against serious illness or hospitalization from COVID-19.
These actions are in addition to the deployment of additional Massachusetts National Guard staff posted at acute care hospitals.