Shortages of healthcare workers and behavioral health resources are top concerns for hospital executives in Pennsylvania.

The group representing most health systems in Pennsylvania says hiring and retaining more health care workers is the top priority of Commonwealth hospital leaders as they face acute staffing challenges. This, along with a focus on the need for behavioral health services, emerged as the main issues at the group’s first in-person meeting since the pandemic halted most conferences two years ago.

Shortages of nurses, doctors and other skilled workers were a challenge before the coronavirus strained hospitals, said Andy Carter, president and CEO of the Hospital and Health System Association of Pennsylvania. However, the virus has accelerated the need for action as exhausted nurses fled intensive care units awash with COVID-19 patients.

Carter pointed to her health systems group’s recent survey, which estimated that 27% of nursing positions were vacant last winter in Pennsylvania.

“COVID has placed extreme stressors on our workforce,” Carter said. “The demand from frontline workers has been extraordinary.”

The virus has also solidified support for change among healthcare executives, who are working on short-term fixes that include more pay, benefits and perks, as well as longer-term solutions such as better access to nursing school. He applauded a $225 million federal relief package passed by the legislature and signed by Gov. Tom Wolf that funnels funds to health care systems for those efforts.

Pennsylvania State Nurses Association CEO Wayne Reich said he favors increased wages and benefits, but he said nurses also want rules limiting the number of patients a nurse can serve. expect to be busy during a shift.

Reich said mandating more nurses when there are already not enough may seem counterintuitive, but in the long run it would keep exhausted workers from leaving the field.

“When nurse staffing becomes an issue, or a shortage becomes an issue, they throw money at nurses and don’t address the underlying causes, and I think ultimately it It’s hard to put a price tag on what you go through on a shift when you have to take care of all these patients,” Reich said.

He supports a bill to fix nurse-patient ratios that has been dormant in the Republican-controlled House Health Committee for a year. The health system association opposes this bill.

In addition to staffing issues, health systems are trying to cope with an increase in the number of people presenting to emergency rooms with a mental health crisis, Carter said.

He noted that emergency departments end up caring for people who would be better served in a behavioral health inpatient bed or with outpatient services.

Once in the emergency department, doctors cannot release a person in crisis until they have access to the appropriate level of behavioral health care. As a result, people with acute mental health issues find themselves in emergency rooms for days or even weeks using resources meant to help those facing a life-threatening medical emergency.

Some health systems have responded to this problem by creating their own inpatient beds, Carter said. Recently, Penn Medicine-Lancaster General and Main Line Health in Delaware County added acute psychiatric care beds to get people out of emergency rooms.

The group called on state assembly leaders to improve access to mental health services. Carter said the hospital association supports Gov. Tom Wolf’s proposed budget increase that would direct more funds to county mental health departments.

“I mean, those would be resources that wouldn’t go directly to hospitals, but we’re extremely supportive of that because we know the underlying architecture of the system is very county-centric,” Carter said.

Carter said the association’s third priority is to find solutions to an expected increase in costs that is expected to strain some health care systems in the coming years.

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