UW Medicine to reschedule some procedures; hospitals agree to share surge of COVID-19 patients

Responding to a surge in COVID-19 caseloads, UW Medicine has decided to postpone surgeries that are not urgent but would require hospitalization afterward, according to an internal email and confirmed by a spokesperson. 

UW Medicine’s action comes as Washington state’s hospitals earlier this week reached an agreement on how to handle the ongoing rise of COVID-19 patients statewide — committing to one another that “no hospital will go into crisis standards alone.” 

Crisis standards are when hospitals are so overwhelmed they cannot provide the typical standard of care, and they are left to triage resources and decide who will receive treatment and who will be left to die. 

The hospitals’ commitment — which expand on agreements reached before the first surge of COVID-19 in spring — says all of the state’s acute care hospitals will make “concrete plans” to scale back on elective procedures as needed, reserve intensive care units for COVID-19 or emergency cases, and readily accept patient transfers from other parts of the state.

It aims to ensure hospitals will work closely with one another and communicate to prevent individual facilities from becoming overwhelmed when others have capacity.  

“It’s essentially to try to manage — all across the system — the capacity,” said Cassie Sauer, of the Washington State Hospital Association (WSHA), which convened a videoconference Monday for the state’s hospital leaders. “In the places that have gone to crisis standards, those doctors and nurses, I’m not sure their soul will ever be the same.” 

Sauer said hospitals hope to create more slack in the system by collaborating closely together and establishing clear communication. Hospitals must document if they deny the transfer of a patient and inform their chief executive officer if a transfer is denied. 

Statewide, as of 4 p.m. Friday, 78% of acute care beds were occupied, according to WSHA. Nearly 84% of intensive care unit (ICU) beds and almost 75% of the ICU beds in airborne infection isolation rooms were in use — numbers higher than two weeks ago.

Sauer said many Washington hospitals, including UW Medicine and Swedish, are beginning to more aggressively scale back on elective procedures.  

“All non-urgent patients who need to occupy a bed [post-operation] for any length of time will be rescheduled,” wrote UW Medical Center CEO Cindy Hecker and Harborview Medical Center CEO Paul Hayes in a message to colleagues Nov. 19. The rescheduling will begin Nov. 23 and continue through Feb. 1, according to the message.  

Procedures for outpatients and in urgent or emergent cases will continue, Hecker and Hayes wrote. 

UW Medicine spokesperson Susan Gregg said the hospital system is “actively contacting” patients whose surgeries will be postponed. 

“Each individual case is being reviewed based on medical urgency and whether the patient would need to be hospitalized after the surgery,” Gregg said in a statement Friday.  

UW Medicine was caring for 77 COVID-19 patients across its campuses as of Thursday. On Oct. 1, the hospital system was caring for 20.  

Dr. Elizabeth Wako, chief medical officer at

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Backus Hospital and the union representing more than 400 nurses agree to a tentative contract after 4 months of bargaining

Backus Hospital and the union representing more than 400 nurses agreed early Saturday morning to a tentative four-year contract the union president hailed as a victory.

Sherri Dayton, president of the Backus Federation of Nurses, said pay raises will help secure a major goal of the union: keeping nurses from leaving for jobs with higher salaries.

In addition, Hartford HealthCare, the hospital’s parent company, agreed to single-use face masks “instead of storing masks in brown paper bags,” she said.

Donna Handley, president of the hospital called the agreement a “fair and responsible contract.”

We greatly value and respect our nurse colleagues and the critical roles they play in our hospital,” she said in an emailed statement.

Nurses have scheduled a ratification vote Thursday.

Nurses went on strike for two days this week to pressure the hospital to negotiate better contract terms. Dayton said the walkout and political involvement by Gov. Ned Lamont helped spur an agreement.

Stephen Singer can be reached at [email protected]

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Four Out of Five Dentists Agree, But What About the Fifth Dentist?

We always hear that four out of five dentists recommend chewing a particular brand of gum or using a certain toothpaste. Yet there’s always one dentist who doesn’t buy into the group-think. Why is there never unanimity? And if one in five don’t recommend a particular brand of mouth wash… well that means there are thousands of dental professionals who wouldn’t recommend it! Well, the truth is that these polls don’t actually represent what they want you think they represent. It’s actually a time-honored obfuscation of truth in American marketing, and it has been used since at least the 1950s (at one point four out of five doctors preferred Camels).

Advertisement is regulated by the Federal Trade Commission but is subject to some legal grey areas that exist where government regulation of commerce meets common law and the First Amendment’s Free Speech Clause. The federal Truth in Advertising Act imposes restrictions designed to ensure that scientific statements are backed by at least some kind of study. However, the law also recognizes certain statements as ‘puffery,’ assertions no sane person would believe to be fact. If you hear words like ‘clinical study’ or ‘national survey’ you have a reasonable belief that some kind of work was done (though that’s no assurance that the work was reliable). The ‘four out of five’ trope is broadly phrased ad-speak that aims to create the illusion of statistical analysis without over-promising much in the way of evidence.

It is often important to pay attention to what exactly is being said in the commercials. For example, if the ad states that four out of five professionals recommend a certain product, they could have only asked five select people, chosen in advance or cherry picked. The ad could also claim that four out of these five dentists recommend flossing with picks, and there are five men in white lab coats on the screen. That could mean four of the dentists pictured recommend it. Or maybe the commercial tells you that nine out of ten recommend brushing your teeth with brand X. That may be true, but they could also recommend brand Y or Z. You have to imagine any dentist would recommend brushing your teeth with most brands of toothpaste.

So if these are all, in one way or another, misleading, why not make everyone agree? Probably because it’s more believable to bluff small, and a majority is good enough. While these claims sound like factual statements, the devil is usually in the details. The words are vague enough or obtusely true in a way that As Mark Twain said, there are lies, damn lies, and statistics. They can often be manipulated to reflect any number of partial truths.

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