An open letter to our incredible clinicians

Amanda Kotler, nursing VP for AACH and ARRMC, shares her appreciation and provides an update to the two hospital staffs on the COVID surge.


This article originally appeared in Connections, Asante Ashland’s employee newsletter

As many of you already know, our three Asante hospitals are in the midst of a rapid influx of COVID-positive patients, which is placing significant strain on our resources and staff.

Even before this surge, our hospitals were faced with record-breaking occupancy due to a high volume of clinically complex inpatients combined with a dwindling number of discharges to subacute care, such as skilled nursing facilities and long-term care residences. This has created a tremendous challenge for ensuring open hospital beds to meet the needs of our community.

Over the past week, the number of people testing positive for COVID-19 has reached an all-time high. Although Southern Oregon represents about 10% of Oregon’s population, we have 25% of the state’s COVID cases. With high community prevalence, we expect a one- to two-week lag between new infections and need for hospitalization.

We want to be transparent with our staff that we expect our numbers to get worse before they start to get better. We went from eight hospitalizations to 131 in four short weeks. Projections show that the peak will not be until early September in the best-case scenario.”

Fortunately, we have learned a great deal about COVID-19 since the beginning of the pandemic. While we know that a surge in our hospitals will likely push us to the max, the surge will run its course and will begin to subside within a number of weeks.

While we work to get better communication streams in place, I recognize there is a need for better communication. Leadership and frontline worlds can be very different but we all have a commitment and dedication to our patients. We are devoting every waking hour to make sure we are prepared for our next step.

We remain at high capacity at all three Asante hospitals:

  • We have limited critical care bed availability.
  • ARRMC’s step-down unit in the Heart Center is open and currently accommodating overflow critical care patients.
  • ARRMC has designated Cardiovascular Recovery as its next critical care overflow unit. Cath Lab and Periop leaders have worked together beautifully to develop workflows and operational plans to merge current CVR staff and workflows into PACU/PAH, when the time comes to open CVR as a critical care unit.
  • AACH has designated its critical care overflow to PACU. It is working on plans to ensure all resources are in place to care for these patients should this need arise.
  • AACH is making plans to expand Med Surg bed capacity into space currently occupied by the Wound Care Clinic. The expansion will provide an additional eight patient beds. Wound Care is looking at temporarily relocating to Same Day Surgery.
  • As of this writing we have 131 COVID inpatients across our three Asante hospitals, but that number fluctuates daily.
  • ARRMC continues to have inpatient boarders in our Emergency Department with overflow to SSU.
  • AACH has seen inpatient boarders in our Emergency Department almost daily.
  • ARRMC has canceled all elective cases that are not urgent or emergent.
  • AACH has canceled all inpatient surgeries and is thoughtfully evaluating the need for additional cancelations regularly.
  • We are working to fill staffing vacancies as much as possible with emergency shift premiums, contract labor and support from other departments.
  • We have made a formal request to the Governor for National Guard to set up a field hospital for subacute patients who we have been unable to discharge to SNFs/LTC and for lower acuity medical patients. Although we have nothing in writing yet, they have given us reason to be optimistic that help is coming. We have also requested clinical and non-clinical staff.
  • Our purchasing team has secured an excess of personal protective equipment and we are well-positioned to provide our frontline staff with the safety equipment required to meet the needs of our patients. Our leadership teams are meeting multiple times each day to ensure we navigate this surge to the best of our abilities and meet the needs of our staff and our patients.

We recognize that many of you are feeling overwhelmed with the challenges that lie ahead. You have weathered the ups and downs of an already-long pandemic and are now wondering what we will see and experience in the coming weeks. Trust us when we say that we will tackle these challenges as we always do: as an Asante team. We are and have always been stronger together.

I am so grateful for your dedication to our patients and our community. You are the reason that Asante is recognized year after year for both quality and excellence. Knowing the strength and determination you each possess as individuals, we are confident that we will overcome any challenge as a team.

Please connect with your leadership team for questions or concerns. Also watch for updates from Asante News and the COVID-19 newsletter to increase frequency with important information about testing, vaccine availability, clinical workflows, exposure management and other resources.

Tags: Amanda Kotler, cases, covid-19, staff, surge plan
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If you have a question, please contact the author or relevant department directly.

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