Even if small town “critical access” hospitals aren’t able to care for COVID-19 positive patients, Dr. Mary Aaland believes they could be an important piece of the treatment plan.
Aaland, director of rural surgery at the University of North Dakota School of Medicine & Health Sciences Rural Surgery Support Program, says statistics in North Dakota and across the country show that the virus is spreading and causing health problems in communities of all sizes.
Aaland envisions a sort of “reverse triage” system, in which hospitals in population centers care for the COVID-19 patients. In exchange, more rural healthcare centers could take on overflow patients from the larger hospitals. That might mean non-COVID-19 pneumonia patients, patients awaiting nursing home beds or other patients that the smaller facilities are ready and able to care for.
Aaland says that while that’s just a “plan c” that she’s considered, she thinks it could be a good outcome for rural hospitals.
“I think we could have a revitalization and acknowledgement of the value the critical access hospital can have in the delivery of healthcare,” she says.
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Aaland says hospitals of all sizes need to be considering their strengths and weaknesses and must keep in mind their equipment requirements if they were to be in a position to care for a COVID-19 patient. For North Dakota’s 36 “critical access” hospitals — mostly smaller, rural facilities — that might mean making plans to transport any COVID-19 patients they would get to a larger facility.
Even transporting requires a plan, Aaland says. Is the equipment available to safely transport the patient? Is the equipment available to keep medical personnel and the community safe? Are the often volunteer ambulance services equipped and willing to transport a COVID-19 positive patient? Such proactive planning is vital, Aaland says.
“I drive hospital administrators crazy,” she says. “I want Plan A, B, C, and then for giggles, let’s get Plan D.”
But Aaland says such contingency planning is nothing out of the ordinary for farmers and ranchers.
“In rural America, that’s what we need to do. And I think farmers are good at it,” she says, noting hospitals “have to take it to a different level.”
For people in rural areas, Aaland stresses the importance of taking the same proactive steps to avoid catching or spreading the “wicked virus.” Maintain distance, stay home as much as possible and wash your hands.
“I don’t want anyone to think it’s different if you’re rural,” she says.
