Healthcare System Capacity

As a result of the COVID-19 pandemic, many New Mexico hospitals are experiencing a medical surge. The term medical surge describes the ability of hospitals to provide adequate medical evaluation and care to the community during events that exceed the limits of the normal medical infrastructure.

Further, healthcare resources may become so scarce that re-allocation decisions are needed, staff may have to practice outside of their normal scope of practice, and the focus of patient care may need to switch to promoting benefits to the population over benefits to individuals. In such an event, hospitals would shift from a medical surge model to a Crisis Standards of Care (CSC) model. Careful planning and coordination among New Mexico hospitals, providers, and state agencies are all designed to prevent the State from entering a CSC (to learn more read here).

As NM evaluates reopening, it will carefully consider the availability of scarce hospital resources, specifically the availability of Adult ICU beds as well as PPE supply among the State’s 7 larger (hub) hospitals. These hub hospitals serve as a resource for smaller satellite hospitals within the state. Significant diminished capacity among the Hub Hospitals would signal concern.

NM Hub Hospitals: 

  1. University of NM (ABQ)
  2. Presbyterian (ABQ)
  3. Lovelace Medical Center (ABQ)
  4. CHRISTUS St. Vincent (Santa Fe)
  5. San Juan Regional Medical Center (Farmington)
  6. Memorial Medical Center & Mt. View Regional Medical Center (Las Cruces)
  7. Eastern NM Medical Center (Roswell)

Gating Criteria Targets: 

Availability of scarce resources across NM’s 7 Hub Hospitals**

  • Adult Intensive Care Unit (ICU) beds occupied: 439 beds or less. A downward trend is a positive development.
  • 7-day supply of Personal Protective Equipment (PPE): minimum of 6 Hub Hospitals have 7-day supply. An upward trend is a positive development. (Beginning 8/1, hub hospitals will report PPE supply Mondays, Wednesdays, and Fridays).

To more holistically illustrate hospital capacity, the NM Medical Advisory Team (MAT) has developed the reporting tools below to provide timely data regarding the status of hospital resources in the State. Although not official gating criteria, this information represents the status of the majority of Hub and/or Spoke hospitals in any given week using a variety of indicators such as clinical care, healthcare workforce, facilities, and equipment and supplies. Each week, the Hub Hospitals conduct a self-evaluation based on their capacity as well as feedback from the State’s smaller Spoke Hospitals. Note, when rows in the grid are colored in more than one item, this indicates the status is near-equally divided between the two levels of care. (Select an image to view it larger).

 

Understanding NM Hub Hospital Capacity

 *ICU capacity is dependent on two factors: adequate supply of beds and adequate supply of healthcare workers. In originally identifying ICU capacity across the HUB Hospitals as seen in the table below, it was presumed beds would be the rate-limiting factor during the pandemic.

However, staff shortages persist across many NM hospitals, becoming the primary rate-limiting factor. Meaning, although beds may be available in a hospital, there may not be enough personnel to provide care.

**The current healthcare worker shortage means hospitals are not able to provide care for the total number of available contingency beds.

*** The current healthcare worker shortage means many hospitals are unable to expand care to Crisis levels, if needed.

 

New Mexico Hub Hospital Adult Intensive Care Unit (ICU) Capacity*

Hub Hospital

Baseline 

Contingency**

Crisis***

Lovelace Medical Center 48 12 29
University of NM Hospital 83 30 47
Presbyterian 53 39 40
CHRISTUS St. Vincent 18 8 16
San Juan Regional Medical Center 14 9 16
Memorial Medical Center & Mt. View Regional Medical Center 55 36 36
Eastern New Mexico Medical Center 19 15 0
TOTAL IN PHASE 290 149 184
CUMULATIVE TOTAL 290 439 623