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Baker administration instructs some hospitals to reduce non-urgent, scheduled procedures amid strain on hospital capacity

The emergency department at UMass Memorial Medical Center in Worcester.Craig F. Walker/Globe Staff

Beginning next week, hospitals in Massachusetts with limited capacity will be required to reduce certain non-urgent, scheduled procedures amid a strain on hospital capacity, the Baker administration announced Tuesday.

The new public health order goes into effect Nov. 29, the state’s Executive Office of Health and Human Services said in a statement. It comes amid several contributing factors, including a staffing shortage, which has contributed to the loss of about 500 medical and intensive care unit beds, and a surge in hospitalizations that arises every year after Thanksgiving through January, the statement said.

“The current strain on hospital capacity is due to longer than average hospital stays and significant workforce shortages, separate and apart from the challenges brought on by COVID,” Secretary of Health and Human Services Marylou Sudders said in the statement. “COVID hospitalizations in Massachusetts remain lower than almost every other state in the nation, but the challenges the healthcare system face remain, and this order will ensure hospitals can serve all residents, including those who require treatment for COVID-19.”

The statement noted that the reduction applies to procedures that are scheduled in advance because they are not an emergency, and delaying them will not result in adverse outcomes to the patient’s health. It will not affect “urgent and essential procedures,” the statement added.


Examples of the type of surgery that will be postponed are total knee and total hip replacements, which typically require a day or two in the hospital, said Dr. Eric Dickson, chairman of the board of the Massachusetts Health & Hospital Association.

“These are people that are having pain, and it is hardship to have them have to be pushed out,” Dickson acknowledged. Dickson, who is also president and chief executive officer of UMass Memorial Health, said his hospital has already had to postpone some of these cases, and expects that 10 to 20 percent of booked surgeries at UMass will have to be rescheduled.


The hospital association worked with the state on a coordinated plan to ensure that emergency rooms across the state would have enough capacity, Dickson said.

Concern about a possible COVID-19 surge after Thanksgiving was one of many factors behind the decision, Dickson said. Hospitals are also heading into the flu season and contending with patients who are sicker than usual because they deferred care during the pandemic. One of the biggest issues is a workforce shortage at skilled nursing facilities, which limits their ability to accept patients leaving the hospital. As a result, patients who are ready for discharge are occupying hospital beds needed for others.

“I’m extremely concerned about our ability to meet the demands of the next six weeks or so,” Dickson said

Steve Walsh, the hospital association’s president and CEO, said in the statement that the state’s hospitals are seeing a strain on capacity due to the workforce shortage and as patients who postponed seeking medical care during the pandemic now seek help.

As of Monday, 89 percent of medical or surgical beds and 79 percent of ICU beds were occupied in Massachusetts, according to state data.

Tuesday’s order, which was signed by Margret Cooke, the acting commissioner of the Department of Public Health, noted that the state was issuing the requirement “to preserve hospitals’ ability to respond to COVID-19 and to ensure that there is acute care inpatient capacity.”


COVID-19 cases and hospitalizations have been increasing in Massachusetts.

The seven-day average of daily case numbers have increased over the past two weeks by 83 percent in Massachusetts, according to data from the Centers for Disease Control and Prevention, and hospitalizations have been rising again since the beginning of the month. On Nov. 4, 502 patients were hospitalized with COVID-19. On Nov. 21, that number stood at 708 patients.

Amanda Kaufman can be reached at amanda.kaufman@globe.com. Follow her @amandakauf1. Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her @felicejfreyer.