UVM Health Network Enacts Plan to Address Patient Access to Care

BURLINGTON – The University of Vermont Health Network announced today additional measures to reduce delays in patient access to outpatient and inpatient care, and help ensure access to emergency care in the face of record patient volumes and other challenges. The Network’s Access Action Plan includes new investments in staffing, technology and infrastructure, and enhanced partnerships with health care institutions outside of the Network and with state and local governments. The Action Plan addresses three main goals: hire successfully amid national staffing shortages, reduce wait times for specialty care, and improve hospital inpatient and emergency capacity.

Regional and National Challenges

Health care systems nationwide – including the UVM Health Network – are under severe strain due to a rapid increase in demand after patients delayed routine and urgent care in the early stages of the COVID-19 pandemic. Many patients are sicker when they arrive, requiring more acute care. In Vermont and the North Country of New York, the population is aging and, in the northwestern part of Vermont, it is both aging and growing rapidly, requiring more specialty care. A national shortage of health care workers has made recruitment of new specialty providers, nurses, and other caregivers extremely difficult, adding to delays in care.

The ongoing regional inpatient mental health crisis has intensified, with many patients waiting in emergency rooms for an open inpatient psychiatric bed. At the same time, lack of staff and open beds at long-term care facilities leaves dozens of patients hospitalized every day when they no longer require hospital-level care. 

“Here and nationally, these challenges have created significant barriers to access, and that is why our team has developed a comprehensive plan to better serve our patients,” said John R. Brumsted, MD, President and Chief Executive Officer of the UVM Health Network. “We care deeply about our patients and community and have put together a robust plan, partnering with the States of Vermont and New York, and others to shore up the system in the near-term and address structural challenges that have plagued hospitals for years. I am confident that if we keep at this and work together, we will make significant progress.”

Our Plan to Hire Successfully Amid National Staffing Shortages

The UVM Health Network remains focused on attracting talented health care providers and staff. Over the past year alone, the Network has hired 94 physicians, hired hundreds of clinical and support staff, brought on more than 500 traveling nurses across Vermont and New York to address nursing vacancies, and increased pay for staff in certain high-needs areas. 

“There is no question that attracting skilled and caring staff and providers is an immense challenge given the national shortage and the competition we face,” said Jerald Novak, UVM Health Network Chief People Officer. “The UVM Health Network is a great place to work and our region is an awesome place to live, and by further intensifying our efforts we can hire and keep the talented teams our communities rely on.”

Our short- and medium-term plan to increase staff recruitment and retention includes:

• Bringing on 12 additional HR recruiters to increase hiring volumes, and hiring physician and nurse recruitment experts to identify talent for hard-to-recruit roles.
• Conducting market analyses to ensure our compensation rates are competitive.
• Creating additional shift bonuses for targeted positions in need.
• Increasing the use of stipends and sign-on or retention bonuses to hire and retain talent.
• Making major investments in Diversity, Equity, and Inclusion to hire and retain diverse talent.
• Engaging with recruitment experts to “convert” traveling nurses to permanent employees.
• Seeking a partnership with local developers to make more affordable housing available for employees, increasing our appeal to new hires and retaining existing staff.

Our Plan to Reduce Patient Wait Times for Specialty Care

During the last several years, the UVM Health Network has made major investments in technology to operate more efficiently and improve the patient experience. In 2019, the Network launched its over $150 million multi-year installation of the Epic electronic health records system to connect patients with more than 1,000 UVM Health Network physicians across our hospitals and clinics in Vermont and Northern New York. The Network also recently launched the Patient Access Service Center, which centralized scheduling services for a small number of clinics in its pilot phase. In its first year, the Center reduced the waiting list for colonoscopies at UVM Medical Center by 60% and for pulmonary care at Champlain Valley Physicians Hospital by 57%. During the initial months of the COVID-19 pandemic, the Network rapidly expanded its use of telehealth, with more than 220,000 telehealth visits in 2020, eclipsing approximately 1,000 telehealth visits just one year prior.

Our short- and medium-term plan to reduce specialty care appointment wait times includes:

• Completing the second and third phases of the multi-year Epic electronic health record installation. All Vermont hospitals and clinics will be on the system by November 2021 and all New York hospitals and clinics will be on the system by April 2022.
• Launching eConsults technology, which allows primary care providers to review patient care options with specialty physicians without needing to refer a patient for an appointment with a specialist, leading to faster care.
• With our approved conceptual Certificate of Need, we are planning for a new outpatient surgery center to replace the outdated Fanny Allen surgery space and expand overall surgical capacity.
• Expanding the Patient Access Service Center by adding 19 new employees and increasing centralized scheduling capabilities.
• Launching patient self-scheduling through the patient portal MyChart in order to improve the scheduling experience for existing primary care and selected specialty care patients in FY22, with further expansion in FY23.
• Increasing the use of telehealth appointments and improving the workflow of telehealth visits.

Our Plan to Improve Hospital Inpatient and Emergency Capacity

Strains on inpatient units and emergency rooms are at a critical level across the country, due to sicker patients seeking care and requiring longer hospital stays, as well as a lack of inpatient mental health and long-term care beds across Vermont and Northern New York. To address this problem, the Network has taken several steps, including getting approval from the Green Mountain Care Board to add 15 inpatient beds at UVM Medical Center in existing units. We have partnered with Birchwood Terrace Rehab to support them in making 25 post-acute beds available for patients who no longer need treatment at UVM Medical Center; to date, we have transferred more than 90 patients for care. Additionally, we are working with the State of Vermont, Brattleboro Retreat, and the Vermont Psychiatric Care Hospital to make more inpatient mental health beds available.

Our short- and medium-term plan to increase access to inpatient and emergency care includes:

• Pursuing Certificate of Need applications for our previously announced psychiatric inpatient care unit at Central Vermont Medical Center and a redesigned and expanded emergency department at UVM Medical Center.
• Developing an emergency department observation unit and acute-hospitalization-at-home program at UVM Medical Center to reduce inpatient demand.
• Continuing to work in partnership with the State of Vermont and hospitals throughout the state to staff nursing and mental health beds to provide patients with quality care in the most appropriate place.

The UVM Health Network is actively implementing this comprehensive plan to support our patients and employees and will share more information as this work continues.

Any patient who is having trouble accessing care in a timely manner should first call their doctor’s office. If additional help is needed, our Patient and Family Advocates are ready to assist.

Vermont

Central Vermont Medical Center: (802) 371-4350

Porter Medical Center: (802) 388-4701

UVM Medical Center: (802) 847-3500

New York

Alice Hyde Medical Center: (518) 481-2258

Champlain Valley Physicians Hospital: (518) 314-3054

Elizabethtown Community Hospital: (518) 873-6377

About The University of Vermont Health Network

The University of Vermont Health Network is an integrated system serving the residents of Vermont and northern New York with a shared mission: working together, we improve people’s lives. The partners are:

• The University of Vermont Medical Center  
• The University of Vermont Health Network Medical Group
• The University of Vermont Health Network – Alice Hyde Medical Center
• The University of Vermont Health Network – Central Vermont Medical Center
• The University of Vermont Health Network – Champlain Valley Physicians Hospital
• The University of Vermont Health Network – Elizabethtown Community Hospital
• The University of Vermont Health Network – Porter Medical Center
• The University of Vermont Health Network – Home Health & Hospice

Our 4,000 health care professionals are driven to provide high-quality, cost-efficient care as close to home as possible. Strengthened by our academic connection to the University of Vermont, each of our affiliates remains committed to its local community by providing compassionate, personal care shaped by the latest medical advances and delivered by highly skilled experts.

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