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Atrium Health and Advocate Aurora Health say they have completed their merger. The new system will be known as Advocate Health and will operate 67 hospitals in six states, and it has a combined $27 billion in annual revenue.

Atrium Health and Advocate Aurora Health say they have completed the merger of the two health systems, concluding one of the hospital industry’s most watched deals and potentially setting the stage for more consolidations.

 Friday saying they have formally combined to create a new system called Advocate Health.

Eugene Woods, CEO of Atrium Health, becomes co-CEO of the new Advocate Health.

The newly merged system organization becomes one of America’s largest nonprofit hospital systems. The new Advocate Health boasts a combined $27 billion in annual revenue with about 150,000 employees, and the merged system operates 67 hospitals in six states. They first 

announced their intentions to merge in May

Jim Skogsbergh, CEO of Advocate Aurora Health, will serve as co-CEO of the new Advocate Health for 18 months, and then plans to retire.

“Powered by 150,000 teammates – including the best and brightest physicians, nurses, researchers and faculty – we are poised to push past traditional geographic and care delivery boundaries to create a healthier tomorrow for all,” Eugene A. Woods, chief executive officer of Advocate Health, said in a statement.

Woods had been CEO of Atrium Health. Wood and Jim Skogsbergh, the CEO of Advocate Aurora, will serve as co-chief executive officers until Skosbergh retires in 18 months.

“We couldn’t be more pleased to bring our organizations together to do more, be better and go faster to help more people live well while training the next generation of health care professionals,” Skosbergh said.

Advocate Health is going to be headquartered in Charlotte, North Carolina, while the organization said it will maintain a strong presence in the Chicago and Milwaukee areas. The new system is planning to build a new institute focused on health equity in Milwaukee.

The Atrium Health, Advocate Health Care and Aurora Health Care brands will continue to be used in their local communities, officials said. The Wake Forest University School of Medicine will serve as “the academic core” of the organization, the system said.

A spokesman for Advocate Aurora said via email Saturday that the systems have taken all the necessary steps needed for regulatory approvals.

North Carolina Attorney General Josh Stein said Thursday that his office won’t be opposing the deal, the 

 reported. In a statement, Stein said “my office has conducted a thorough review into this transaction and concluded that there is no legal basis to prevent it.”

“Therefore, the state will take no further action,” he said.

However, Stein said, “I am concerned about this combination’s possible effects on health care access in rural and urban underserved communities.”

The planned deal has drawn some scrutiny. 

North Carolina State Treasurer Dale Folwell

 said Friday, “I have deep concerns about this merger.” Folwell said Atrium is “notorious for its aggressive medical debt collections”, and noted Advocate Aurora has been sued for allegations of anticompetitive behavior.

Folwell said he worries about the impact of the deal for consumers. “There is widespread evidence that mergers make hospital care less affordable and less safe,” he said.

 with a key regulatory board in Illinois. The Illinois Health Facilities and Services Review Board initially voted against the deal in September, but then reversed course and allowed the systems to present more information for more consideration. The Illinois board signed off on the deal in November, 

Federal Trade Commission has applied more scrutiny to hospital consolidations

, and some systems have abandoned planned deals due to regulatory opposition. The FTC has taken action on deals involving systems in overlapping markets, saying the deals would lead to higher prices and reduced services for consumers. President Biden signed 

 in July 2021 directing regulators to closely examine mergers, including hospital consolidations, to be sure they don’t hurt consumers.

These planned hospital mergers and acquisitions collapsed. Here’s why.

However, the Atrium-Advocate merger involves two systems operating in very different markets, thus avoiding a concern of regulators about reduced competition in overlapping or adjacent markets. Atrium, based in Charlotte, runs hospitals and care sites in North Carolina, South Carolina, Georgia and Alabama. Advocate Aurora, with corporate offices in Downers Grove, Illinois and Milwaukee, Wisconsin, operates in Illinois and Wisconsin.

Jim Skosbergh, left, and Eugene Woods, will serve as co-CEOs of the new Advocate Health.

Atrium-Advocate Aurora merger could spur other health systems, including larger systems, to pursue similar mergers

. The deal sets a model for other transactions by partnering with systems in other areas, as opposed to trying to form a deal with an organization in the same region and risking regulatory opposition, analysts say.

Kenneth Kaufman, managing director and chairman of Kaufman Hall, a healthcare consulting firm, said he expects to see more mergers and acquisitions. Kaufman Hall advised Atrium Health and Advocate Aurora Health in their plans to merge.

“I’d be really surprised if this is a one-and-done deal. I think we’ll see a handful of these other transactions,” Kaufman told 

“The reason this deal is so important is it addresses really critical healthcare decisions coming out of the pandemic,” Kaufman said.

“Healthcare is no longer a solely community-based product,” he continued. “It’s a series of really hard problems and trying to create an organization with the size and scale and intellectual capital to solve those problems.”

When Atrium and Advocate Aurora first announced their intentions to merge, Woods said one of the driving factors among the organizations is, “We change before we have to.” Both systems have said they are focused on improving health equity in the deal and aim to expand access to healthcare in urban and rural areas.

The last two years have seen fewer hospital mergers, as hospital officials have been consumed with the COVID-19 pandemic and have had less time to devote to long-term planning.

 In 2021, there were 49 hospital mergers and consolidations, compared to 79 the previous year

In the first half of 2022, there were 25 hospital transactions announced

, roughly matching the slower pace of 2021.

the pace of hospital deals is starting to pick up

Intermountain Health completed its merger with SCL Health this year

, one of America’s largest Catholic systems, completed its acquisition of MercyOne, an Iowa-based system, in September.

More deals have been announced in the fall. 

Gundersen Health System and Bellin Health

 completed their merger last week. The new system will operate 11 hospitals and more than 100 clinics serving patients in Wisconsin, Michigan, Minnesota and Iowa.

Essentia Health and the Marshfield Clinic Health System

 said in October that they have signed a memorandum of understanding to examine the possibility of creating a regional health system. If they move forward, the combined system would operate 25 hospitals in Minnesota, North Dakota, Wisconsin, and Michigan.

 announced in October it has struck a deal to buy three hospitals in the New Orleans area from HCA Healthcare. 

 said it has reached an agreement to buy two Connecticut health systems, including three hospitals, from Prospect Medical Holdings.

The prospect of more hospital mergers worries some critics. Michael Abrams, a managing partner of Numerof & Associates, a consulting firm, told 

 in July that he feared the Atrium-Advocate Aurora deal would drive other systems to pursue similar deals, and consumers would pay the price.

“The end game is we get to a relatively small oligopoly of healthcare systems that provide care to the majority of citizens in this country,” Abrams said. “They are too big to fail, and too big to care.”

Analysts say some systems may be looking to pursue mergers to find opportunities, while others may be looking to find partners out of necessity. Many hospitals are struggling financially, and 

more than half of the nation’s hospitals could finish the year in negative margins

, according to the American Hospital Association.

Some hospitals may look to mergers to keep their doors open, Anu Singh, managing director of partnerships, mergers and acquisitions at Kaufman Hall, told 

“For some it will be a lifeline conversation, for others it may be a strategic tipping point,” Singh said. “I think we’re going to see financial tipping points for need, I think we’ll see some strategic tipping points for investment.”

Articles

The systems say they have now formally merged to create Advocate Health, forming one of America’s largest hospital systems. Analysts have said it could pave the way for  more consolidations.

Atrium Health, Advocate Aurora Health complete merger, and more hospital deals could follow

Former MetroHealth CEO Akram Boutros vowed to pursue legal action after

, and he wasted little time in backing up those words.

Akram Boutros, former CEO of MetroHealth in Cleveland, Ohio. He has sued MetroHealth over his dismissal.

Boutros is suing MetroHealth, saying the Cleveland-based system acted improperly in terminating him Nov. 22. Boutros, who was slated to step down at the end of the year, said the board’s firing was retaliatory and that the board violated Ohio state law in hiring his successor, 

. He said in the suit that the “illegal firing” gives him claims against MetroHealth and its board.

In that court filing in the Cuyahoga County Court of Common Pleas, Boutros said he plans to file a separate lawsuit “to recover damages from this retaliation and other misconduct.”

MetroHealth said the board fired Boutros because he paid himself more than $1.9 million in bonuses from 2017 through 2021 without notifying the board or seeking board approval. Only the board can set compensation for the system’s chief executive, Vanessa Whiting, chairwoman of MetroHealth’s board of trustees, said in a statement.

MetroHealth’s board demanded repayment of the bonuses. On Oct. 31, Boutros repaid $2.1 million, which represented the supplemental bonus money, and more than $124,000 in interest, the system said.

In the lawsuit, the former CEO alleges that the MetroHealth board skirted Ohio’s open meeting law “in orchestrating and executing Dr. Boutros’ discharge.”

The suit also claims that the board acted improperly by “secretly hiring counsel” to investigate Boutros. And he argues that the board moved to fire Boutros without mandatory public notices and deliberation.

Jason Briston, Boutros’ attorney, issued a statement explaining the suit, 

“The suit is the result of an investigation that clearly demonstrates the wanton disregard for Ohio’s Open Meetings Act and the board bylaws by its board and Chair Vanessa Whiting in both the hiring process for the health system’s new CEO and the so-called investigation of Dr. Boutros’ compensation,” Bristol said.

MetroHealth said Boutros was terminated after an outside investigation uncovered that Boutros had secretly paid himself $1.9 million in bonuses.

On Nov. 25, the MetroHealth board released the 

 by the law firm, Tucker Ellis, which investigated the bonus payments.

Boutros, by his own admission, did not involve the board in the payment of the bonuses or the establishment of benchmarks to determine his eligibility for bonus payments. Only the board is authorized to determine the CEO’s compensation, the report stated.

The bonuses approached Boutros’ base salary, according to the report. “The performance bonus compensation Boutros received exceeded 80% of his base salary in each relevant year and in the last two years exceed 90% of his base salary,” the report stated. Boutros never disclosed his payment of bonuses to the board at relevant times, including contract negotiations, the report stated.

“This evidence, at a minimum, establishes the Board’s right to terminate Boutros’s employment for Cause, as defined in the employment agreement,” the report stated. “And, at worse, this evidence suggests that Boutros may face potential criminal liability for Ohio ethics violations, theft in office, and other related statutes.”

Whiting said in a statement Nov. 23 that Boutros’ allegations of improper conduct by the board “are false and a distraction from the facts we have previously communicated about the issue at hand.”

Boutros began serving as MetroHealth’s CEO in 2013. In November 2021, he announced he planned to retire at the end of December 2022.

Airica Steed, executive vice president/system chief operating officer of Sinai Chicago Health System and president of Mount Sinai and Sinai Children’s Hospital, takes over as MetroHealth’s president and CEO on Dec. 5. MetroHealth announced the selection of Steed as the next CEO in September.

MetroHealth operates four hospitals and dozens of sites of care in and around Cleveland.

Making good on a threat to take legal action, Akram Boutros said his termination was improper. The board said Boutros was ousted for paying himself $1.9 million in bonuses without board approval.

Fired MetroHealth CEO sues over termination, claims ‘illegal firing’

Ruth Phillips is vice president of medical affairs at Blue Spark Technologies.

Every day, nurses work tirelessly to ensure patient safety.

It's a challenging profession that requires coordination across care teams, sufficient knowledge of multiple, complex protocols, and unwavering compassion in an ever-changing environment. 

A nursing shortage was evident long before the COVID-19 pandemic but is now of significant concern. While the pandemic tapers, nurses continue to face demanding workloads due to 

 to poor patient outcomes, specifically in sepsis cases. Integrating technology into today’s healthcare system can help buffer the strain of the nursing shortage, with the potential to improve sepsis care–a steady problem for hospitals.

Today’s medical devices can remotely and continuously track a patient’s vitals, including body temperature, which is often a key indicator of infection. This opens the door for rapid fever identification to support early infection detection, intervention, and better patient outcomes.

 in the U.S annually, with one-third of hospital deaths being related. Sepsis occurs when the body has an excessive immune response, typically from an infection. Comorbidities like cancer, advanced age, and obesity increase one's risk of developing this life-threatening condition.

The impact of the nursing shortage on sepsis care is striking, with understaffing linked to the 

Vital sign monitoring is another major issue when it comes to being short-staffed. Nurses primarily use vital signs to monitor patients' health and escalate care as necessary, but the heavy 

 vital sign collection and decrease adherence to guidelines for sepsis care.

With devices that can measure continuous vital signs, there is an opportunity to advance sepsis care and simultaneously enhance patient safety.

Early fever detection with medical wearables

According to multiple studies, each hourly delay in treatment increases the risk of sepsis-related death (

). As such, there is an active effort to identify sepsis earlier with the help of assessment scores. To calculate sepsis risk, these scores depend on vital sign metrics, which clinical staff collects on average every four hours. Considering missed or inaccurate vital sign recordings are common–even more so with the nursing crisis–the value of these scores is limited.

As fever is a frequent sign of infection, continuous temperature monitoring (CTM), also referred to as high-frequency temperature monitoring (HFTM), proves valuable for the early detection of infection.

CTM technology uses a wireless, Bluetooth-enabled device that records temperatures seconds apart and displays them on the facility's central workstation in real-time. These data are color-coded to quickly identify readings outside the normal range. The technology also allows clinical staff to set alerts, tailored to patient’s specific needs.

In contrast, standard temperature measurements typically occur every four to eight hours outside the intensive care unit. This frequency is problematic for catching a fever at its onset.

Continuous temperature monitoring eliminates these extended gaps and enables staff to obtain a patient’s temperature at any time with a simple glance at a computer. This ability to observe temperature closely without repeated trips to the bedside saves time for today’s overstressed nurses.

Multiple studies support that CTM can detect fevers several hours earlier than the standard of care (

). For example, in a study of cancer patients receiving hematopoietic stem cell transplant or CAR-T therapy–a group at increased risk for sepsis–CTM detected fevers roughly 

 than periodic temperature checks in those with confirmed infections. With nearly a full day of lead time, CTM can prevent treatment delays that are often a 

Trend prediction brings possibilities for early detection

Artificial intelligence (AI) tools are rapidly advancing for disease diagnosis and can pair with CTM devices.

As a recent example, AI-driven analysis of breathing patterns was able to 

 early Parkinson's Disease. Likewise, CTM can offer the same for early sepsis detection through AI-based analytics to identify predictive temperature trends. Body temperature is tightly regulated and particularly well-suited for trend prediction as patterns are naturally present in healthy individuals.

Well-known examples of this are the daily cycle of temperature, which is lowest in the morning and highest in the late afternoon, and temperature’s distinct pattern during a women's ovulatory cycle. These predictable variations reflect normal physiology, but an illness can disrupt these patterns. Therefore, AI analysis of CTM data could help identify trends like the loss of this natural rhythmicity, increased fluctuations, or other irregularities to aid in the early detection of sepsis.

There is already research on using temperature patterns as an indicator of fever. 

 used circadian modeling to predict fevers at least 3.5 hours in advance. This finding demonstrates that temperature patterns are evident long before an actionable temperature rise and highlights the benefit of more lead time for clinical staff.

But not all infections involve a fever; septic patients also present with hypothermia which correlates with worse outcomes (

). Situations involving hypothermia aren’t as attention-grabbing as fevers, presenting more of a challenge for clinical staff to detect and act promptly. 

Trend prediction may be a better indicator for detecting sepsis in such cases. In support of this, some 

 suggests that temperature patterns could prove more useful than fever in the setting of sepsis. This observation also highlights the advantage of trend prediction in situations where individual characteristics may mask a fever.

 to mount a typical fever response during infection. This is a relevant concern given that adults 65 or older are more likely to develop sepsis and are at greater risk of adverse outcomes. Thus, CTM presents pioneering capabilities, namely temperature pattern recognition, that promote early infection detection­–fever or not.

With more time and technology, better care is possible

Further challenged by the nursing shortage, sepsis continues to pose a significant burden on the healthcare system. Continuous temperature monitoring technology can relieve understaffed hospitals and support the early diagnosis of life-threatening conditions including sepsis.

CTM detects fevers sooner than traditional methods, giving clinical staff advanced warning of a possible infection. Additionally, with the added advantage of AI analytics, temperature pattern identification can produce even more lead time and a greater ability to recognize sepsis than fever alone. With more time, caregivers can act sooner to obtain testing, administer life-saving therapies, or initiate closer observation.

The benefits of CTM stretch far beyond sepsis management, but its use in this setting could make a meaningful difference for patients and healthcare providers.

The benefits stretch beyond sepsis management, but its use in this setting could make a meaningful difference for patients and healthcare providers.

How continuous temperature monitoring can lead to early sepsis detection, and help nurses | Ruth Phillips

Stephanie D. Conners has been named the chief executive officer of the BayCare Health System, based in Clearwater, Florida.

Conners, 51, succeeds Tommy Inzina, 64, who announced he is stepping down earlier this year. Conners joined BayCare several weeks ago to work with Inzina on the transition. BayCare announced Conners began serving as CEO on Nov. 28.

She has visited more than 50 BayCare sites and met with thousands of BayCare team members to learn more about the system.

“I knew BayCare was among the nation’s best health care systems and now my experience on the ground makes clear why,” Conners said in a statement. “Our leaders’ and team members’ commitment to their patients, their providers and the entire community is palpable: They truly care. Together, we will build BayCare’s next great chapter.”

Conners began her career in healthcare as a nurse and has maintained her nursing license.

Most recently, Conners served as executive vice president and chief operating officer for Jefferson Health, the nonprofit system based in Philadelphia.

BayCare is opening its 16th hospital in Wesley Chapel in early 2023. The system is also weighing a decision about opening another hospital in north Manatee County.

UPMC hires first chief clinical information officer

John Fairbaugh has been elevated to a new role as UPMC’s first chief clinical information officer.

Fairbaugh will begin in the new post on Dec. 5. The system said he will support clinical operations across UPMC’s 40 hospitals and 800 outpatient sites by enhancing technology applications.

“I’m kind of the translator between the information technology leadership and the clinical leadership,” Fairbaugh said in a news release.

He has served as director of clinical and operational informatics/emergency services at UPMC Magee-Womens Hospital. He will continue in that role until a successor is found, the system said.

Fairbaugh brings more than 21 years of experience in nursing and he also has a background in emergency medicine and informatics.

“John is committed to open and strong communication and is inclusive of varying perspectives - critical qualities in ensuring the successful selection, deployment and continuing improvement of our clinical technologies,” Maribeth McLaughlin, vice president and chief nurse executive of UPMC, said in a statement. She will oversee the new position as part of the UPMC Center for Nursing Excellence.

Missouri Baptist Medical Center selects president

Ann Abad has been named the new president of the Missouri Baptist Medical Center, part of BJC Healthcare.

She begins in that position today. She succeeds John Antes, who is taking a new role as CEO for Southern Illinois Healthcare, a member of the BJC Collaborative.

Abad has been with BJC for the past 17 years. Most recently, she served as president of Barnes-Jewish West County Hospital since 2019. In that role, she has led the team’s growth of diagnostic and short-stay surgical and medical care, and also helped to strengthen patient safety and quality, the system said.

Previously, Abad served as the vice president of operations for Barnes-Jewish St. Peters Hospital and Progress West Hospital, where she led the operational and strategic development for BJC's St. Charles County hospitals for eight years.

Missouri Baptist Medical Center has 425 staffed beds and nearly 2,500 workers. BJC Healthcare operates 14 hospitals across the midwest and is concentrated in St. Louis, southern Illinois and southern Missouri.

BJC hopes to identify a new president of Barnes-Jewish West County Hospital president “in the very near future," Bob Cannon, BJC group president, said in a statement.

North Carolina health system announces CEO 

Tory Shepherd no longer needs the label of “interim.”

Shepherd has been named the new chief executive officer of Rutherford Regional Health System, a Duke LifePoint hospital in Rutherfordton, N.C. She had been the interim CEO since September.

"I am incredibly honored and excited to have the opportunity to stay here in Rutherfordton and grow with this team and our community," Shepherd said in a news release. "I’m excited to continue to work with our hospital leadership, providers and staff to explore new ways that we can make a difference in the lives of those we serve."

Shepherd came to the hospital after holding leadership posts at Sovah Health-Martinsville, a Lifepoint facility in Virginia. She served as interim chief executive officer and chief operating officer at the Martinsville hospital. Before joining Sovah Health’s administrative team, Shepherd was director of cardiopulmonary neurophysiology services and a cardiopulmonary coordinator and respiratory therapist.

Jackie Godlock, chair of the Rutherford Regional Health System Board of Trustees, called Shepherd “a great addition to Rutherford Regional, and we are excited to see where she will lead this hospital.”

"This decision to make her a permanent fixture on our leadership team and in this community was an easy one,” Godlock said in a statement. “Tory has shown a great commitment to our patients, physicians and employees in her time here, and we are looking forward to working alongside her to expand RRHS’ services to meet the evolving needs of our region."

Craig Henneman has been named the new president of CentraCare-Paynesville, a critical access hospital in central Minnesota.

Henneman possesses more than 17 years of experience with CentraCare, which operates eight hospitals and dozens of other care sites in Minnesota.

He previously served as executive director for surgical services at St. Cloud Hospital. Henneman also co-led the CentraCare Covid-19 response team, the system said.

Henneman said he has a keen understanding of the importance of rural healthcare providers.

"I grew up and live in a small community and very much appreciate the importance and impact that rural healthcare has on people no matter where they live,” said Henneman. “CentraCare has been an important focal point in my life and career. Both of my parents worked and retired from CentraCare, my wife works here, my children were born here. I look forward to and am excited about the opportunity to support our mission and purpose at CentraCare - Paynesville and surrounding communities.”

UPMC selects a chief clinical information officer, BJC Healthcare hires a hospital president, and other leaders take new roles.


BayCare Health System names new CEO, and more | MED MOVES

UPMC Children's Hospital of Pittsburgh has set up a tent to help deal with the high volume of patients. (Photo: UPMC)

Children’s hospitals continue to struggle with a high number of patients with RSV and other respiratory illnesses, with many hospitals at or above their normal capacity.

Hospitals began seeing scores of patients with respiratory syncytial virus, also known as RSV, and other respiratory viruses in October

, several weeks earlier than normal. Hospital leaders and physicians say they are seeing 

extremely long wait times in their emergency departments

Hospitals all around America are packed with kids with respiratory illnesses. Wendy Woods, chief medical officer of Blank Children's Hospital in Des Moines, Iowa, told 

 Thursday that the system is seeing far more patients with RSV and respiratory viruses than in previous years.

“It’s unprecedented,” Woods said in a phone interview.

Typically, the hospital sees around 80 patients in the emergency department each day, but lately the number is between 140 and 150. Other hospitals in Iowa have been packed, making it difficult to find available beds, Woods said.

“All those around us in our region are full and are at capacity themselves,” she said. Similar shortages are being seen in Nebraska and Missouri, she said. Blank Children’s also transports patients from rural areas to other hospitals when beds are available. Recently, a transport crew traveled into Illinois to get a child to an open bed at a hospital in Iowa, a round-trip that took several hours, she said.

In Texas, 91% of the state’s pediatric beds are occupied, John Hawkins, president and CEO of the Texas Hospital Association, said in a media briefing this week.

Pediatric hospitals are experiencing a “double whammy,” because some general hospitals have cut back on their pediatric services, Hawkins said. As a result, pediatric hospitals are seeing more patients and have fewer options to transfer kids to other hospitals.

“You’re seeing the lack of capacity play out in a lot of our facilities,” Hawkins said.

Some hospitals, such as UPMC Children’s Hospital in Pittsburgh, have set up tents to help accommodate the number of patients coming to the emergency department. Dr. Raymond Pitetti, director of the emergency department at UPMC Children’s Hospital of Pittsburgh, said the tent is helping the system accommodate the volume.

“The hospital is still seeing a steady uptick in RSV and other respiratory illnesses in Pittsburgh,” he said in a statement. “This tent is well equipped and fully staffed, enabling us to further streamline our process as we assess the needs of our patients.”

UCSF Benioff Children's Hospital in San Francisco set up a tent last month to accommodate children who needed treatment but were less seriously ill, 

 set up a tent a few weeks ago at the medical campus in Aurora, CBS reported.

More than three quarters of the nation’s pediatric hospital beds are occupied, and in some states, more than 90% of pediatric beds are filled, according to the Children’s Hospital Association and the American Academy of Pediatrics. The two groups sent a 

 to President Biden’s administration on Nov. 14 urging the declaration of a 

national emergency to address the crisis in children’s hospitals

“Our system is stretched to its limit and without immediate attention the crisis will only worsen,” Mark Wietecha, CEO of the Children’s Hospital Association, said in a statement last month.

Hospital officials have warned of fears of a “triple-demic,” referring to a mix of patients with RSV, the flu and COVID-19 cases.

Nemours Children’s Health is seeing many patients with RSV, but now more children with the flu are showing up.

“Children’s hospitals across the U.S., including Nemours Children’s Health, continue to experience an influx of respiratory illness cases,” Dr. Jonathan Miller, medical director of value-based care and chief of primary care at Nemours Children's Health, Delaware Valley, said in a statement. “While RSV continues to drive hospital admissions, we are now beginning to see an increase in flu cases as well.”

Nationally, RSV cases may be starting to drop, according to 

 from the Centers for Disease Control and Prevention. However, the volume of RSV cases seen this fall remains high, well above the past two years, and 

Some physicians and healthcare leaders have likened the current situation at children’s hospitals to the early days of the COVID-19 pandemic, when hospitals were overwhelmed with cases. Brian Peters, CEO of the Michigan Health and Hospital Association, made that comparison in a 

“In short, it feels like déjà vu in Michigan’s children’s hospitals, but instead of a surge of COVID-19 patients stressing capacity to the limits, our facilities are strained by a high number of pediatric patients suffering from respiratory illnesses largely driven by RSV,” Peters wrote. “Similar tactics that have been implemented in prior years, such as initiating incident command systems, have been in operation to ensure appropriate direction and communication is occurring throughout those systems impacted by this crisis.”

Just as in Texas, Michigan pediatric hospitals are feeling extra pressure because other hospitals don’t have enough staffing to accommodate more patients.

“Hospitals operating at capacity is nothing new and the staffing challenges that continue to result in Michigan operating with 1,700 fewer staffed beds than we had prior to the pandemic are well documented,” Peters wrote. “What we’re seeing today is the real impact of what those staffing challenges mean: longer wait times in the emergency department, lack of available beds for patient transports (particularly in rural Michigan) and pediatric ICUs operating at beyond 100% capacity.”

California hospitals continue to see a high volume of patients with RSV and respiratory viruses, 

Vidya Mony, pediatric infectious disease specialist and associate hospital epidemiologist at Santa Clara Valley Medical Center, told 

 that the hospital is seeing “an acute surge of patients … in both our inpatient pediatric ward and pediatric ICU.”

While no vaccine is available for RSV, doctors are urging parents to get the flu vaccines and the COVID-19 vaccines for their kids. They are also urging parents to take their children to primary care physicians or urgent care centers before arriving at the emergency departments, which have been packed for weeks.

Staffing shortages, combined with the high number of patients, are taxing pediatric hospitals. At Blank Children’s Hospital, Woods said the shortage of nurses and other staff are limiting the facility's capacity, because only so many beds can be safely staffed.

Since the RSV wave started early, Woods said she’s hopeful it will subside in the near future, but she’s not exactly confident that will happen.

“I don’t think we’re near the exit,” she said.

Around the country, children’s hospitals are at or above capacity due to high numbers of patients with respiratory viruses. 
