Perceived Hospital Stress, Severe Acute Respiratory Syndrome Coronavirus 2 Activity, and Care Process Temporal Variance During the COVID-19 Pandemic*

George L. Anesi; Adair Andrews; He Bai; Pavan K. Bhatraju; David M. Brett‐Major; M. Jana Broadhurst; Elizabeth Salvagio Campbell; J. Perren Cobb; Martin Gonzalez; Sonya Homami; Cameron Hypes; Amy Irwin; Christopher J. Kratochvil; K. Krolikowski; Vishakha K. Kumar; Douglas Landsittel; Richard A. Lee; Janice M. Liebler; Karen Lutrick; Lucian T. Marts; Jarrod Mosier; Vikramjit Mukherjee; Radu Postelnicu; V. I. Rodina; Leopoldo N. Segal; Jonathan Sevransky; Christine Spainhour; Avantika Srivastava; Timothy M. Uyeki; Mark M. Wurfel; David Wyles; Laura Evans

doi:10.1097/ccm.0000000000005802

Key Points

To examine how perceived operational stress and care process deviations in hospitals, emergency departments, and intensive care units correlated with local SARS-CoV-2 transmission surges.
Conducted a prospective weekly survey from November 2020 to June 2022 across 13 hospitals within seven U.S. health systems in the SCCM Discovery SARI-Preparedness cohort.
Evaluated 839 hospital-weeks over 85 pandemic weeks and five viral waves, measuring perceived overall hospital, ICU, and emergency department stress alongside county-level viral infection rates.
Perceived overall hospital, ICU, and emergency department stress occurred in a mean of 43% (SD, 36%), 32% (SD, 30%), and 14% (SD, 22%) of hospital-weeks, respectively, with care deviations reported in 36% (SD, 33%).
Each 10 SARS-CoV-2 cases per 100,000 county residents increased the odds of overall hospital stress by 9% (95% CI, 5–12%), ICU stress by 7% (95% CI, 3–10%), and emergency department stress by 4% (95% CI, 2–6%).
During the Delta surge, overall hospital stress persisted for a median of 11.5 weeks (IQR, 9–14 wk) and ICU stress for 11 weeks (IQR, 6–14 wk; p = 0.59 vs overall) after local case peaks, whereas emergency department stress resolved earlier at 6 weeks (IQR, 5–6 wk; p = 0.003).

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Implication

Prospective cohort study shows hospital stress persisted for weeks after COVID-19 peaks in U.S. health systems, indicating prolonged clinical strain following community surges.

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Anesi et al. (2023) studied this question.

synapsesocial.com/papers/6aab5a2fb4c480661287ec67 https://doi.org/10.1097/ccm.0000000000005802

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Perceived Hospital Stress, Severe Acute Respiratory Syndrome Coronavirus 2 Activity, and Care Process Temporal Variance During the COVID-19 Pandemic*

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Perceived Hospital Stress, Severe Acute Respiratory Syndrome Coronavirus 2 Activity, and Care Process Temporal Variance During the COVID-19 Pandemic*

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