Care During a Public Health Emergency

Dear Patient and Family:

Thank you for trusting Methodist Hospital with your medical care. Our doctors, nurses and all of our staff care deeply about your health, and are committed to keeping you safe while we strive to provide the best possible care.

We want to keep you updated about the medical care that is available at this time of rampant pandemic and high demand for hospital services.

Limited Resources During a Public Health Emergency

Los Angeles County is experiencing a public health emergency that is severely impacting the availability of key medical resources. As Methodist Hospital cares for an ever-increasing number of COVID-19 infections, like all hospitals across the region, we are experiencing shortages of essential equipment, supplies, and staff. As a result, we must be extraordinarily watchful of how we utilize key resources in order to ensure the hospital’s ability to serve our entire community, including those with injuries or illnesses unrelated to COVID-19. Among the resources currently limited in availability are life-support equipment (like ventilators), sufficiently-staffed critical care (ICU) beds, and healthy clinical staff (doctors, nurses, therapists, and technicians). Such shortages impact our ability to care for patients.

In response to this critical situation, we have convened a triage team -- comprised of doctors, community members, a bioethicist (with expertise in the ethics of providing healthcare), and spiritual care providers – to review the severity of all critically ill patients at Methodist Hospital. This team will make the difficult, but necessary decisions about allocating limited resources based on the best medical information available, using the same criteria and methodology being used nationally and throughout California at this time. Our triage team is given no information about patient race, ethnicity, gender, sexual identity, religion, citizenship, insurance or any other information unrelated to a patient’s health.

What This Means for Patients and Families

• A patient may have limited options regarding their medical care during this public health emergency, as key resources become scarce. In order to provide the most effective care to every patient, it is very important for a patient to tell family members (or their representative) as well as hospital staff if the patient has any of the following:
  • Current medical conditions
  • An advance healthcare directive (or a desire to establish one)
  • A “Do Not Attempt Resuscitation” (DNR) order
  • No desire for blood products or life-saving treatments, such as mechanical ventilation, dialysis, or a surgical procedure that may prolong their life
  • A single representative who is to make medical decisions for the patient should the patient become unable to communicate.
• If a patient becomes ill and their physician believes that the patient needs ICU care or mechanical ventilation (i.e., a breathing machine), their case will be reviewed by our triage team as described above in order to prioritize allocation of these limited resources.
• If a patient becomes extremely ill and very unlikely to survive their illness (even with life-saving treatment), then certain resources currently limited in availability, such as ICU care or a ventilator, may be allocated to another patient who is more likely to survive. If a ventilator or ICU care is not offered or is stopped, the patient has the right to ask their doctor for further detail regarding this decision, and will receive everything needed to ensure that they are free of pain or discomfort.
  • Importantly, the status of all critically ill patients is re-evaluated daily by our triage team in order to ensure best possible use of limited resources. In other words, if an ICU bed or ventilator is not available at first, such resources could become available to the patient at a later date.

This is an extremely challenging time for our entire community. Know that everyone at Methodist Hospital is working tirelessly to provide the best care possible. And please feel free to ask your physician or nurse about any questions you might have.

Coronavirus COVID-19 Information and Resources