Care During a Public Health Emergency

Dec 2020

Dear Patient* and Family

We thank you for trusting Coast Plaza Hospital with your medical care. Our doctors, nurses and staff members care deeply about your health and are committed to keeping you updated about the medical care  that is available at our facility to patients at this time.

Limited Resources During a Public Health Emergency

Los Angeles County has been facing a public health emergency since earlier this year that has reduced the amount of medical resources available to hospitals and patients. As we hit record COVID-19 infections  we are doing everything possible to procure all the staff, equipment, and supplies to serve our entire community, including those who have illnesses unrelated to this virus. These resources include life support machines (like ventilator or breathing machine), Intensive Care Unit (ICU) beds and healthy medical staff  (like doctors and nurses)to care for patients. Despite our best efforts we are providing this communication because we are worried that we may fall short in one or more of these categories due to the staggering current demands on the healthcare system (including the use of emergency rooms and hospital beds).

If we reach a point where our hospital faces a shortage that will impact our ability to care for all patients, a team including doctors, a community member, a Bioethicist ( who has expertise in the ethics surrounding healthcare), and others, will review the cases of  patients who are critically ill. This team will make necessary decisions about allocating limited medical resources based on the best medical information possible and will use the same decision criteria that is being used nationally and throughout California. This team will be given no information about patient race, ethnicity, gender, sexual identity, religion, citizenship, insurance or any other information unrelated to the patient’s health.

What This Means for Patients and Their Family or Representative

  1. During this crisis we may not be able to offer you or your loved one the health care resources that we would normally offer for their medical conditions. The limitations may include the number of days you will be allowed to stay in the hospital, the number of staff members that will be assigned for your care, the areas of the hospital where you might be treated, and the equipment and medications used to treat your condition. To help us make any decisions regarding the allocation of scarce resources to you and other patients we will be requesting information with regards to the following:
    1. Do you have any other medical conditions?
    2. Do you have an advance healthcare directive, or would you like to complete one?
    3. Do you have a Do Not Attempt to Resuscitation (DNAR) order?
    4. Do you want blood products or important life-saving treatments, such as mechanical ventilation, dialysis or surgeries to prolong your life?
    5. Can you please identify one representative that we should reach out to if you become uncommunicative?
  2. If you become ill and the doctor believes that you need extra care in an ICU or need mechanical ventilation (breathing machine), your case will be reviewed, along with other patient cases, to determine how these resources should be shared throughout the hospital.
  3. If you become extremely sick and very unlikely to survive your illness (even with life-saving treatment)- limited medial resources may go to treat other patients who are more likely to survive.
    1. If a ventilator or ICU care is not offered or is stopped, you or your representative have the right to ask your doctor for further detail concerning this decision and will receive everything you need to ensure that you are comfortable and free of pain or discomfort. Your physician can also appeal any decision made in this regard on your behalf.

This an extremely hard time for our entire community. We are all working together to provide the best care possible. We are doing everything possible to obtain additional resources so that we can avoid these difficult decisions if at all possible. Please feel free to ask your medical team any questions you might have.

*” Patient” refers to the patient or their designated representative if the patient is unable to communicate

If you have questions or concerns, please call (562) 868-3751 ext. 2158