MaineGeneral Medical Center in north Augusta is seen on Sept. 15. Staffing has been a challenge for MaineGeneral and other hospitals in 2021, after a statewide vaccine mandate led to the loss of 4% of its workforce, or 191 employees, in October. Joe Phelan/Kennebec Journal file

AUGUSTA — MaineGeneral Health, like many hospital systems across the country, endured a challenging year as a result of the COVID-19 pandemic, losing about 4% of its workforce because of the vaccine mandate for health care workers even as a surge in cases pushes hospitalizations to their highest levels of the pandemic.

Next year, officials at the Augusta area’s flagship hospital system hope to address workforce issues, expand telehealth options, and reduce emergency department wait times.

MaineGeneral spokeswoman Joy McKenna said many of the year’s greatest challenges were related the COVID-19 pandemic, which is entering its third year.

“Compounding the increased hospitalizations we’ve seen for COVID-19, patients have been coming in sicker overall,” McKenna said. “We’ve been able to maintain our services but just as other hospitals in Maine have experienced, there’s an overall bed shortage and staff are stretched thin after 22 months of COVID-19.”

The state’s vaccine mandate, originally introduced by Maine Gov. Janet Mills in August with the deadline later extended to Oct. 29, required all health care workers to be inoculated against the virus.

Health care facilities across the state lost staff, and MaineGeneral lost 191 of its employees because of the mandate. Out of that 191, McKenna said 112 were terminated from employment and 79 resigned because of the mandate.

The employees were spread throughout the system, with approximately one half in clinical roles and the other half serving nonclinical roles.

McKenna said that MaineGeneral has roughly 4,500 employees across the entire system and that they have taken multiple steps to address issues with the workforce in the wake of the staffing losses.

“More recently, we’ve focused on retention efforts such as giving annual raises across the board to staff and providing a retention bonus to all staff,” she said. “This is supplemented by competitive wages and great benefits including: no increase to the employee share of our two medical plans; generous and matching retirement plans; career development including earn to learn programs; leveling/advancement programs; tuition reimbursement; loan reimbursement; parental leave; and an all-employee, all-positions referral program.”

She said the hospital has a “multi-pronged approach” to hiring more staff, including expanding the facility’s “Earn to Learn” program to train and hire certified nursing assistants, medical assistants, and lab techs. The “Earn to Learn” program allows students to get a hands-on learning experience at the hospital while receiving wages.

They also started a “Helpful Hands” program, which involves asking retirees and past staff to provide nonclinical help in inpatient units. Extra hours are also being offered to all staff, including per-diem staff.

McKenna said they are also strategically using contract labor. “Our focus is to fill positions with long-term staffing versus temporary staff, but we use contract labor as needed,” she said.

The spokesperson said some of the hospital’s greatest achievements in 2021 include its COVID-19 response, vaccination efforts, and ability to keep services available.

For the COVID response, she said staff met numerous challenges and uncertainties amid the pandemic while still caring for patients.

“We’ve never been prouder of the way our staff have met the challenges before them and continued to deliver the very best care possible to our patients and families,” she said.

For about half of the year, MaineGeneral along with the Maine CDC and city of Augusta, established a mass vaccination clinic at the Augusta Civic Center. More than 46,000 doses of the vaccine were administered to more than 23,500 area residents.

The mass vaccination clinic opened in February and closed in July due to a decline in demand. Activity peaked in March, when just under 6,000 doses were administered in one week. By late June, about 103 doses were administered in a single week.

Since closing the clinic, MaineGeneral reached out to surrounding communities and began offering pop-up clinics. The hospital also offered vaccine clinics for children later in the year, and are currently offering vaccinations for children at area schools and MaineGeneral pediatric practices.

McKenna said more than 1,400 vaccinations of students were provided in schools, and more than 2,300 doses of the flu shot were administered in various schools throughout the fall.

And as for keeping services available, McKenna said MaineGeneral has employed careful and continuous planning with the help of staff, patients and visitors, and as a result they have not had to divert patients to other facilities or pause health care services. In order to do this, she said officials had to carefully balance beds and staff.

Expansions in 2021 include several new community health programs and a new MaineGeneral Express Care location in Winthrop. McKenna said the hospital now has four “Express Care” locations, with the other three being in Gardiner, Augusta, and Waterville.

The hospital also expanded telehealth services this year.

“We offer telehealth visits for MaineGeneral Express Care and for MaineGeneral Primary Care,” said McKenna. “We began moving in this direction before the pandemic and have found for follow-up appointments and for less-serious health issues, telehealth provides a convenient option for patients.”

Looking ahead, MaineGeneral hopes to continue expanding telehealth options in both primary care and behavioral health next year, and to use telehealth as a way to reduce emergency department wait times.

McKenna said she and MaineGeneral officials are thankful for the staff and community that supported them throughout the pandemic.

“We know our community and staff have been feeling the weight of the pandemic, especially during the holidays when case numbers continue to be high,” she said. “These are stressful times on us all. At MaineGeneral, we’ll continue to be here for our patients and our community. We thank our 4,500-strong workforce. And we especially want to thank our community for supporting us throughout these 22 months.”