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Ballad Health trauma realignment could lead to emergency room expansion, additional helipad at JCMC

Zach Vance • Nov 15, 2018 at 2:04 PM

Ballad Health leaders answered a question Wednesday that has been posed since the merger was first announced: How will the hospital system manage its two Level I trauma centers located 20 miles apart?

The answer is the formation of a regional trauma and emergency care system that entails shifting Holston Valley Medical Center’s trauma center status from Level I to Level III, while maintaining the Level I trauma center at Johnson City Medical Center.

The realignment is expected to expand access to services while increasing the effectiveness of care through specialization and better coordination, according to a Ballad Health press release announcing the move.

Because it will retain its Level I trauma designation, what changes can be expected at Johnson City Medical Center over the next 10 months as the realignment is implemented?

“When you look at what’s going to happen tomorrow, there really aren’t changes to our system,” Eric Deaton, senior vice president of market operations at Ballad Health, told the Johnson City Press Wednesday.

Of the 5,190 trauma patients treated at trauma centers in the Tri-Cities region last year, roughly 60 percent received care at Johnson City Medical Center. Now, an additional 10 percent of “major” trauma cases will also be treated at Johnson City Medical Center, the Ballad Health press release stated.

Once the regional trauma center model is fully implemented, Deaton expects the number of trauma patients treated at the Johnson City Level I trauma center to increase by 200 to 250 patients annually, based on historical data.

“Really, things will not change until later on as we start to move more of our higher-acuity patients to JCMC,” Deaton said.

Another big announcement made by Ballad Health Wednesday was the formation of a new pediatric trauma service at Niswonger Children’s Hospital located inside Johnson City Medical Center. The hospitals in Kingsport and Bristol will also be getting pediatric emergency rooms.

The increase in trauma patient volume and addition of a pediatric trauma service will likely increase the demand for staffing at Johnson City Medical Center, as well as lead to a possible expansion of the emergency room, Deaton said. Those details will soon be fleshed out by the hospital’s leadership staff.

“What we need to kind of do immediately is ... to look at the facility, to look at staffing and so forth and see what the needs will be based on the projected volumes in the future,” Deaton said.

“So we might have to do some additional facility construction around the emergency department or around our intensive care unit. I know we’re probably going to have to add another helipad to the campus to accommodate two helicopters potentially at one time.”

Dr. Bracken Burns, assistant president of trauma services and medical director of JCMC’s Level I trauma center, said the formation of a regional trauma center is a truly unique opportunity, not just for Johnson City, but for the entire region.

Ballad Health’s press release called the regional trauma system a “first of its kind in Tennessee” and one of only a few in the nation.

“There are very few what you would consider trauma systems within the United States. A lot of that is due to things like competitive markets and health systems that are opposed to each other,” Bracken said.

“We have the opportunity to not focus on a center, which is basically a hospital of excellence in caring for injured patients, and focus on a system. Because all trauma really starts wherever the injury was. And this gives the opportunity to affect that level of care by working with EMS partners, by working with the other hospitals within the Ballad system to provide a level of care at the time of injury.”

The trauma center realignment will not affect services at Franklin Woods Community Hospital, and there will be no reduction in workforce as a result of these changes.

“We are grateful to our local leadership, our physicians and other experts who worked collaboratively for months to plan all of these evidence-based improvements,” Ballad Health CEO Alan Levine said. “We thank them for their insight, experience and forward thinking.”

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