Hawkins officials concerned about patient transport times after Kingsport trauma center downgrade

Jeff Bobo • Nov 23, 2018 at 8:30 AM

ROGERSVILLE — Hawkins County officials will likely ask Ballad Health to reconsider plans for changing Kingsport’s Trauma Center from Level 1 to Level 3, but they will also be looking for ways to address concerns created by that change, including increased patient transport times.

John Metz, who chairs the county commission’s Public Safety Committee, said Wednesday the county has about 10 months to prepare for that impact, particularly with regard to Hawkins County EMS.

The Public Safety Committee met last week in special session with officials from Ballad Health, including Eric Deaton, senior vice president of market operations.

Deaton noted that major metropolitan areas such as Knoxville, Memphis, Nashville and Chattanooga all have one Level 1 trauma center.

He noted that the Tri-Cities already has three of Tennessee’s 13 trauma centers, including Level 1 centers in Kingsport and Johnson City and a Level 2 center in Bristol. Under the new plan, Kingsport and Bristol will become Level 3 trauma centers.

However, Ballad isn’t closing any of its three trauma centers or any of its 20 emergency rooms across the region, including the one at Hawkins County Memorial in Rogersville.

Only about 8 percent of trauma cases would be affected by the change. In Hawkins County last year, that would have amounted to 35 cases that would have been transported to the Johnson City Medical Center instead of Kingsport’s Holston Valley Medical Center.

Accompanying Deaton was Dr. George “Milum” Testerman, Ballad’s new vice president of trauma emergency services.

Testerman is also a Rogersville native, the medical director for Hawkins County EMS and has been involved with the Kingsport trauma center since it started in 1988.

He said the Tri-Cities has a “luxury” of having three trauma centers.

“Over the years, it’s been somewhat difficult to fully staff our (Kingsport) Level 1 trauma center,” Testerman said. “A trauma center has to have a lot of specialists, sub-specialists to just be on call.”

Deaton noted that the reason Johnson City was chosen for the Level 1 center was because that’s where those specialists are more readily available. However, Kingsport will still have staff on hand to treat about 85 percent of all trauma cases.

“We still are going to have a trauma center there with pretty much full services. By that, I mean we’re going to have neurosurgery, orthopedic surgery and general surgeons in trauma centers doing trauma like we did before. When it’s fully implemented, only the sickest and most severely injured patients would be taken to Johnson City,” Testerman said.

Deaton also discussed Ballad’s increased investment in its cardiac program at Kingsport, as well as the creation of a call center for coordinating EMS and 911 with the hospitals.

Lisa Carter, who is CEO of Niswonger Children’s Hospital and vice president of Pediatric Services at Ballad Health, also spoke to commissioners about the plan to establish Niswonger Children’s Hospital pediatric emergency rooms in Kingsport and Bristol.

Following Ballad’s presentation, Commissioner Rick Brewer expressed concern that ambulances traveling the extra miles to Johnson City will leave the county without adequate coverage for longer periods of time.

“We would have to add one ambulance, but that wouldn’t be the big problem,” Brewer said. “Staffing that ambulance is probably going to be the biggest problem.”

Metz noted there is a shortage of paramedics and EMTs in Hawkins County as well as across the region and country. Based on his research, Metz said there are about 14 EMS personnel combined graduating at Walters State and Northeast State this year, and all 14 already have job offers.

“My primary concern is dealing with response times,” Metz told the Times News after the meeting. “That’s an issue we’ve dealt with for several years.”

Metz said Hawkins County needs to ask Ballad to reconsider its plans, but it also needs to take the next 10 months before Ballad’s changes take effect to begin planning for their impact on Hawkins County EMS.

“If we put all our time and resources into getting them to change plans they’ve already set in stone ... I don’t want to look back and say we’ve had eight to 10 months and we’re not prepared for the transport of patients (to Johnson City),” Metz said.

Hawkins County EMS Director Jason Murrell told commissioners that from several areas in the county the transport time to Johnson City would be well over an hour.

“That’s in ideal weather,” Murrell said. “When it’s ideal weather, we’re going to be able to use flight services. But if it’s a rainy day, foggy day, snowing, it’s well over an hour to transport to the Johnson City Medical Center.”

Rep. Gary Hicks (R-Rogersville), who also attended Wednesday’s meeting, said his main concern is access to care for Hawkins and Hancock counties.

When you talk about transporting a patient from Mooresburg to Johnson City, as opposed to Kingsport, Hicks noted, “There’s no doubt about it. The access is getting further away.”

Hicks added, “That is definitely a problem that within the next 10 months is going to have to be worked out — the logistics of that. The staffing of EMS, paramedics — that’s also a major issue that will have to be addressed. We’re going to have to come up with a comprehensive plan.”


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