Greeneville Community Hospital accelerates plans to enhance cardiac and vascular care and optimize capacity

With severely limited elective volumes, interventional cardiology program will be consolidated with Johnson City Medical Center and Holston Valley Medical Center’s high-volume program will be accelerated

Plans underway at Greeneville Community Hospital to expand the award-winning regional cardiology network tied to Holston Valley Medical Center and Johnson City Medical Center have been accelerated by the leadership of Greeneville Community Hospital in consultation with physician leaders. This decision to accelerate these plans was made based on a significant decline in elective procedure volumes affecting the interventional cardiology program at Greeneville Community Hospital, and the desire to ensure all patients benefit from a high-volume interventional program fully integrated with tertiary services.

Capital will be invested in upgrading the cardiac imaging diagnostics and vascular surgery capabilities at Greeneville Community Hospital – expanding its capabilities with the most leading technology for cardiac diagnosis in the nation. Interventional cardiology services will be provided at Johnson City Medical Center and Holston Valley Medical Center, where patients will benefit from a high-volume program supported by additional experienced physicians and surgeons providing on-site support for the catheterization lab – a benefit never before available at Greeneville Community Hospital.

The volume impact of the COVID-19 pandemic has severely reduced elective procedure volumes at Greeneville Community Hospital for a service which has already previously struggled with low volumes. Performing a low volume of procedures runs contrary to national evidence supporting interventional procedures being done in a higher volume center.

The entire Appalachian Highlands region benefits from an award-winning cardiac network which provides for stabilization of patients experiencing chest pain, and transport to a cardiac center with consistently short “door-to-balloon” times and experienced provider and surgical support for more complex procedures best performed in a tertiary facility such as Holston Valley Medical Center or Johnson City Medical Center.

“As we were planning for the future growth of our cardiology program, the issues presented by the pandemic have caused us to accelerate certain plans in the interest of good patient care,” said Tammy Albright, chief executive officer of Greeneville Community Hospital. “While we were excited about the investments we were planning to make, after consulting with physician leadership, we share the opinion that we cannot wait in order to take these steps. We made these recommendations to the leadership of Ballad Health, and we are pleased they have approved of them.”

The recommended steps for Greene County include:

• Greeneville Community Hospital fully participating in the region’s award-winning cardiology network – providing immediate transport to a high volume tertiary cardiac center for patients experiencing a heart attack. This will reduce the time to treatment and follows the best practices in the nation.
• Ballad Health recruiting additional cardiology specialists to Greeneville to serve the community and will expand the current cardiology practice. Dr. O’Roark has recently joined Dr. Whitaker in Greeneville.
• Ballad Health investing capital in bringing the most advanced cardiac diagnostic technology to Greeneville – one of the first in the region – to provide advanced, non-interventional identification of risk for heart attacks. This technology, CT Angiography (CTA), is an outpatient service which provides enhanced capability to diagnose risk of coronary disease.
• Ballad Health investing capital to upgrade the C-Arm and Imaging Table at Greeneville Community Hospital, enhancing vascular surgery capabilities at the local hospital.
• Providing privileges to the cardiologists serving Greene County, and their partners, to practice at Johnson City Medical Center – allowing them to follow their patients with the full support of the practitioners they work with and trust.

Cardiac catheterization procedures first became available at Greeneville Community Hospital’s East campus (the former Laughlin Memorial Hospital) in 2006. However, its cardiac interventions did not have surgical support available on-site, and some acute cases were transferred to other hospitals in the region. Dr. Mark Chang, president of Ballad Health CVA Cardiology Services explained, “over the past several years, Greene County patients have received their most complex cardiac care in the catheterization laboratories at JCMC and HVMC. Outcomes at those facilities, with our cardiologists and surgeons, have been among the best in the nation. We have been, and will remain, fully committed to continuing timely access and the highest quality of care to all Greene County patients.”

Additionally, while research continues to demonstrate a strong correlation between higher volumes and better outcomes, the catheterization lab at Greeneville Community Hospital only averaged 44 cases a month, even before the COVID-19 pandemic, including all vascular cases, diagnostic catheterization and interventional cardiology. In contrast, more than 590 cardiac catheterization procedures are performed at Johnson City Medical Center every month, and the hospital has earned a Chest Pain certification from The Joint Commission.

“The team members at Greeneville Community Hospital provide excellent care for our patients, and I’m tremendously proud of the service they provide the people of our community,” Albright said. “By accelerating these plans, we are doing the right thing for our patients and for our staff.”

Albright noted that, even before the drop in elective volumes associated with the government-imposed deferral of elective procedures, the limited staffing available at Greeneville Community Hospital often led to elective cardiac procedures being canceled or rescheduled when team members needed to utilize personal or medical leave. That challenge is not present at Ballad Health’s tertiary facilities, which have larger teams of certified and specialized caregivers, backed up by robust interventional capabilities and highly qualified surgical teams.

Moreover, the door-to-balloon times for heart attack care (the metric that indicates how quickly a patient’s procedure is complete upon entering a facility) at Greeneville Community Hospital averages 66 minutes, while the same measure averages below 60 minutes at Johnson City Medical Center and Holston Valley – often being as low as 40 minutes. This includes patients transferred from other healthcare facilities – indicating a highly effective process for getting patients to treatment in industry leading times.

To that end, Albright and clinical leaders anticipate the participation in the region’s award-winning cardiology network will result in more consistent coverage and access to the best tertiary cardiac services in the nation.

“The interventional cardiology programs in Johnson City and Kingsport are practically unparalleled, and we’re excited to make that level of care readily and promptly available to the people of Greene County,” said Mark Patterson, MD, president of Ballad Health Medical Associates and the former chief medical officer at Greeneville Community Hospital. “At the same time, we’re bolstering the heart and vascular services that are available in Greeneville, such as diagnostic imaging, so our patients can really benefit from that array of care.”

This change to the composition of the cardiac program at Greeneville Community Hospital is being accelerated due to the need to address the precipitous drop in volumes related to the pandemic, and is a step being taken in the interest of patient care.

No additional changes, other than those previously announced, are anticipated. Those announcements include:

• Greeneville Community Hospital West has been selected as a transitional care facility for patients with coronavirus disease 2019 (COVID-19), and;
• In the future, Greeneville Community Hospital West will be converted into a residential campus for women who are pregnant and in need of certain behavioral services, addiction treatment and other supports.

“I am proud that Greeneville Community Hospital is making new investments to serve not only Greeneville, but the entire region, and has become a critical part of the Ballad Health system of care,” added Albright. “Our team is up to this challenge and we are committed to this community.”

Information about COVID-19 can be found on our COVID-19 information site, and anyone who thinks they might be at risk for the virus can call Ballad Health Nurse Connect at 833-822-5523 to be screened.

Learn more about Greeneville Community Hospital and Ballad Health’s cardiology services.