State of Tennessee Survey Gives High Marks to Region’s Level I Trauma Program

Report by survey team concludes the trauma program serving the Appalachian Highlands provides “outstanding commitment to care for the injured patient” and finds zero deficiencies

The Tennessee Department of Health, after conducting a rigorous review of the trauma program at Johnson City Medical Center, issued its Level I Trauma Center Reverification Site Visit Report on Wednesday, July 14.

The report found the hospital “has demonstrated an outstanding commitment to care for the injured patient.” Further, the survey resulted in zero deficiencies, a first for trauma care in the region. The survey reviewed the trauma center, emergency department, surgical ICU, hemodialysis, radiology, operating rooms, lab services, quality assurance programs and the qualifications of the entire trauma team.

Prior to the effort to create a regional and coordinated system of trauma care, which was implemented nearly two years ago, neither of the region’s Level I trauma centers were able to achieve surveys with zero deficiencies, and the region did not have a coordinated single trauma system. This was due to a replication of services, which experts cited as not being a best practice. The hospitals were routinely cited for a lack of coordination and inadequate availability of specialties required for immediate call to serve the needs of patients.

The 2021 report details the accomplishments made at the trauma center since its last survey in 2017, which was before the consolidation occurred. It also specifically cites improvements in the region’s trauma system since the consolidation, which include:

• Consolidation of the air-medical transport service and centralization of trauma traffic coordination in a single Ballad Health Command Center
• Excellent response times to trauma activations
• Addition of multiple key trauma program staff
• Additional resident coverage for the trauma service
• Significant increase in research publications with the addition of new trauma faculty and a research coordinator
• Surgical specialty coverage was reviewed, and consultants are readily available and invested in the trauma program. No coverage problems were noted.
• The trauma surgical team is entirely board-certified, and all but one is also board-certified in critical care medicine.
• Nurse ratios in the intensive care units are appropriate, and there is immediate access to laboratory and imaging services. All essential equipment is available on the units.
• There is a well-defined budget, which demonstrates excellent support for the program.

The trauma program at Johnson City Medical Center is operated through a partnership between East Tennessee State University’s Quillen College of Medicine and Ballad Health. In addition to the cited qualifications of the trauma team, the survey report also cites the addition of research capacity and an “increase in the program’s research output,” a stated goal of the consolidation of the region’s trauma program.

“East Tennessee State University is proud to be partnering with Ballad Health as we, together, have created a high-quality regional trauma program,” said East Tennessee State University President Dr. Brian Noland. “This report is the result of a rigorous and thorough review by the State, and we could not be prouder of our faculty, leadership and the leadership of Ballad Health. The entire region benefits from the creation of this new, high-quality trauma program that is now, for the first time, coordinated and performing at a level everyone in the region deserves. It is my understanding this is the first time a Level I trauma center in our region has received zero deficiencies in a state survey.”

“The Quillen College of Medicine made a commitment to partner with Ballad Health in creating a high-quality regional trauma system, and I am proud of the results of that partnership,” said Dr. Bill Block, Dean of the Quillen College of Medicine. “This trauma survey result demonstrates the incredible work our teams are doing with Ballad Health. The collaboration has enhanced care for everyone in the region, and we are excited about being able to deliver such a provably high quality of care and service.”

“We have seen recent events where the coordinated trauma system has saved the lives of people from the far reaches of Southwest Virginia and throughout Northeast Tennessee,” said Ballad Health Chairman and Chief Executive Officer Alan Levine. “The observation of the state experts make it clear why this is happening. The commitment to quality, speed, and patient outcomes has helped us see a reduction in trauma-related mortality. This has translated into lives saved and lives improved.

“I’m not only proud of the folks at ETSU and Johnson City Medical Center, but at all our hospitals – Kingsport, Bristol, Greeneville, Norton – all of them. A regional and coordinated trauma system is what we wanted to create, and to do so successfully requires the participation and support of the entire Ballad Health family.”

The report cited the strength of the leadership of Dr. J. Bracken Burns, DO, professor of surgery at East Tennessee State University, who serves as the medical director of the trauma program. It says, “he has demonstrated significant dedication to the program, as well as a vision which has helped the program grow and improve.”

“This was an extremely thorough evaluation of our program, for which we are grateful,” Dr. Burns said. “Given the dedication of our team, I am pleased there were zero deficiencies. But that is not our only goal. Our goal is to save lives and provide the highest quality of care. To that end, we are also appreciative of the recommendations the State provided us, which can help us become even better in our effort to serve the whole region, and which Ballad Health and ETSU will seriously consider.”

“I see each and every day the commitment to our patients that our entire clinical team puts forward,” said Kenny Shafer, interim chief executive officer of Johnson City Medical Center. “While this survey result is extraordinary, it is never enough, and we will continue to strive to be even better. Our patients deserve it.”

According to the Tennessee Department of Health, the survey report and recommendation for recertification will be presented to the Board for Licensing Health Care Facilities on Tuesday, Oct. 5.