by Sarah Jane Tribble
Competition and collaboration.
It doesn't take long to discover that these are the two themes in the debate over University Hospitals' plans to open a Level 1 trauma center.
University Hospitals announced plans to open the region’s second top-level trauma center over the summer.
MetroHealth System, which currently operates the region's only Level 1 trauma center on the near west side, as well as leaders of a regional trauma coordination network have raised opposition to the plans.
During a hearing at Cleveland City Hall Friday, the group asked council members to encourage UH to not open the trauma center. MetroHealth also called for an independent community needs assessment and more collaboration.
“We need UH to stop working independently,” Dr. Jeffrey Claridge, medical director of the Northern Ohio Trauma System as well as director of trauma, critical care and burns at MetroHealth told the packed room Friday.
We are at a crossroads, he told the group.
“The decisions that are made in this room, about adding another trauma center independently needs to have the brakes applied to avoid a costly collision,” he said.
UH Chief Medical Officer Dr. Michael Anderson told city council members Friday that his hospital has done due diligence to make sure there is a need for their trauma center.
“I believe this is a new day in Cleveland,” Anderson says. “I believe with three Level 1s in town. We can be a very collaborative amazing community that we can look back on in 10 years and be very proud of where we are.”
UH has operated a Level 1 trauma center for children over the past two decades at its Rainbow Babies & Children Hospital. After three years of planning, hiring staff and working to achieve verification from the American College of Surgeons, University Hospitals is on track to open its trauma doors December 1.
Mike Williams, a national trauma consultant and president of California-based Abaris Group, said trauma has become a “highly competitive” industry.
Trauma centers treat the most severely injured patients, often from car crashes and knife-and-gunshot wounds. The hospital that has the region’s only top-level trauma center, can negotiate better contracts with health insurers who pay claims, he said.
“They have a lot of leverage,” Williams said.
Emotions ran high during nearly day-long hearing Friday, with some council members yelling and audience member wiping tears away as hospital leaders and the directors of the region's emergency networks debated whether UH should open the second top-level trauma center located near University Circle.
UH leaders say the need for another trauma center has only increased since the closing of East Cleveland's Huron Hospital closed in 2011. And city council members from the city's east side largely agree.
“We need a Level 1 Trauma care on the east side,” said Councilman Michael Polensek. “Is it all about the money? Is it all about the billable dollars. It should be about service.”
MetroHealth works within the Northern Ohio Trauma System, which includes the Cleveland Clinic, to coordinate where patients in the region go after severe injuries.
Over the past several years, since the collaboration was formed, mortality rates have decreased even after Huron Hospital closed in 2011.
Claridge and leaders of a regional trauma network told council members Friday that patients will receive better care if there is less competition for trauma in the region. They also question whether University Hospitals' trauma center will work well within the region's designated emergency network, which UH has not joined.
"We have a regional system that works very well because of coordination, expertise and quality review,” Claridge says. “Creating an additional trauma center that works independently to that system actually fractures the system. It creates unnecessarily competition that is not necessarily in the best interest of the patient."
Cleveland City council has held three hearings on the issue. Before the latest on Friday, each hospital system was asked a series of questions and turned in a report. Among the questions asked was how much in revenues or expenses each hospital earned from their ED or trauma centers.
The Cleveland Clinic listed five year’s worth of net revenues percentages. For example, the Clinic’s main campus reports that year-to-date 2.4 percent of net revenue came from their emergency department.
Both UH and MetroHealth declined to share that information. Both said it is "proprietary."
(Ideastream’s Jasmine Gallup contributed to this report).