JOHNSON CITY, Tenn. (WJHL) — A decision about whether to close the Sycamore Shoals Hospital (SSH) intensive care unit (ICU) will likely come within a few weeks, Ballad Health CEO Alan Levine said.
Levine told News Channel 11 clinical quality and finances both point toward a closure and that he supports one, but said the hospital system hasn’t made a final call on the unit, which Levine treats a very low volume of patients.
Levine was quick to praise the hospital and its staff, but said the volume of patients and ICU strategy in place at Johnson City Medical Center (JCMC), and its proximity to SSH, make it difficult to justify keeping the service line open in Elizabethton.
“The people at Sycamore Shoals do great work,” Levine said. “It is a fabulous hospital and the ICU staff there has been wonderful, so I can understand that people get upset if we say we’re looking at it.”
He said if the ICU closes, there will be no staff layoffs and affected employees could work at other roles at SSH or take positions in ICU or PCU (progressive care) at JCMC or Johnson City’s other hospital, Franklin Woods.
But Levine said multiple studies have shown that regionalizing critical care and using what’s called an “intensivist” model at ICUs improve outcomes for patients. JCMC is using intensivists, he said.
“We get accused of doing it to save money,” Levine said of previous consolidation moves within the system. “Improving quality saves money. That’s not a bad thing.”
Levine said SSH’s ICU isn’t even treating most patients from Elizabethton, and that it has an average census of five people.
“The evidence shows unequivocally that high volume ICUs that are regionalized where you have intensivist programs deliver better care, lower mortality,” he said. “That’s not me saying that, that’s years of science and peer-reviewed studies, which I rely on when I make those decisions.”
The lower volumes also create a higher cost per patient, Levine said.
“Then the question is ‘alright, now does it make sense to spend more money on something that the evidence shows is not the best approach?’ You don’t spend more money on something unless it’s a better model.”
He pointed to a decision a couple years ago to close the ICU at Indian Path Medical Center in Kingsport and shift that volume to Holston Valley Medical Center. He said Holston Valley was more appropriate for higher-acuity care and the same holds true with JCMC (and even Franklin Woods) and SSH.
Levine said Ballad informs the state about service line decisions and also puts proposals through a variety of “stress tests” to make sure leadership has thought through everything, “that we’ve got plans in place to more sure that we’re executing it properly.”
“I’m the last person to lay eyes on it and make the final decision. I believe it’s the right decision.”
He said he’s unsurprised that people are disappointed about the prospect.
“But I think over time, they’ll realize that … the evidence will support the decision.”