Chattanooga: Erlanger hospital closes burn unit

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Interesting article from the Chattanooga Times Free Press - Thursday, July 3, 2008

http://www.timesfreepress.com/news/2008/jul/03/chattanooga-erlanger-hospital-closes-burn-unit/?local

Link to: USA Burns Center Facilities Directory
http://media.timesfreepress.com/docs/2008/07/U_S_Burn_Care_Facilities.pdf


Chattanooga: Erlanger hospital closes burn unit

By: Emily Bregel

Unable to replace its former medical director, Erlanger’s burn unit has shut down, hospital officials said Wednesday.

The unit’s medical director, Dr. Lesley Wong, left in February, and the hospital’s recruitment efforts since then have come up short, according to an e-mailed statement from Erlanger spokeswoman Jan Powell.
“After careful consideration and consultation with the local plastic surgeons providing coverage for the unit, Erlanger officials have determined that closing our burn unit is in the best interests of major burn patients,” the statement said.

Erlanger’s burn unit, which marked its 30th anniversary in February, treated 128 patients in fiscal year 2007, according to the Associated Press.

On Wednesday, no one at the hospital was available to comment on the closing of the unit, which shut down Tuesday, Erlanger spokeswoman Nancy Poston said.

“I was saddened to hear the news,” Dr. Wong said in a telephone interview Wednesday. “Nationwide, it’s difficult to find burn surgeons. The majority of them are general surgeons that specialize in burns” and to find a plastic surgeon who specializes in burn injuries — such as Dr. Wong — is even more challenging, she said.

Dr. Wong, who now works at a private practice in Evansville, Ind., said she left Chattanooga so she could work in the same city as her husband.

Erlanger’s burn unit was one of three in the state. The others are Vanderbilt Regional Burn Center in Nashville and the Firefighters Regional Burn Center in Memphis, according to the American Burn Association.

Georgia has two burn centers: one at Grady Memorial Hospital in Atlanta and the other at the Joseph M. Still Burn Center in Augusta.

A NATIONAL TREND

Nationwide, the number of burn centers is falling.

In August, The Associated Press reported that the number of burn centers in America dropped from 132 in 2004 to 127 in 2007, and burn beds have fallen from 1,897 to 1,820, according to American Burn Association records, which are compiled from voluntary reporting by hospitals.

“If you look at a national state of readiness for something like a terrorist attack or some sort of severe mass casualty, we have less beds now than we did prior to 2001,” said Dr. Jeffrey Guy, director of Vanderbilt Medical Center’s 29-bed burn center in Nashville.

The Nashville center, which treats about 600 major burns and 3,400 minor burns a year, now will receive transfers of severe burn patients from Erlanger, he said. The transfers likely will add about 100 patients a year to the center’s burn unit, he said.

Across the nation, hospitals with relatively small burn centers are closing those units and making transfer agreements with regional burn centers for the treatment of severely burned patients, Dr. Guy said. Such patients actually can be transported by helicopter with relative ease, he said.

Smaller burn units often struggle in the face of the extremely high overhead costs, as well as the high number of uninsured or underinsured burn patients, he said. A patient with burn injuries on more than 20 percent of his body easily can cost a hospital $10,000 a day and remain in a hospital for months, Dr. Guy said.

“In today’s economic model, where we can move patients around that are critically ill pretty easily, it makes sense to care for those patients at large regional centers,” he said.

Erlanger hospital officials have said, however, that the hospital’s burn unit actually brought in revenue for the hospital in some years, according to the AP.

Erlanger remains a Level I Trauma Center, and the burn unit’s employees have been absorbed into other areas of the hospital, Erlanger officials said in the statement.

Erlanger hospital still will accept burn patients, but patients with major burns, after being assessed and stabilized, will be transferred to the Joseph M. Still Burn Center in Augusta or the Vanderbilt Regional Burn Center in Nashville, hospital officials said in the e-mail statement.

Pediatric burn patients still will be transferred to the Shriners Burns Hospital in Cincinnati, Ohio, which always has been the hospital’s protocol, the statement said.

Patients with less severe burn injuries will be treated in Erlanger’s Intensive Care Unit, inpatient rooms or the hospital’s Wound Care Center, the statement said.

“This decision was made with the best interests of our patients as our primary consideration. We will continue to assess the situation,” Ms. Powell said in the statement.
 
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