For at least the next week, Summa Health’s Akron City Hospital is asking area ambulance providers to take some patients with complex head traumas or strokes requiring immediate surgery to another hospital for care.
The other Level 1 trauma center in the Akron area for adult care is Summa’s cross-town rival, Cleveland Clinic Akron General.
Summa has neurosurgeons on staff, but there are not enough under contract to offer around-the-clock coverage for traumas because of recent staffing changes, said Dr. David Custodio, Summa’s senior vice president and president of Summa Health Akron Campus.
The move, which is called a “diversion,” began at 4:30 p.m. Wednesday and is projected through Feb. 8. Custodio said Summa hopes to lift the diversion before then, but there may also be sporadic gaps in coverage that would cause the hospital to go on “selective diversion” again.
Telling emergency crews to divert patients away from an ER is uncommon in recent years, acknowledged Custodio and Dr. Richard George, Summa’s chief of the division of trauma.
Custodio was unsure the last time Summa went on any type of diversion, including for issues such as overcrowding or computer issues, but “those are far and few between.”
Summa is being proactive in the care of patients, George said. He also emphasized that if a patient came to the ER or hospital, there still are neurosurgeons available to provide the needed care.
“There are certain patients — and it’s a truly small number of patients on a monthly basis — where those patients would be best served to go to another Level 1 trauma center,” he said. “We’re very lucky in Akron to have two Level 1 trauma centers” for adults.
In a prepared statement, Cleveland Clinic Akron General said its “neurosurgical team is prepared to handle additional trauma cases and has the full support of Cleveland Clinic to ensure that the Akron community receives care of the highest quality and safety.”
Summa used its emergency activation system to send a page to all emergency partners, including community EMS crews, at 4:30 p.m. Wednesday, Custodio said.
However, leaders of emergency crews for the city of Akron and Cuyahoga Falls early Thursday afternoon were not aware of the selected diversion. About an hour later, Akron Fire Department spokeswoman Lt. Sierjie Lash said the city’s director of EMS heard from Summa confirming the diversion.
For neurological trauma cases, Akron emergency crews “will be taking our patients to Akron General unless otherwise indicated or unless they tell us to specifically send them to Summa or another hospital,” she said.
Cuyahoga Falls Assistant Fire Chief Chris Martin said Thursday afternoon that he and his shift commander were not aware of Summa’s selected diversion, but others may know.
Before Akron General and Akron City expanded their emergency departments, diversions were more common for overcrowding and there were some struggles between emergency crews and the hospitals, Martin said.
“That was a while ago and diversions have since become a thing of the past. Hospitals for obvious reasons don’t want to turn patients away,” he said.
Even with Summa’s temporary diversion status, ambulance crews in Cuyahoga Falls will decide on a case-by-case basis where to transport patients with head traumas and strokes, Martin said.
Patients with head traumas may also have other injuries, he said. Crews always call the closest ER or the patient’s preferred hospital when they are en route.
“Depending on the call and injuries the person has, our protocol says to take them to the closest applicable facility and to stabilize there and if needed, they can transport [to another facility],” he said. If the case is “an isolated head injury only, that diversion will have more sway” where crews would go, he said.
George said the selected diversion does not threaten Summa’s status as a Level 1 Trauma Center with the American College of Surgeons.
Summa’s ability to train emergency department resident physicians was revoked in early 2017 because of numerous cited deficiencies following an abrupt staffing switch of its longtime emergency medicine physician group and subsequent upheaval among its staff. Summa’s application to restart the program was denied in September by the Accreditation Council on Graduate Medical Education (ACGME). Summa officials have said they are actively working on another application with the goal of having emergency department residents again by July 2020.
The selected diversion is a “trauma surgery program issue” and “has no bearing on the ACGME or residency accreditation for the emergency department,” Custodio said.
Betty Lin-Fisher can be reached at 330-996-3724 or firstname.lastname@example.org. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ.