The Cleveland Clinic announced today it is looking to open a trauma center at its main campus that would treat severely injured patients, such as those injured in car crashes or with traumatic brain injuries or gunshot wounds.
That would require the hospital to have surgeons and doctors qualified to handle a range of traumas working at all times.
The Clinic’s move to establish what’s referred to as a Level I trauma center alarmed MetroHealth Medical Center, which has provided the highest level of trauma care for adults since 1992.
The Clinic, which is proposing to treat both adults and children, wrote in a press release that trauma care was a “gap” at its main campus and that providing that treatment would reduce the risks that come with transferring trauma patients to other hospitals.
“This would allow us to fulfill the full spectrum of our patients’ needs,” said Dr. Scott Steele, president of the Cleveland Clinic Main Campus Submarket.
MetroHealth, considered the county’s safety net hospital, responded to the Clinic’s announcement by saying the area could not sustain another Level I trauma center.
“It will harm patient outcomes and increase costs for the entire community,” MetroHealth’s statement said.
University Hospitals, which also operates a Level I trauma center in Cleveland, did not express alarm about the Cleveland Clinic’s announcement.
“We hope to be able to work together across the Level I trauma providers to ensure that our community always has access to the best trauma care,” a spokesperson for University Hospitals wrote in a text.
The Clinic hopes to open the new trauma center by 2028.
Cleveland health systems have argued over trauma centers before
Drama around trauma centers has bubbled up repeatedly in the city of Cleveland for more than a decade.
MetroHealth, the county’s public hospital, has the oldest Level I trauma center in the city.
University Hospitals opened its Level I trauma center about a decade ago.That also rankled the MetroHealth system, whose leaders at the time said they were concerned at the thought of having two high-level trauma centers in the city, cleveland.com reported at the time.
But University Hospitals insisted that it was necessary because of a gap in trauma care on the county’s east side. A Level II trauma center in East Cleveland closed in 2011, leaving some public officials on the county’s east side supportive of more trauma care.
University Hospitals officially opened its trauma center’s doors in November 2015. And in 2017, it joined the Northern Ohio Trauma System, a regional network that coordinates trauma care, cleveland.com reported.
The system includes Southwest General and the Cleveland Clinic. A representative of NOTS said it could not comment on the Cleveland Clinic’s decision to pursue a new Level I trauma center.
What it takes in Ohio to become a trauma center
In Ohio, the process to become a trauma center is largely based on certification from the American College of Surgeons. The nonprofit medical association for surgeons reviews hospitals’ trauma care capabilities and performance and then verifies or denies them trauma center status.
The state of Ohio largely relies on the American College of Surgeons’ certification to determine whether a hospital can become a trauma center and accept trauma patients, according to the Ohio Revised Code.
The state doesn’t require that the hospitals demonstrate the need for additional trauma services in the area, said Diane Simon, the chair of Ohio’s trauma committee, which advises a state board on emergency medical, fire and transportation services.
That means hospitals can pursue what they want in Ohio, said Simon, an emergency nurse who is also the trauma program manager at a Level III trauma center in western Ohio. The downside, though, is that “you can get a bunch of trauma centers in one area while you have other areas that are in need,” Simon said.
She said some states limit where trauma centers can be, but Ohio does not.
For the Cleveland Clinic, the first step to make the main campus into a trauma center will be a consultation site visit with the American College of Surgeons this year, the press release wrote.
After that meeting, the American College of Surgeons typically shares a report of the hospital’s strengths and weaknesses when it comes to trauma care, according to its website. Then, the hospital makes an action plan to address any deficiencies, Simon said.
The Clinic wrote in its press release that plans to become a trauma center could include expanding the main campus’ emergency department, hiring trauma experts and training current caregivers.
After its action plan is put in place – and less than a year after the first visit – the hospital is then supposed to apply for another verification from the American College of Surgeons. That’s when, Simon said, the state would consider the hospital as a provisional trauma center.
That’s important because it means ambulances can – and in some cases must – take trauma patients to the newly accredited hospital. State law says EMS has to take patients with traumatic injuries to the nearest available trauma center, with some exceptions.
State, Cleveland officials have mixed feelings about a new trauma center
Even before the center was announced Thursday, some local and state officials had already caught wind of the Clinic’s plan and were raising questions about it.
In an interview on Monday, Cleveland City Council Member Stephanie Howse-Jones said she wanted to know what “data is out there” that made the Clinic decide that another Level I trauma center is needed in Cleveland.
Signal Cleveland asked the Cleveland Clinic to share data that shows the need for the new trauma center and how many trauma patients it transfers to other hospitals. In response, a spokesperson for the Clinic wrote that it transfers several hundred trauma patients out of its care each year, and that treating them within the Clinic could lead to improved outcomes.
In its press release, the Clinic also said that 2024 data from NOTS shows that the majority of traumas in northern Ohio come from falls and motor vehicle collisions.
State Rep. Darnell Brewer wrote on Facebook in December that he was concerned about plans for a new trauma center at the Clinic. Brewer recently stepped up anti-gun violence efforts and said he worried a new trauma center on Cleveland’s East Side could institutionalize an “if they build it, they will come” mentality in the city.
“I believe that they would not work with me to decrease the violence in my community,” Brewer said in an interview. “Will they allow community violence interrupters in their facility? Will they change their policy around bringing gunshot victims to the trauma center?”
The policy Brewer referred to is a Cleveland Clinic Police Department protocol to detain anyone accompanying a gunshot victim to the emergency department. Brewer spoke out against it in a Signal Cleveland article in December, saying it could discourage residents from driving people who’d been shot to the hospital. The Cleveland Clinic said its policies around responding to security threats are designed to uphold a safe environment for patients, visitors and caregivers.
Other city officials said that they believe more trauma care is needed. Council Member Kevin Conwell, who oversees council’s Health and Human Services Committee, said that he supports a new Level I trauma center because there are not enough beds at current trauma centers.
“I noticed it at least three times — people, they’re in the hallway, without enough beds,” Conwell said. “And the nurses have told me and the doctors, we just don’t have enough beds.”
Tim Sommerfelt, a leader with the Cleveland Association of Rescue Employees, the city’s EMS union, said that a lack of inpatient hospital beds sometimes stalls patients in emergency rooms. If the Cleveland Clinic’s new trauma center adds inpatient beds, they would be much-needed, he added.
“There’s a dearth of inpatient beds across all the hospital systems,” Sommerfelt said. “So if people are willing to add capacity, we’ll approach it with an open mind, as long as it’s done in a tactful manner, in a collaborative and responsible manner.”
Commander Ellen Kazimer, a spokesperson for Cleveland’s EMS department, wrote in an email that “anytime there are multiple options for care throughout the City can only be viewed as a positive for the residents and visitors in need of medical care.”
In the press release, the Clinic wrote that it would continue to work with local government and community leaders.
Signal Cleveland updated this story to include a quote from a representative with Cleveland’s EMS union.
