MetroHealth President and CEO Christine Alexander-Rager, MD, is calling on Cleveland Clinic President and CEO Tomislav Mihaljevic, MD, to reconsider the system’s plan to pursue level 1 trauma center designation at its main campus.
In a Feb. 2 letter to Dr. Mihaljevic that was shared with Becker’s, Dr. Alexander-Rager said adding another level 1 trauma center in Cleveland could jeopardize patient safety, disrupt the region’s coordinated trauma system and drive up healthcare costs.
“It is deeply concerning that this announcement appears to have been made without regional planning, stakeholder consultation, or a demonstrated community need,” she wrote. “It also raises grave concerns about the safety of trauma patients in our region, the future quality of trauma care in Greater Cleveland, and the stability and performance of our current regional trauma system.”
Cleveland Clinic announced Jan. 15 that it is seeking level 1 designation, citing rising demand for trauma services and the need to reduce transfers of critically injured patients to other hospitals. Level 1 trauma centers are required to provide around-the-clock access to surgeons and specialists and play a leadership role in trauma education and research. Ohio’s trauma verification process is overseen by the American College of Surgeons in coordination with the Ohio Department of Health.
MetroHealth and Cleveland-based University Hospitals currently operate the city’s two level 1 trauma centers, located roughly seven miles apart. If approved, Cleveland Clinic’s main campus would become the third such center within Cleveland.
MetroHealth and state Rep. Darnell Brewer, D-Cleveland, raised concerns about Cleveland Clinic’s proposal in January, urging greater transparency and community discussion around the potential impact on the region’s trauma infrastructure.
At the time, University Hospitals said it supports collaboration among providers to ensure access to high-quality trauma care.
“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,” the system said in a statement.
On Feb. 5, a Cleveland Clinic spokesperson referred Becker’s to the system’s January statement outlining its rationale for pursuing level 1 designation.
In that statement, Cleveland Clinic said it transfers several hundred trauma patients each year and believes caring for those patients within its system could improve outcomes and continuity of care. The system said its expertise in high-acuity care and depth of clinical resources position it to support a level 1 program.
In her letter, Dr. Alexander-Rager argued that the Cleveland area’s current trauma network is appropriately sized for the region’s population and patient volumes. She emphasized the importance of maintaining sufficient case volume to preserve clinical expertise, support workforce stability and meet accreditation standards. She said research shows that spreading trauma cases across additional level 1 centers can weaken team readiness and coordination, increasing the risk of worse outcomes for severely injured patients.
She also expressed hope for broader collaboration among the health systems, writing that regional partners could work together more effectively on prevention, post-acute recovery, behavioral health and efforts to address the underlying factors that contribute to traumatic injury.
Editor’s note: This article will be updated if more information becomes available.
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