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Amy Williams

I’ve been reading that 400 is the magic number. That is the projected number of admitted COVID-19 patients in the coming weeks that will strain the Ballad Health system to a breaking point and may force them to invoke their “Scarce Resources Allocation” protocol.

If you haven’t heard, this protocol will be utilized if resources at Ballad Health are stretched beyond limits, and a triage team will make decisions as to who gets medical equipment, medication, treatment, etc. The health system even has a form for you to sign stating you understand the medical decisions they may be making for you.

This document states: “Because you are being admitted to the hospital during a period where the system may find it necessary to implement crisis standards of care, you should be aware that there is a chance, however unlikely, that regardless of your reason for admission to the hospital, certain resources may not exist to provide you with live-saving treatment if you become critically ill because the health system has become overwhelmed with COVID-19 admissions.”

Let’s look at some other numbers given by Ballad Health:

21 counties in Tennessee and Virginia. This is the established service area Ballad Health covers.

20 medical hospitals (Wood Ridge Hospital is not counted for this summary)

2,338 published medical hospital bed capacity

Factor in the total population of Ballad’s service area is 945,362, and Ballad health is stressing out over a census of 400.

The high COVID-19 census is not a new thing to Ballad either. The in-house admissions stayed between the ranges of 306-361 patients from last December 2020 through the first two weeks this past January 2021. I don’t remember hearing about a COVID surge plan or a Scarce Resources Allocation protocol or back then. What is different now?

Albeit, I’m not sure I trust their published numbers. Ballad publishes a daily COVID Scorecard detailing the system’s COVID admissions, discharges, total census, ICU and Ventilated patients. In August alone there have been a few discrepancies.

On August 20th, Ballad Health reported no change in their in-house census, yet they also reported 22 discharges and 18 admissions (more out than in). On August 26th, they reported an increase of their COVID-19 hospital census by 8 patients from the previous day.

They also reported the exact same total number of admission and discharges (46 in and 46 out) on that day. Finally on August 27th, the system reported an increase of the COVID-19 hospital census by 6 patients from the previous day, however there were only 40 admissions and 45 discharges. Again, more patients leaving than being admitted, yet their in-house numbers continued to rise.

When questioned on Facebook about the discrepancies of their reporting, Ballad Health replied, “ Due to technical difficulties, the state-reported data for our area (listed at the top) was not updated yesterday. Today’s numbers are correct.”

Their answer to the question referenced the state reported data they relay pertaining to COVID positivity and death rates. The inconsistencies throughout August (and other months if one were to investigate) come from Ballad’s own reporting system and not from the any outside venue. When asked again to decipher the in-house number variance, they refused to further elaborate.

Is it any wonder that a health system that can’t keep up with the current real number of patients they are treating, may be inept at managing treatment resources? I have great safety concerns due to Ballad Health’s declaration of lack of assests and the subsequent harm to patients that could occur. I further argue that Ballad Health has abundant resources throughout their 21 hospital system and are poorly managing these resources in a time of stated health crisis.

Amy Williams is a resident of Rogersville, lifelong resident of East Tennessee, and a retired nurse with 25 years experience in healthcare. Amy is married to a retired police officer and is the proud mother of three children, two of which are currently serving in the US Navy. You can email her at amy.whatshername@gmail.com