Erlanger Health System

Erlanger Health System
Erlanger Baroness Campus
Geography
Location	Chattanooga, Tennessee, United States
Coordinates	35°02′54″N 85°17′23″W / 35.0482°N 85.2897°W / 35.0482; -85.2897Coordinates: 35°02′54″N 85°17′23″W / 35.0482°N 85.2897°W / 35.0482; -85.2897
Organization
Care system	Public
Hospital type	Teaching
Affiliated university	University of Tennessee College of Medicine
Services
Emergency department	Level I trauma center
Beds	813
History
Founded	1889
Links
Website	erlanger.org
Lists	Hospitals in Tennessee

The Erlanger Health System (often referred to as Erlanger Hospital or simply Erlanger), is an academic system of hospitals, physicians, and medical services based in Chattanooga, Tennessee. Erlanger is a tertiary referral hospital and Level I Trauma Center serving a 50,000 square-mile (125-mile radius) region of Southeast Tennessee, North Georgia, North Alabama, and Western North Carolina. The system’s critical care services are accessible to patients within a 100-mile radius through five LIFE FORCE air ambulance helicopters, each equipped to perform in-flight surgical procedures and transfusions.

Founded in 1889, Erlanger is the 10th largest public healthcare system in the United States^[1] with more than half a million patient visits a year.^[2]

Erlanger is led by President & CEO Kevin Spiegel, FACHE. Spiegel joined the health system in 2013, after serving more than five years as CEO at Methodist University Hospital in Memphis, TN.

Academic affiliation

As the primary teaching hospital for the University of Tennessee College of Medicine's Chattanooga campus, Erlanger trains physicians enrolled annually in the medical college’s residency and fellowship programs. Enrollment for the 2015–2016 academic year includes 176 residents and 13 fellows. Medical students from the University of Tennessee Health Science Center in Memphis,TN may also elect a variety of clinical rotations at Erlanger. Nursing students, paramedic students, and many other allied health students also train at Erlanger in conjunction with the University of Tennessee at Chattanooga (UTC), Chattanooga State Technical Community College (CSTCC), and other regional colleges.

Level I Trauma Center

As a Level I trauma center, Erlanger meets state and national criteria^[3] to serve as a comprehensive regional resource for adult and pediatric patients suffering from major traumatic injuries. Erlanger is one of six Level 1 trauma centers in the state of Tennessee.

Erlanger serves as an essential safety net^[4] for the region, ensuring access to care for underserved and uninsured populations. The system provided $85 million in uncompensated care during fiscal year 2014–2015.^[5]

Hospitals, facilities, and practices

• Erlanger Baroness Hospital is the health system’s medical, academic, and administrative headquarters, located just east of downtown Chattanooga, TN. Baroness Hospital houses the system’s Level I trauma center, major in-patient and surgical departments, and ambulatory care center.
• Children’s Hospital at Erlanger is a Comprehensive Regional Pediatric Center (CRPC), designated by Tennessee to function at the highest level of medical and trauma care for children. It includes 21 pediatric subspecialties, a pediatric trauma center, emergency department, and Level IIII Neonatal Intensive Care Unit. The facility is located next to Erlanger Baroness Hospital.
• Erlanger East Hospital became the region’s first full-service lifestyle hospital with the completion of a $50 million expansion in 2016.The expansion includes a 58-bed patient tower providing medical/surgical care, a six-bed intensive care unit (ICU) and cardiovascular interventional radiology lab.Other services include 24/7 emergency care and women’s centers for breast health and obstetrics.
• Erlanger North Hospital is a community hospital serving Signal Mountain, Red Bank, and North Chattanooga communities. It offers 24/7 emergency care, sports and family medicine practices, an inpatient seniors program, and a sleep disorders center accredited by the American Academy of Sleep Medicine.
• Erlanger Bledsoe Hospital is a community and safety net hospital in Pikeville, TN, serving residents of a rural three-county area along the Cumberland Plateau and Sequatchie Valley. Services include 24/7 emergency care, family medicine practices, cardiac rehabilitation program, and a 25-bed inpatient unit.
• Erlanger Murphy Medical Center includes a 25-bed critical access hospital with emergency department as well as wound care, urgent care, and athletic/rehabilitation centers. The hospital provides inpatient and outpatient medical services for a seven-county region in western North Carolina, North Georgia, and East Tennessee.
• Erlanger Behavioral Health Hospital is an 88-bed mental health facility providing access to psychiatric and addiction services. Established through a joint-venture with Acadia Healthcare, the hospital opened in June of 2018.
• The Southside and Dodson Avenue Community Health Centers are safety-net clinical care providers operating under comprehensive federal standards.
• Erlanger Sequatchie Valley in Dunlap, TN, offers primary care and 24/7 emergency services, as well as weekly clinics for cardiology, orthopaedics, and women’s health.
• Erlanger at Volkswagen Drive is a multi-use health and wellness center that includes a family practice, a fitness center, adult urgent care, and childcare facility.
• Erlanger Medical Group is the health system’s physician practice consisting of more than 200 employed physicians in 56 locations. Physicians in this group also teach medical students through Erlanger’s affiliation with UT College of Medicine.

LIFE FORCE Air Medical

Bell 407 taking off from LIFE FORCE 4 base in McCaysville, GA

Erlanger’s six LIFE FORCE helicopters enable the health system to reach critically injured or ill patients within a 100-mile radius of Chattanooga.

Erlanger dispatches the aircraft from six bases outside of Hamilton County: Calhoun and Blue Ridge in Georgia; Sparta, Winchester, and Cleveland in Tennessee; and Andrews in North Carolina. The helicopters then transport pediatric and adult patients to Erlanger’s Level I Trauma Center at Baroness Hospital in Chattanooga.

Each aircraft is staffed by specialized flight nurses and paramedics, and is equipped to carry blood and perform in-flight surgical procedures.

In fiscal year 2014-2015, LIFE FORCE transported 2,143 patients to and from Erlanger hospitals.

LIFE FORCE began operations at Erlanger in December 1988. In 2008, Med-Trans Corp., a Dallas-based air medical provider, began operating the program under a 10-year lease agreement.

LIFE FORCE uses Eurocopter EC-135 (now Airbus Helicopters H135) and Bell 407 helicopters.

Specialized Centers of Excellence

As a tertiary hospital that receives primary and secondary referrals, Erlanger provides specialized medical care, research, and educational training in the following clinical centers of excellence:

• Neurosciences – This department includes the Southeast Regional Stroke Center at Erlanger, which is certified by the Joint Commission as a comprehensive program. At the 2015 International Stroke Conference, the program was recognized for clinical research supporting the efficacy of neurointerventional stroke care.^[6] Other sub-specialties include neurosurgery, neuromuscular medicine, sleep medicine, movement disorders, and epilepsy care.
• Pediatrics - See Children's Hospital at Erlanger.
• Trauma – Erlanger is a Level I Trauma Center treating critically ill and traumatically injured patients in a 63-county service area. The health system also serves as a tertiary care facility central to the area’s Regional Trauma System covering Tennessee, Georgia, Alabama, and North Carolina.
• Orthopaedics – In addition to treating patients, Erlanger’s fellowship-trained orthopaedic surgeons provide coverage for the system’s Level I trauma center and serve as sports medicine doctors for professional, Olympic, and regional sports teams. Specializations include minimally-invasive, arthroscopic surgery, total and partial joint replacement, and lower-extremity deformity correction through the UT Erlanger Foot and Ankle Institute.
• Urology – This academic group treats general and pediatric urologic disorders as well as bladder, pelvic and men’s health issues. The center also specializes in robotic, minimally-invasive techniques for treating cancers of the kidney, bladder, and prostate.
• Oncology – Accredited by the American College of Surgeons, Erlanger’s oncology department provides multidisciplinary cancer treatment in which medical, radiation, and surgical oncologists review each case in weekly tumor board reviews. The program includes five-day, targeted radiation therapy for early-stage breast cancer and robotic-assisted radiation therapy.
• Cardiology – Erlanger’s Heart and Lung Institute is a regional referral center for patients with complex cardiovascular conditions. Subspecialties include preventive cardiology, electrophysiology, heart failure, women’s cardiology, vascular/structural heart disease, and advanced imaging.
• Emergency – Erlanger operates 24/7 emergency centers at each of its five hospitals as well as a free-standing emergency facility in Dunlap, TN. In 2015 and 2016, Erlanger was named “Best Emergency Room” in The Chattanooga Times-Free Press “Best of the Best” awards.^[7] That year the health system also established the $1.6 million Erlanger Regional Operations Center (EROC) to provide medical support, dispatch, and control for emergency medical services across Southeast Tennessee.
• Primary Care – Erlanger operates 16 primary care and family medicine practices across the region. Services include acute care, chronic disease management, preventive care, and sports medicine.
• Women’s Care and Childbirth – Erlanger Baroness Hospital is a tertiary level III care center for high-risk obstetrics, and also provides labor and delivery services for low-risk patients. Erlanger East Hospital offers single-room maternity care for vaginal deliveries, surgical facilities for C-sections, and a Level IIA special care nursery. Erlanger was the first health system in Tennessee to achieve “Baby Friendly” accreditation for best-practices in breastfeeding education.^[8] Erlanger East was named “Best Place to Have a Baby” in the 2017 “Best of the Best” people’s-choice awards sponsored by the Chattanooga Times-Free Press.^[9]
• Bariatrics - Erlanger's Metabolic and Bariatric Center is an accredited comprehensive center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Emphasizing education, support and life-long weight loss, the center is staffed by bariatric surgeons, dietitian, life coach, nurses, and bariatric navigators.

History

Photo of Erlanger Hospital taken in the late 1800s

1889 – Baron Frédéric Emile d'Erlanger, a European financier with railroad holdings in Chattanooga, TN, donates $5,000 ($131,600 in today’s dollars) to establish the region’s first permanent hospital.

1890 – Civic leaders work to raise the rest of the money to build the facility, and begin construction on a four-acre tract on Harrison Avenue, now East 3rd Street.

1891 – Community leaders hold a cornerstone ceremony to celebrate completion of the building’s foundation. They decide to name the facility in honor of the Baron’s Southern-born wife, Baroness Marguerite Mathilde Slidell d’Erlanger.

1899 – At a cost of $50,000 ($1.3 million in today’s dollars), Baroness Erlanger Hospital opens with 72 beds.^[10]

1957 – The two oldest portions of the hospital, the original west and central wings, are razed to make way for expanded in-patient and surgical facilities.

2007 – U.S. President George W. Bush tours Erlanger Baroness Hospital, where he is briefed on the latest advancements in stroke treatment and receives a hands-on demonstration of the da Vinci robotic surgical system. During a healthcare forum at the Chattanooga Convention Center, President Bush expresses admiration for Erlanger’s commitment to cutting-edge care.

2014 – Erlanger announces plans for the largest expansion in its history.^[11] The six-phase, 20-year master facilities plan includes a $51 million expansion of Erlanger East Hospital, a 100,000-square-foot children’s and women’s ambulatory center, an 85,000-square-foot stroke and neurosciences center, a new Children’s and Women’s hospital, and a health sciences center to house Chattanooga facilities of UT College of Medicine.

2016 – In a year marking the health system's 125 year of service to the region, Erlanger and Vanderbilt University Medical Center (VUMC) enter a strategic affiliation agreement creating a collaborative relationship between the two institutions. As part of the agreement, Erlanger also joined the Vanderbilt Health Affiliated Network, to facilitate greater care coordination, including population health and wellness initiatives.^[12] In Nov. of 2016, the health system completed a $50 million expansion of Erlanger East Hospital, creating the region’s first full-service, lifestyle hospital,^[13] That month Erlanger also launched a new Heart and Lung Institute, expanding the health system’s cardiovascular team, capabilities, and facilities.^[14]

2017 – Community and health system officials break ground on a 90,000-square-foot pediatric outpatient center at Erlanger's downtown campus. The facility is phase one of plans for a new Children's Hospital at Erlanger.^[15]

2018 – On April 1, 2018 Erlanger assumed operation of Murphy Medical Center in Murphy, N.C. It is the health system’s sixth hospital and its first outside of Tennessee.

Statistics

For fiscal year 2014–2015, Erlanger Health System revenues exceeded expenses by $37.4 million. Significant fiscal activity during the year also included the sale $149.9 million in bonds in late 2014.^[16]

• Gross Revenue $2,120,121,222
• Payroll & benefits: $320,445,596
• Operating expenses: $630,380,620
• Uncompensated care: $89,712,165
• More than 5,686 employees
• More than 1,850 nurses
• 211 employed physicians; 935 staff physicians
• 974 licenses beds
• 72% market share of births
• 35,237 admissions
• 230,765 physician office visits
• 131,978 emergency department visits

Accreditations, certifications, and awards

Accreditations

• Accredited NAPBC Breast Center – Erlanger Center for Breast Health, by the American College of Surgeons 2018^[17]
• Accredited Hospital and Critical Access Hospital – Erlanger Health System; by The Joint Commission, 2015^[18]
• Level I Trauma Center – Erlanger Health System; by the State of Tennessee, 2015
• Certified Comprehensive Stroke Center – Erlanger Southeast Regional Stroke Center; by The Joint Commission, 2015^[19]
• Certified Acute Myocardial Infarction (AMI) Program – Erlanger Medical Center; by The Joint Commission^[20]
• Accredited Comprehensive Cancer Program – Erlanger Health System; by the American College of Surgeons Commission on Cancer, 2015^[21]
• Accredited Comprehensive Bariatric Center – Erlanger Metabolic and Bariatric Surgery Program; by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), 2015^[22]
• Baby-Friendly Designation – Erlanger Baroness Hospital; Baby Friendly, USA, Inc., 2015^[23]
• Accredited in Mammography and Ultrasound Center – Erlanger Imaging Mammography Center, Erlanger North Breast Center and Erlanger East Imaging; by the American College of Radiology, 2014/2015^[24]
• Accredited Clinical Hyperbaric Medicine Facility – UT Erlanger Wound Care & Hyperbaric Medicine Center; Undersea and Hyperbaric Medical Society, 2015^[25]
• Accredited Critical Care Air Transport Service – Erlanger LIFE FORCE Air Medical; Commission on Accreditation of Medical Transportation System (CAMTS), 2015^[26]
• Perinatal Care Certification – Erlanger Baroness and Erlanger East hospitals; by The Joint Commission, 2016^[27]

Awards

• Silver Plus "Get With The Guidelines" for Stroke – Erlanger Health System; from The Joint Commission, 2014^[28]
• Gold-level Certified Safe Sleep Champion – Erlanger Baroness and East Hospitals; from the Cribs for Kids® National Infant Safe Sleep Initiative, 2015^[29]
• Service of the Year Award for outstanding emergency medical services – Erlanger LIFE FORCE air medical program; from the Southeastern EMS Director’s Association, 2015

References