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Saving Children’s Lives – NICU Updates

Ballad Health’s planned neonatal intensive care unit improvements


As part of the systemwide improvements that Ballad Health is making to the delivery of healthcare across the region, we are focused on enhancing pediatric care for the thousands of children and families we serve.

One of the improvements we are making is to realign our level III neonatal intensive care (NICU) services at Niswonger Children’s Hospital, where high-risk newborns can benefit from the expertise provided at the region’s state-designated perinatal center.

Realigning these services to Niswonger Children’s means the most high-risk babies born in our region will have access to everything they need in one place.

This decision was made very thoughtfully, in consultation with other physicians, pediatric care providers, experts, and after reviewing our own region’s data and anticipated needs to determine a solution for pediatric care designed with our communities in mind.

We know changes like these raise important questions. Please reach out to us, and we will do our best to make sure you get the information you need.

Why we’re making these improvements

Realigning our NICU services is one critical part of our systemwide commitment to save lives and improve quality of life for those we serve – including the most vulnerable and high-risk babies born in our region.

Studies have shown that focusing higher-acuity services in one location improves outcomes and reduces costs. By increasing the volume of care and number of specialists at single site, we can improve the quality of newborn care we provide.

Both Holston Valley Medical Center and Niswonger Children’s have seen a decline in inpatient NICU use – largely because of our focus on prevention, outreach and better prenatal care. However, the declining need leads to challenges in providing adequate staffing and services for two NICUs so close together.

  • Holston Valley currently operates 15 NICU beds with an average daily census of 8 babies.
  • Niswonger currently operates 39 NICU beds with an average daily census of 27 babies.

The American Academy of Pediatrics strongly advocates for the regionalization of NICU services by concentrating care for the sickest newborns in high volume specialty centers.

While both Holston Valley and Niswonger Children’s Hospital have provided important services for the region, Niswonger Children’s Hospital’s level III NICU is far more comprehensive and can provide these high-risk babies with the latest technology solutions such as nitric oxide administration and whole-body cooling for brain injuries as well as onsite access to pediatric specific specialists, including:

...none of which are available today at Holston Valley or any other Ballad Health hospital. All of these services are critical when it comes to helping the most vulnerable babies in our region.

Because Holston Valley does not offer these specialized services for newborns, prior to our merger, high risk infants requiring pediatric physician specialist care were transferred from Holston Valley to Knoxville for care.

Now, by working together as a unified system, we are able to provide care for these infants much closer to home at Niswonger Children’s Hospital, the region’s state-designated perinatal center.

Our advancements

Importantly, these improvements apply only to babies born with serious health issues requiring intensive care. We are maintaining newborn services and nurseries at our hospitals throughout the region. Healthy babies, or babies born with minor complications, will still receive the excellent care they need at our nurseries in Kingsport, Bristol, Johnson City, Greeneville, Abingdon and Wise County, VA.

We are committed to expanding and investing in the services we provide today at Niswonger Children’s.

We are actively recruiting for additional pediatric specialists to add new services and expand current coverage including:

  • Pediatric surgery
  • Pediatric gastroenterology
  • Pediatric pulmonology
  • Pediatric neurology
  • Pediatric ENT
  • Pediatric urology
  • Pediatric neurosurgery
  • Pediatric ophthalmology
  • Child abuse specialists

These improvements will be made deliberately over the next few months. There will be no job reductions for nurses because of these improvements – there will be a position for every nurse who wishes to continue working with Ballad Health.

Our goal is to save lives and improve quality of life for high-risk babies in our region. We have these excellent, advanced services right here in the Tri-Cities. Fortunately, there is no need for families to drive to Knoxville when already dealing with a stressful and overwhelming situation.

By coordinating our perinatal services as a unified system, we will be better equipped to conduct research, outreach, and prevention efforts geared toward preventing premature birth and ensuring successful outcomes for newborns through proactive prenatal care initiatives.

Have a question or comment?

Read frequently asked questions about the NICU improvements.

Or use the contact form here to reach out about the new Regional Trauma and Emergency System or other improvements.