Allina Health is in the unusual position of publicly quarreling with doctors and nurses over plans to halt intensive care at the Unity hospital campus in Fridley and whether it will hurt an overburdened ambulance system in the north metro.

Unity's patients will be transferred nine miles to Allina's Mercy Hospital in Coon Rapids if they end up needing intensive care, but caregivers said that could prove harmful because ambulances aren't always available.

"Ambulance transfers between Unity and Mercy take hours, even when the patient status is critical," said Gail Olson, a nurse at Unity for three decades. "Reducing Unity's ability to care for critically ill patients will make this worse."

The grievance spilled out earlier this month when a recently unionized group of Allina doctors joined with nurses and others to protest the health system's changes to Mercy and Unity, which are licensed as a single hospital with two campuses.

Allina leaders said the changes, including the elimination of inpatient pediatric beds, will replace underutilized services with those that can reduce hospital overcrowding and backlogs in the emergency room. More details are expected at a public hearing Tuesday.

Patients too often are "boarding" in ER bays while waiting for inpatient beds to open up, said Dr. Jay MacGregor, Allina's vice president of medical affairs for both campuses. "That is something we need to be very proactive about solving."

How hospital changes affect 911 response is a concern. Response times in the Twin Cities held steady from 2022 to 2023, when ambulances took about 10 minutes to arrive at emergency scenes in Hennepin County and 11 minutes in Anoka County, according to a report from Minnesota's Emergency Medical Services Regulatory Board. But EMS leaders have raised concerns about the increasing requests to transfer patients when their agencies are running short on drivers and paramedics and need to prioritize emergencies.

MacGregor said the number of ambulance transfers is a problem that has worsened with the overcrowding and boarding in hospitals. More than 3,000 patients are transferred between the Mercy and Unity campuses each year, according to state EMS data. Many involve patients with psychiatric crises who are taken to Unity, which houses all of the inpatient mental health and substance abuse beds on the two-hospital campus.

Transfer times from Unity to Mercy have increased on average from 88 minutes in 2021 to 115 minutes so far this year, state data shows.

MacGregor said he believes that Allina's changes actually will reduce transfers and delays. Unity since its 2016 merger with Mercy has lost the staffing to provide 24-7 intensive care, so some critically ill patients already have to be moved on weekends or at other times, MacGregor said.

Consolidating ICU care at Mercy will result in more patients with critical care needs going to Coon Rapids first, he said. "We really want our patients to go to one location and stay there."

Unity will maintain a special care unit that can provide advanced care, but not long-term treatment of the sickest patients, such as those who are dependent on mechanical ventilators.

Hospitals have merged under one license in other areas to conserve funds and eliminate redundant or underused services. Allina also merged Regina Hospital in Hastings with United Hospital in St. Paul, and Mayo combined its southeast Minnesota hospitals in Austin and Albert Lea.

Even so, eliminating intensive care would be an unusual step at a hospital campus the size of Unity. While it is no longer a standalone hospital, Unity operates 150 beds and almost every U.S. hospital that size has intensive care beds, federal data shows.

Any hospital that size is going to have patients who deteriorate and need intensive care urgently, said Dr. Alia Sharif, a hospitalist who treats patients admitted to the Fridley campus. "Unity ... needs to have an intensive care unit."

The public dispute is the first since Mercy's inpatient doctors voted to unionize and be represented by the New York-based Doctor's Council. Several physicians said the union movement allows them to be more vocal against changes they think are hurting health care in their hospitals.