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How to recognize when your trauma center is in jeopardy

July 12, 2021
Emergency Medicine
Image source: Philips
By Angie Chisolm

Trauma centers should not run the risk of closing, downgrading, or receiving a follow up focused review from being ill prepared for their site visit, the on-site review that verifies or designates their center’s resources and processes to care for trauma patients. It’s not uncommon to hear stories of trauma centers at risk of losing their designation or verification for failure to adhere to the essential requirements and standards.

No program is perfect. In fact, hospitals should have a continuous improvement process in place with documentation of performance improvement activities. The minimum standards of designation or verification must be in place, or hospitals face the real possibility of their trauma center closing, downgrading, or receiving unintended provisional status. Any of these outcomes are costly to the organization.

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Designation and verification
Obtaining state designation and/or American College of Surgeons Committee on Trauma (ACS-COT) verification requires allocation of hospital resources in many areas. It also mandates complete “buy in” at all levels, most importantly from members of the departments of surgery, emergency medicine, anesthesia, radiology and nursing. Operating a trauma center requires financial and operational commitment by the hospital leadership, physician staff and board of directors.

To achieve trauma center designation or verification, a review of the hospital’s performance is required by the state (for designation) and the ACS (for verification). The state designation of trauma centers is a regulatory and bureaucratic process performed by state government agencies. Not all states require a designation process, deferring to the ACS verification instead.

The ACS Verification, Review, and Consultation Program (VRC) helps hospitals evaluate and improve trauma care. It provides an objective, external review of a trauma center’s resources and performance. A team of ACS trauma experts completes an on-site review of the hospital. The team assesses relevant features of the program. These include commitment, readiness, resources, policies, patient care and performance improvement. Proper trauma center verification takes a substantial amount of time and money, which is why it is imperative to get it right the first time.

Avoid the most common mistakes
The most common areas that lead to failure include non-compliance with registry data abstraction, failure to demonstrate loop closure through performance improvement activities, or allowing physicians without the proper credentials to be on the trauma call panel.

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