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Thu Oct 5 17:27:12 BST 2006

Re:  ACS and "local" designation.  There is NO state or system that
calls trauma centers "certified".   There are a number of states that
have established their own trauma center standards (IL, WA, OR, MD, PA,
and more) by adapting the ACS guidelines to the rural nature of their
state and DESIGNATE trauma centers.  The differences are minor for the
most part.  I know of no system that would call a hospital a Level II
that would otherwise only be an ACS Level IV.  

Cost has been a factor, but mostly this is driven by the rural nature of
the state and weak evidence basis for some ACS standards which are being
reviewed.  These same states have been involved in peer-reviewed
published research by some of the most respected clinicians and
researchers in the nation (Mullins, Jurkovich, Nathens et al) and cited
repeatedly by Federal agencies and others to justify the need to trauma
centers and systems.  To say that the ACS is the only "temperature" to
take is like comparing oral to axillary.  For example, Maryland,
Washington, and Oregon, three of the few states that meet all of the
West, et al, criteria, do not use the ACS verification process.
California designates by county, and each can use ACS or develop its own
process.  

This differentiation is counterproductive when, by working together,
trauma would be further ahead than its current mostly unfunded and
unappreciated condition.   We should be more worried about the growing
number of trauma centers opting out entirely or "downgrading" their
status than "who is on whose list".   If you only use the ACS list you
will miss a large number of centers providing excellent trauma care
under state or other designation.  

To researchers: The NFTC, a non-profit trade association, can provide a
list and addresses of LI-III designated or ACS verified trauma centers
to a bona fide researcher once their research intent is approved by our
Board and an agreement as to the use of the list is signed.  We can
identify which are ACS or "designated".  Re: PA's, I also suggest you
contact Dr. Mary McCarthy at Miami Valley Hospital who has already
conducted a study on mid-level practitioners. 

Connie Potter, Executive Director
National Foundation for Trauma Care
(505) 525-9511

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-----Original Message-----
From: Bjorn, Pret [mailto:pbjorn at emh.org] 
Sent: Wednesday, October 04, 2006 6:15 AM
To: Trauma &amp; Critical Care mailing list
Subject: RE: Request for Research Project

If this is a research project, you should be aware that combining lists
of verified (ACS) and certified (local system) centers is an expressway
to invalidity.  

Some ACS Level II's are system Level I's, and MANY system Level II's are
ACS Level III's or IV's.  It's like combining lists of Fahrenheit and
Centigrade temperatures, with three quarters of the Centigrades being
inverted and/or unpredictably fudge-factored.  Analysis becomes dark
comedy.

Trust me; we've been included in any number of benchmark groups where
hospitals declare their trauma center status without qualification.
Sadly, the same mistake appears in published research too frequently.
The comparison products are worse than useless.

Make it easy on yourself; stick to the ACS list.  Whatever its flaws,
it's the most reliable collection out there.

Pret Bjorn, RN
Trauma Coordinator
EMMC Trauma Program
(MEMS Level I, ACS Level II)

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of
adjohnston at wichita.edu
Sent: Tuesday, October 03, 2006 9:46 PM
To: trauma-list at trauma.org
Subject: Request for Research Project

Hello

My name is Angela Johnston, I am a First Year PA student at Wichita
State University in Wichita Kansas.  I am currently working on my
Research Project and am looking at the prevalence of Physician
Assistants and Nurse Practitioners in Level 1 Trauma Centers. 

I am needing to get a list of all ( I know that is a big word) the Level
1 (and maybe Level 2) Trauma Centers in the United States.  If you know
of a resource that I could use or which direction to start going in, I
would greatly appreciate it.
I have a list of ACS Trauma Centers, but was also needing the facilities
that are not accredited through ACS.

Again, any direction would be very helpful.

Thank you
Angela Johnston, WSU PA Student
adjohnston at wichita.edu
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ACS or local designation