List Archives

Thu Oct 5 17:09:02 BST 2006

----- Original Message -----
From: "Connie Potter" <Connie at traumafoundation.org>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Thursday, October 05, 2006 4:27 PM
Subject: ACS or local designation

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.

Connie,

If you think the differences are "minor for the most part," then you've got
to get out more.

Maine's is one example of a binary, inclusive, voluntary system, resulting
in two levels of trauma hospital: the Regional Trauma Center and the Trauma
System Hospital.  Many administrative spokespersons at Trauma System
Hospitals, when asked what level their hospital is, have no familiarity with
any sort of third or fourth level, and will therefore predictably answer
"Level II."   When sophisticated system members answer, correctly, that
they're Trauma System Hospitals, the surveyors aren't left with a box they
can check.  Some will throw a dart into Level III or IV (and be right about
half the time), some will talk the System Hospital into Level II, some will
leave a blank.  I've seen it happen countless times.

Likewise when my hospital -- a regional trauma center -- is asked the same
question, we struggle to explain the various
designation/certification/verification constructs which exist.  We are a
Maine RTC, which is Level I within our binary system (which can't be
properly compared to Texas or Wyoming or California or Illinois); but we are
ACS Level II, which is the only reliable common frame of reference.  When
I'm done explaining this, the questioner invariably asks, "So which level
are you?"

Whatever you claim to know, or believe has been established in the
literature, there are no reliable common denominators for trauma center
capability outside of the only international verifying body, that being the
ACS.  It's not about belonging to anybody's list; it's about structural,
functional, and cultural differences from system to system.  We can agree
that systems improve patient care; but we can't compare systems without
describing standards -- and simply having a system does not describe
anything close to a standard.

Pret

List Archives

For your convenience, find the Trauma List Archive Below

ACS or local designation