Mass vs NH vs Conn. Trauma Stds

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Maine's trauma system uses ACS level I or II verification as criteria
for "Regional Trauma Center" designation.  There are three RTC's in
Maine: Portland (ACS level I), Lewiston (level II) and Bangor (likewise,
level II).

All other hospitals are non-verified, but pretty much any among them
would qualify as ACS level III or IV.  The system is voluntary and
inclusive by necessity, owing to the state's geography (big and sparsely
populated), economy (poor), and disease-related demographics (relatively
old and frightfully blunt-mechanism).  

In short, any licensed hospital with a 24/7 ED is -- by default -- a
"Trauma System Hospital."  Disqualifying any of these (often very
remote) hospitals would surely cause more M&M than it might ever hope to
prevent.  Instead, the system relies on the RTC's to provide education
and performance improvement to their respective service areas: feedback,
outreach, CME, and so forth.  

Because the system is binary, some hospitals will self-identify as
"level II trauma centers."  Apart from being a little confusing to folks
outside of the system (like survey-takers), it's a fairly harmless
choice of terms for marketing and recruiting.  Sometimes it's just
misspeach. 

Where the trauma system is concerned, there are no differences between
ACS levels I and II: an RTC is and RTC, representing the tertiary care
target for all major injuries throughout the respective rural service
area.  This basically aligns with generations of prudent practice: the
three RTC's find themselves at the bottom of regional service area
"funnels."  

There's considerably more to the system, of course; but that's the
30,000-foot view.

Pret Bjorn, RN
Trauma Coordinator
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
Sent: Sunday, August 19, 2007 6:24 PM
To: SURGINET at listserv.utoronto.ca
Cc: trauma-list at trauma.org
Subject: Mass vs NH vs Conn. Trauma Stds

I know what was intended by the ACS regarding Level 1, Level 2, and
Level 3 trauma centers, but I am curious about Massachusetts, New
Hampshire, Connecticut, Maine, etc., Is there a quality difference for
general surgery trauma cases, neurosurgery cases, etc. between a Level I
and a  Level II trauma center as defined by the State Health Departments
in the North  Eastern states...
 

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