Recent changes in health care economics have made trauma
center designation generally more desirable, and certain areas have
developed a perceived oversupply of high-level trauma centers with
potentially adverse effects on cost and efficiency of patient care.
• The lead agency should be guided by the local needs of
the region(s) for which it provides oversight. As such, it
is the responsibility of physicians, nurses, prehospital
health care providers, and their respective organizations to advocate for the interests of the patients and
citizens they serve throughout the entire region. The
collective interests of these citizens and patients supersede the interests of the providers and their respective
•Trauma center designation should be guided by the
regional trauma plan based upon the needs of the population being served, rather than the needs of individual
health care organizations or hospital groups. It is the
professional obligation of the surgeons, physicians,
nurses, emergency medical services (EMS) providers,
and public health professionals to work together to
ensure that the patients’ needs come first.
• Trauma system needs should be assessed using measures of trauma system access, quality of patient care,
population mortality rates, and trauma system efficiency. Possible measures to be considered include:
Ȗ Number of Level I and Level II centers per
Ȗ Percentage of population within 60 minutes of a
Level I/Level II center
Ȗ EMS transport times
Ȗ Percentage of severely injured patients seen at a
Ȗ Trauma-related mortality
Ȗ Frequency and nature of inter-hospital transfers
Ȗ Percentage of time trauma hospitals are on
•Allocation of trauma centers should be reassessed on
a regular schedule based on an updated assessment of
trauma system needs.
• The applicability of specific metrics and benchmarks
for trauma care resources, as well as the resources
available to meet these needs, will vary from region
to region; the details of the needs assessment methodology and regional trauma center designation criteria
should be derived through a broad-based, locally driven
consensus process that is balanced, fair, and equitable.
•An international group of recognized experts, stakeholders, and policymakers should be convened to discuss and plan for optimal future regional trauma system development.