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VRC Criteria Type I for Pediatric Level I
Effective May 1, 2007, the updated criteria for trauma center verification outlined in the Resources for Optimal Care of the Injured Patient: 2006 go into effect. In addition, the Committee on Trauma (COT) of the American College of Surgeons has made substantive changes to the outcomes of a verification site visit in order to better serve the trauma community. These changes also go into effect May 1, 2007, and are detailed below.
Outcomes of Verification
Previously, after completion of a verification or re-verification site visit a trauma center was either “verified” (certificate for three years) or “not verified.” One of the current missions of the Verification Review Committee (VRC) is to provide guidance and recommendations for trauma programs during the site visit process, while at the same time verifying that the essential criteria of a trauma center are in place. With this emphasis the COT has added a third category as an outcome to a verification site visit. This category is “verified” with a certificate of verification for one year. This category is further described below and in the attached outline entitled Verification Site Visit Outcomes.
Type I and Type II Criteria
One of the most significant changes is the identification of the essential requirements as Type I and Type II criteria (or deficiencies). Type I criteria must be in place at the time of the verification site visit in order to achieve verification. Type II criteria are also required, but are less urgent criteria. If three or less Type II deficiencies are present at the time of the site visit, a one year certificate of verification will be issued, during which time if the trauma center successfully corrects the deficiencies, the period of verification will be extended to three years from the date of the initial verification visit.
If any Type I deficiency or more than three Type II deficiencies are present at the time of the initial verification site visit, the hospital is not verified. As in the past, a successful Focus Review would be required in order to achieve verification. The Focus Review must occur 6 to 12 months from the date of the notification.
Site Visit Report
The format and the executive summary of the site visit report will not change. The final results of the site visit (including identification of Type I and Type II criteria or deficiencies) will be determined by the VRC. The findings will be noted in the VRC’s letter to the hospital after the report has been reviewed by the committee.
This new process will be continually evaluated and future revisions of specific criteria or requirements included in each category may be necessary.
Frank (Tres) L. Mitchell, III, MD, MHA, FACS
Chair, Verification Review Committee
Verification Site Visit Outcomes
| Pediatric Level I |
Chapter |
Requirement by Chapter |
|
| ∙ |
10 |
10-2 A Level I pediatric trauma center must annually admit 200 or more injured children younger than 15 years. |
TYPE I |
| ∙ |
10 |
10-4 and 10-5 All pediatric trauma centers must have a pediatric trauma program manager or coordinator and a pediatric trauma registrar. |
TYPE I |
| ∙ |
10 |
10-7 All pediatric trauma centers must have a pediatric trauma PIPS program. |
TYPE I |
| ∙ |
10 |
10-10 A Level I pediatric trauma center must have at least 2 surgeons who are board-certified or board-eligible in pediatric surgery by the American Board of Surgery |
TYPE I |
| ∙ |
10 |
10-11 and 10-12 There must be 1 board-certified or board-eligible orthopaedic surgeon and 1 board-certified or board-eligible neurosurgeon on staff who have had pediatric fellowship training. |
TYPE I |
| ∙ |
10 |
See CD 10-11 |
TYPE I |
| ∙ |
10 |
10-15 There must be 2 physicians who are board-certified or board-eligible in pediatric critical care medicine or in pediatric surgery and surgical critical care by the American Board of Surgery. |
TYPE I |
| ∙ |
10 |
10-22 and 10-23 In a Level I pediatric trauma center, the pediatric trauma medical director must have successfully completed board examinations in general surgery and be board-certified or board-eligible in pediatric surgery. |
TYPE I |
| ∙ |
10 |
See CD 10-22 |
TYPE I |
| ∙ |
10 |
10-24 There are non-pediatric trained surgeons serving on the pediatric panel with proper qualifications: (1) credentialed by the hospital to provide pediatric trauma care, (2) members of the adult trauma panel, (3) the pediatric trauma medical director has agreed to their having sufficient training and experience in pediatric trauma care, and (4) their performance has been reviewed by the pediatric PIPS program. |
TYPE I |
| ∙ |
10 |
10-25 For Level I and II pediatric trauma centers, it is expected that the trauma surgeon be in the emergency department on patient arrival, with adequate advance notification from the field. The maximum acceptable response time is 15 minutes. Response time will be tracked from patient arrival rather than from notification or activation. An 80% attendance threshold must be met for the highest level of activation. |
TYPE I |
| ∙ |
10 |
10-28 An organized pediatric trauma service led by a pediatric trauma medical director must be present. |
TYPE I |
| ∙ |
10 |
10-33 There must be a multidisciplinary peer review committee with participation by the trauma medical director or designee and representatives from pediatric/general surgery, orthopaedic surgery, neurosurgery, emergency medicine, critical care medicine, and anesthesia to improve trauma care by reviewing selected deaths, complications, and sentinel events with the objectives of identification of issues and appropriate responses. |
TYPE I |
Online June 7, 2007
Consultation/Verification Programs for Hospitals
Trauma Programs
This page and all contents are Copyright © 2007
by the American College of Surgeons, Chicago, IL 60611-3211
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