Since our founding, the ACS has espoused a broad and bold vision for surgical care.
In 1913, ACS founder Franklin H. Martin, MD, FACS, and his colleagues united to advance the extraordinary goal of ensuring excellence among surgeons and hospitals worldwide. At the time, medicine was just discovering effective antiseptics, many hospitals had only rudimentary infrastructure, and surgical education was inconsistent. Nonetheless, Dr. Martin and his colleagues recognized the possibility of advancing surgical care.
Their impact was impressive. Within a few years, the ACS had connected with surgeons on multiple continents, created some of the earliest quality programs and data registries, and advocated directly to the US President, in addition to establishing our flagship surgical conference, Clinical Congress.
Today, the same ambitious spirit of innovation undergirds how the ACS approaches opportunities to strengthen and transform surgical care. One example is our effort to deliver better trauma care throughout the US by developing a National Trauma and Emergency Preparedness System (NTEPS) and Regional Medical Operations Coordination Centers (RMOCCs).
NTEPS and RMOCCs
During the COVID-19 pandemic, many trauma surgeons, based on their expertise with multi-casualty disasters, began working with medical operations coordination centers (MOCCs). These centers managed surges in patient volume by facilitating coordination across healthcare systems and regions. This helped ensure critical resources and information were distributed efficiently and equitably, and patients received the best care available.
The ACS is now expanding upon this concept with NTEPS and RMOCCs, which would create permanent coordination of trauma care. Each RMOCC would serve as a foundational component of a national system coordinating responses to both daily trauma needs and mass casualty incidents. NTEPS would also strengthen the role of emergency medical services, engage community stakeholders, and implement evidence-based improvement.
Why Is Improved Coordination Necessary?
This plan is bold and necessary.
Our current trauma system is largely fragmented across more than 2,000 trauma centers, with high variability in access, quality, and continuity of care. Few mechanisms connect centers across regions or states. While most trauma teams deliver exceptional care, many systems and teams operate under strained resources or conditions.
Improved coordination can save lives. MOCCs operating during the pandemic were estimated to reduce mortality by 25%. As COVID-19 showed, these challenges become more consequential when emergencies arise.
Growing concerns about large-scale armed conflict underscore the need to strengthen the current system. Despite the large size of the US healthcare system, if war were to occur domestically or if military forces abroad sustained significant injuries, our existing trauma beds would be quickly overwhelmed. Addressing vulnerabilities requires meaningful improvement before war occurs.
A recent meta-analysis revealed that if optimal trauma care were available to all patients, an estimated 20% of trauma-related deaths could be prevented, saving approximately 40,000 lives per year.
How the ACS Is Involved
The ACS is well-positioned to lead the effort to create NTEPS and RMOCCs because of our longstanding, far-reaching leadership in trauma care.
For more than a century, the ACS has worked to improve trauma care via the Committee on Trauma (COT). We have established a global standard for trauma care through the Advanced Trauma Life Support® course, now in its 11th edition and approaching its 50th anniversary. We have advocated successfully for building US military-civilian partnerships in trauma surgery, including supporting the MISSION ZERO Act.
Most importantly, we know our work saves lives. The ACS Trauma Quality Improvement Program has more than 1,000 participating hospitals, and studies consistently show that patients who receive trauma care at ACS-verified centers have an improved chance of survival and better outcomes when compared to those receiving care at nonverified centers.
What Has Been Achieved Thus Far
In 2022, the ACS COT, then led by Chair Eileen M. Bulger, MD, FACS, and Medical Director Ronald M. Stewart, MD, FACS, released a blueprint for NTEPS. (The COT updated the document in 2025.)
Over the subsequent 4 years, under the leadership of Chair Jeffrey D. Kerby, MD, PhD, FACS, the COT laid further groundwork. They engaged with the National Institute for Defense Health Cooperation (NIDHC), which implemented the federal National Disaster Medical System pilot program to ensure military and civilian health operations readiness during conflict and crisis. These conversations established that, despite substantial progress in military health system preparedness, critical gaps remained in coordination and readiness among civilian hospitals.
As a result, the NIDHC has secured Congressional funding through the National Defense Authorization Act for 15 federally funded, civilian-led RMOCCs in strategic locations nationwide. The ACS will participate in establishing these centers, which will support approximately a third of trauma beds nationwide.
Additionally, the ACS blueprint and grassroots efforts have helped influence the ongoing development of independent RMOCCs in South Texas, rural Kentucky, and elsewhere. The ACS will also support these efforts, which will help realize the vision of NTEPS.
Under the current leadership of Chair Kristan L. Staudenmayer, MD, MS, FACS, the COT continues to refine and strengthen this work. Current priorities include addressing the financial sustainability of RMOCCs, ongoing federal advocacy, and strategies for longer-term implementation.
Transformative and Practical
It is undoubtedly ambitious to unite more than 2,000 trauma centers to address the daily demands of trauma care and the potential for a large-scale armed conflict. That said, the pursuit of this goal is practical, evidence-based, and grounded in realism about the capacity of the ACS to address national needs.
In this way, it echoes the insights that motivated Dr. Franklin Martin and his peers so many years ago. Through our ambitious pursuit of excellence, the ACS and its members have the capacity to transform surgical care for the better and truly Heal All with Skill and Trust.
Clinical Congress
Registration is now open for Clinical Congress 2026. Please join us in Washington, DC, September 26–29, for sessions on myriad surgical topics, many of which are urgent, transformative, and within our reach. Learn more at facs.org/clincon2026.
QSCC
This year, our first joint Quality, Safety & Cancer Conference (QSCC) will explore the theme “QI Powered by AI.” Join us in Orlando, Florida, July 30–August 2, for sessions on quality, safety, and cancer care. Register today at facs.org/QSCC26.
