The American College of Surgeons' (ACS’) long history of activities directed toward the improvement of trauma care was enhanced substantially in 1987 with the creation of the Consultation/Verification Program. This program validates the resources for trauma care at trauma centers. The program is administered by the Consultation/Verification Ad Hoc Committee of the ACS Committee on Trauma (COT), commonly referred to as the Verification Review Committee.
Resources for Optimal Care of the Injured Patient outlines the resources necessary for optimal care and is used as a guide for the development of trauma centers throughout the United States. It is the document by which trauma centers are reviewed by the ACS-approved site surveyors.
The designation of trauma facilities is a geopolitical process by which empowered entities, government or otherwise, are authorized to designate. The ACS does not designate trauma centers; instead, it verifies the presence of the resources listed in Resources for Optimal Care of the Injured Patient. Read more about ACS trauma verification below.
The ACS Verification, Review, and Consultation (VRC) Program is designed to assist hospitals in the evaluation and improvement of trauma care and provide objective, external review of institutional capability and performance. These functions are accomplished by an on-site review of the hospital by a peer review team, experienced in the field of trauma care. The team assesses commitment, readiness, resources, policies, patient care, performance improvement, and other relevant features of the program as outlined in Resources for Optimal Care of the Injured Patient.
To create national guidelines for the purpose of optimizing trauma care in the United States. This objective may be accomplished through a voluntary review of potential and existing trauma centers so that trauma centers may provide an organized and systemic approach to the care of the injured patient. Essential elements include trained and capable personnel, adequate facilities, and ongoing self-assessment as outlined in the Resources for Optimal Care of the Injured Patient: 2006 document.
There are three levels of ACS trauma center verification, each defined by specific standards. These standards denote the spectrum of care that must be available to the injured patient at the facility, along with other expectations related to research and educational contributions to advance the field and increase capacity.
Level I trauma centers must be capable of providing system leadership and comprehensive trauma care for all injuries. In its central role, a Level I trauma center must have adequate depth of resources and personnel. Most Level I trauma centers are university-based teaching hospitals due to the resources required for patient care, education, and research. In addition to providing acute trauma care, these centers have an important role in local trauma system development, regional disaster planning, increasing capacity, and advancing trauma care through research.
Level II trauma centers are expected to provide initial definitive trauma care for a wide range of injuries and injury severity and may take on additional responsibilities in the region related to education, system leadership, and disaster planning.
Level III trauma centers typically serve communities that may not have timely access to a Level I or II trauma center and fulfill a critical role in much of the United States by serving more remote and/or rural populations. Level III trauma centers provide definitive care to patients with mild to moderate injuries, allowing patients to be cared for closer to home. These centers also have processes in place for the prompt evaluation, initial management, and transfer of patients whose needs might exceed the resources available.