American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Level III TQIP Frequently Asked Questions


What are the eligibility requirements to participate in Level III Trauma Quality Improvement Program (TQIP)?

To participate in Level III TQIP, a center must be either ACS Verified or state designated as a Level III trauma center, or be an “in process” Level III trauma center.

A center is considered “in process” if they meet one of the following criteria:

  • Center has completed an application to schedule an ACS Verification or Consultation visit within the next 24 months.
  • Center has applied for trauma center designation at the state level (documentation must be provided).
  • Center is provisionally designated as a Level III trauma center by their state (documentation must be provided).

What are the steps for joining TQIP?

See Getting Started with Level III TQIP available on the TQIP website.

What is the annual TQIP participation fee for Level III centers?

To provide for the ongoing stability of our programs and to support advancements in technology, analytics, and training for participants, we have established a long-term pricing structure for the Level III TQIP Program.  Please log in to the TQP Account Center to view current pricing. 

Are there any additional costs associated with joining Level III TQIP?

In budgeting for program participation, hospitals should factor in the cost of travel and hotel accommodations for the TQIP Annual Conference. Each participating hospital will receive two (2) free registrations to the Annual Conference. Visit our TQIP Annual Conference webpage for more information on registration.

Additionally, we encourage you to contact your registry vendor for more details about your specific software requirements and fees. We are asking Level III centers to continue to only submit Core Data Elements (all NTDS data elements without Process Measures) when they join TQIP. At this time, we are not asking Level III centers to collect or submit Process Measures.  

If my hospital joins TQIP, do we still need to pay the National Trauma Data Bank (NTDB) annual participation fee?

All fully enrolled Level III centers are exempt from the NTDB annual participation fee.

When can my hospital join Level III TQIP?

TQIP registration will be open year round for your center to join at any time. Deliverables will vary by join date.

The table below displays risk-adjusted benchmark report eligibility, based on the timing of center enrollment.

Center Enrollment Deadline

Eligible for First Benchmark Report

January 15, 2020

Spring 2020 Report Cycle

July 1, 2020

Fall 2020 Report Cycle

January 8, 2021

Spring 2021 Report Cycle

June 1, 2021

Fall 2021 Report Cycle

December 1, 2021

Spring 2022 Report Cycle

Data Submission/Registry

As a new TQIP participant, will I need to submit data quarterly?

Yes, beginning with the first TQIP Quarterly Call for Data window that occurs after you complete enrollment in TQIP, your hospital submits data quarterly. See the TQIP Data Submission Schedule available on the TQIP webpage for a detailed submissions timeline.

To ensure that there are no gaps in data submissions, we encourage all new TQIP centers to submit the full year of 2019 admissions data during the 2020 NTDB Annual Call for Data.

What additional data elements will need to be added to my registry when I join Level III TQIP?

We are asking Level III centers to continue to only submit the Core Data Elements (all NTDS data elements without Process Measures) when you join TQIP. At this time, we are not asking Level III centers to collect or submit Process Measures. These fields can be found in the NTDS Data Dictionary.

We encourage you to notify your vendor that you will be joining Level III TQIP and moving from annual data submissions to quarterly data submissions as a part of the program.

We also encourage you to work with your vendor to ensure that you are up-to-date with the current version of the NTDS.

What File Type should I choose when submitting my data as a fully enrolled Level III TQIP participant?

Fully enrolled TQIP participants should choose "File Type: TQIP" when submitting data that contains Process Measures. The "File Type: TQIP without Process Measures" should be used for data that does NOT contain process measures.


When will I receive my first Risk-adjusted Benchmark Report?

A TQIP center will become eligible to receive their first risk-adjusted benchmark report depending on their enrollment date.  See the Level III TQIP Report Eligibility Table for more detailed information.

What is the difference between the NTDB Benchmark Report we receive annually and the TQIP Benchmark Report?

The main difference between the NTDB Benchmark Report that you receive each year and the TQIP Benchmark Report, is that the NTDB Benchmark Report is purely descriptive, providing only a simplistic baseline without accounting for the case variation of trauma centers, while the TQIP Benchmark Report applies complex statistical models to account for those hospital-to-hospital differences.

More specifically, TQIP uses a mixed-models approach to risk-adjustment which accounts for case-mix differences in demographic, medical history, and injury characteristics to provide more actionable and accurate like-to-like comparisons across a variety of outcomes. Additionally, as TQIP risk-adjusted reporting is based on a subset of more severely injured patients, we focus our feedback on those at the greatest risk for an adverse outcome and those with the greatest opportunity to benefit from improved interventions.

I am a high volume Level III center, treating neurosurgery patients. Is there a way I can be benchmarked against Level II centers treating similar patients?

Because the TQIP Benchmark Report for Level I’s and II’s uses different patient inclusion criteria than the Level III report, we are unable to directly compare outcomes between Level II and III centers at this time.


What education will be offered to centers participating in Level III TQIP?

Education is a key component of the program. Educational opportunities available to Level III TQIP centers include the following:

  • TQIP Online Course, which covers updates to the NTDS Data Dictionary, understanding and using data quality information, and the roles of the TQIP team at your hospital
  • Monthly quizzes
  • Regular TQIP webinars for registry staff
  • Level III specific sessions at the TQIP Annual Conference
  • Access to the TQIP Education Portal
  • Participation in the TQIP Google Group

Will I have access to the TQIP Education Portal once I join the Level III program?

Once fully enrolled in TQIP, the TQIP team members listed on your PreApplication Form will receive an e-mail with information on how to access the TQIP Education Portal. The Data Primary Contact can add additional staff at any time through the TQP Account Center.

Will there be information at the TQIP Annual Conference that will be beneficial to Level III centers?

Yes, the TQIP Annual Conference offers sessions specifically targeted to the needs of Level III centers. Please see our TQIP Annual Conference webpage for more details.

Is my center required to attend the TQIP Annual Conference?

While we strongly encourage hospitals to attend the meeting, we realize that not all centers can participate each year. Included in your TQIP participation fee are two (2) complimentary registrations to the TQIP Annual Conference that we hope will encourage you to attend. Additional staff are welcome to attend but must pay the meeting registration fee. Please see our TQIP Annual Conference webpage for more details.