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

Frequently Asked Questions

1. How is a trauma system consultation different from a hospital verification visit?

While an American College of Surgeons (ACS) trauma center verification visit focuses on hospital- level criteria, a trauma system consultation is broader in scope, examining the integration of trauma system components for a state-, regional-, or county-level system of care.

Rather than conducting a verification process, trauma system consultation teams provide recommendations for system improvement and enhancement.

2. What is the cost of a trauma system consultation?

The fee for a standard trauma system consultation is $65,000.

3. Are there other costs besides the fee charged by the ACS for the consultation?

The ACS fee does not include costs associated with meeting space, audio/visual needs, and meals for participating stakeholders.

4. How have states or regions paid for consultations in the past?

Examples of the funding sources states or regions have used previously to fund consultations include:

  • State appropriations
  • Federal Bioterrorism Hospital Preparedness funding
  • Rural Flex Funding
  • Foundation grants
  • HRSA Block G rants
  • Donations from trauma centers

5. How far in advance do we need to schedule a trauma system consultation?

Six months provides sufficient time for the requesting agency to develop and finalize the contract with the ACS, to plan and generate support for the consultation visit, and to develop the prereview questionnaire (PRQ) for the consultation visit. Consultation Program staff members are flexible and will work with requesting agencies to accommodate other timelines.

6. What does the state or region need to do to prepare for the consultation?

Please see the Trauma Systems Consultation Client Manual for more information on consultation preparation.

7. How many days does the consultation take?

The consultation visit usually takes place over 3.5 days, with a half day of review team travel on each side of the visit. The team arrives at the hotel in the early afternoon before the formal start of the site visit for a two-hour prereview meeting with the team leader and technical support staff. A sample agenda for the consultation visit is provided in Appendix B of the Client Manual.

8. Who is on the review team?

Typically, the multidisciplinary Trauma System Consultation review team consists of eight members: two trauma/general surgeons (one of which serves as team leader), one emergency physician, a state EMS/trauma director, a trauma program manager, a technical consultant, and two trauma system consultation program staff members. An additional team member being oriented to the trauma systems consultation process may also be in attendance (at no cost to the requesting agency).

9. Who should attend the consultation?

A broad representation of program managers and providers from multi-agency and multidisciplinary groups from all components of the trauma system will facilitate the best overall assessment of the current trauma system, leading to the development of recommendations for future system enhancements.
When identifying system participants to invite, keep in mind that the team members will be seeking information about the following system components and how well the individual components are integrated in the overall trauma system.

  • Injury epidemiology
  • Indicators as a tool for system assessment
  • Statutory authority and administrative rules
  • System leadership
  • Coalition building and community support
  • Lead agency and human resources within the lead agency
  • Trauma system plan
  • System integration
  • Financing
  • Prevention and outreach
  • Emergency medical services
  • Definitive care facilities
  • System coordination and patient flow
  • Rehabilitation
  • Disaster preparedness
  • Systemwide evaluation and quality assurance
  • Trauma management information systems
  • Research

See Appendix C of the Client Manual for a suggested list of participants to invite.

10. Where is the consultation held?

Meeting space is selected based on the geographic needs of the requesting agency and its stakeholders and on the logistical needs of the review team. Due to the work schedule of the team, it is optimal to convene the consultation meetings at a hotel that is able to accommodate both the larger stakeholder meetings and smaller team meetings, along with sleeping rooms and meals for the review team.

In some cases, Consultation Program staff members will work with the requesting agency to hold the larger stakeholder sessions at a site other than the hotel where the review team has sleeping rooms and the team meeting room.

11. Does a system need to be at a certain level of development in order to have a consultation?

The consultation process is designed to review a trauma system at any stage of development, early in the planning process or addressing specific barriers or issues associated with a more developed trauma system. The team members work from the perspective of an inclusive trauma system model when reviewing the existing system resources and recommending strategies to use and improve all system resources. To address the needs of a specific system, a hand-chosen multidisciplinary team is selected.

12. Which states or regions have had consultations?

View a list of previous trauma system consultations.

13. What guidance or support is provided as the state prepares for a consultation?

The ACS Trauma Systems Consultation Program staff members provide on-going support and guidance to members of the requesting agency during all phases of consultation planning and implementation.

14. Can any of the meetings be conducted through telecommunications?

Although in-person participation from a broad range of system stakeholders is optimal during the consultation process, we understand that at times, due to circumstances, some key individuals are not available for the on-site meetings. Program staff will work with the requesting agency to determine if providing a conference line or telecommunications link during all or part of the meetings is possible.

15. Can the meetings be recorded?

The requesting agency may choose to record meetings, if resources are available.