Trauma center verification.

Sanctioned trauma center designation began in the late 1970's to improve hospital capabilities to care for injured patients. Guided by criteria established by the American College of Surgeons Committee on Trauma and led by surgeons dedicated to improving trauma care, many states focused early on the quality of care issue only to later struggle with the political consequences that followed the designation process. Institutional commitment to trauma care was often stated but seldom measured. Unlike the designation process with its strong emphasis on capabilities assessment, the verification process focused on performance documentation. Confirmation was sought in response time of key personnel, completeness of registry database, and trauma death audits. Trauma Committee minutes were reviewed and prehospital personnel interviewed to confirm institutional involvement in paramedic education and overall EMS system design. Other areas of documentation included trauma education at all levels, research, nursing audits, and outreach programs. We conclude that trauma center designation and verification are both essential and complementary. Effective trauma system performance requires trauma center designation plus a verification process to confirm institutional commitment of these resources for optimal care of the injured patient.