American College of Surgeons, Committee on Trauma Verification Review: does it really make a difference?
BACKGROUND
Although not directly involved in designation per se, the American College of Surgeons (ACS) Committee on Trauma verification/consultation program in conjunction with has set the national standards for trauma care. This study analyzes the impact of a recent verification process on an academic health center.


METHODS
Performance improvement data were generated monthly from the hospital trauma registry. Forty-seven clinical indicators were reviewed. Three study periods were defined for comparative purposes: PRE (January, June, October 1997), before verification/consultation; CON (April 1999-October 1999), after reorganization; and VER (November 1999-September 2000), from consultation to verification.


RESULTS
Statistically significant (p < 0.05) quantitative and qualitative changes were observed in numbers (percent) of patients reaching clinical criteria. These included prehospital, emergency department, and hospital-based trauma competencies. Trauma patient evaluation (including radiology) and disposition out of the emergency department (< 120 minutes) improved in each study section (PRE, 21%; CON, 48%; VER, 76%). Enhanced nursing documentation correlated with improved clinical care such as early acquisition of head computed axial tomographic scans in neurologic injured patients (PRE, 66%; CON, 97%; VER, 95%). Intensive care unit length of stay (< 7 days) decreased (PRE, 87%; VER, 97.8%). Other transformations included increase in institutional morale with recognition of trauma excellence within the hospital and resurgence of the trauma research programs (60 institutional review board-approved projects).


CONCLUSIONS
The ACS verification/consultation program had a positive influence on this developing academic trauma program. Preparation for ACS verification/consultation resulted in significant improvements in patient care, enhancement of institutional pride, and commitment to care of the injured patient.
Ehrlich
Peter F
PF
Department of Surgery, West Virginia University, Morgantown, West Virginia 26505, USA. pehrlich@hsc.wvu.edu
Rockwell
Sherry
S
Kincaid
Stephanie
S
Mucha
Peter
P
D000704:Analysis of Variance; D006780:Hospitals, Rural; D006785:Hospitals, University; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011785:Quality Assurance, Health Care; D012042:Registries; D012955:Societies, Medical; D014193:Trauma Centers / Q000592:standards*; D014481:United States; D014903:West Virginia