title: Two hospitals with 1 trauma system: a joint approach to the care of the injured patient.
abstract: BACKGROUND
  Trauma centers are closing at an alarming rate, but the need for trauma care persists. This article shows the sustainability and feasibility of a joint trauma system whereby 2 university-affiliated hospitals function as a single trauma center system in a moderate-sized city.
  
  
  METHODS
  Since 1994, 3 days per week, trauma patients are transported by emergency medical services (EMS) to hospital A. The other 4 days they are transported to hospital B. Trauma registry data from 1994 to 2008 were analyzed. Cost data were also examined.
  
  
  RESULTS
  The joint system admitted 28,338 trauma patients. On each center's nontrauma days, trauma team activation was required infrequently. The 2 centers share costs; they perform joint outreach, educational training, and quality control. The joint trauma system has been sustained since 1994.
  
  
  CONCLUSIONS
  Two hospitals functioning as a single trauma center system is a viable model of care for injured patients in a moderate-sized city with mostly blunt trauma.
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198-3280, USA. rjawa@unmc.edu
authors: Randeep S
authors: RS
authors: Jawa
authors: David H
authors: DH
authors: Young
authors: Michel
authors: M
authors: Wagner
authors: Diane
authors: D
authors: Yetter
authors: Valerie
authors: V
authors: Shostrom
authors: Samuel
authors: S
authors: Cemaj
authors: Lawrence
authors: L
authors: Nelson
authors: Robert
authors: R
authors: Ramey
authors: Megan
authors: M
authors: Sorensen
authors: Michelle
authors: M
authors: Schwedhelm
authors: David W
authors: DW
authors: Mercer
authors: Joseph
authors: J
authors: Stothert
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D000293:Adolescent; D000328:Adult; D017046:Cost Savings; D005240:Feasibility Studies; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D012042:Registries; D018570:Risk Assessment; D015996:Survival Rate; D014193:Trauma Centers / Q000458:organization & administration*; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D055815:Young Adult