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The Level I Difference

The Committee on Trauma (COT) of the American College of Surgeons (ACS) has re-verified Barnes-Jewish Hospital's trauma center at Level I, the highest level of trauma care available.

As the busiest trauma center in the state, treating more than 11,580 trauma patients last year, Barnes-Jewish Hospital's trauma center is one of only three in the State of Missouri to earn this national distinction.

"The trauma center at Barnes-Jewish Hospital voluntarily seeks national Level I verification every three years as part of the ongoing commitment to ensuring that our patients have the best chance for recovery following their injuries," says Douglas Schuerer, MD trauma center director. "During the verification process, independent reviewers scrutinize not only the records of individual patients, but also the systems that we have in place to ensure that the safest and most effective care is rendered to each and every trauma patient."

Established by the ACS in 1987, the COT's Verification/Consultation Program for Hospitals promotes the development of trauma centers that provide not only the hospital resources necessary for trauma care, but also the entire spectrum of care to address needs of all injured patients. This spectrum encompasses the pre-hospital phase through the rehabilitation process.

Verified trauma centers must meet the essential criteria that ensure trauma care capability and institutional performance, as outlined by the ACS. The ACS COT's verification program does not designate trauma centers. Rather, the program confirms that a trauma center has demonstrated its commitment to providing the highest quality trauma care. The actual establishment and designation of trauma centers is the function of local, regional, or state health-care system's agencies.

The trauma center at Barnes-Jewish Hospital is designated by the state of Missouri as a Level I trauma center. Although state requirements for Level I designation are high, national requirements are higher still. The Level I verification from the ACS is the highest national recognition a trauma center can receive. "We're committed to maintaining a leadership role in advancing excellence in trauma care throughout the midwest," says Julie Nash, RN, trauma services manager.

The four separate categories include Levels I through IV, with Level I ranking the highest. A Level I trauma center is a comprehensive regional resource that is a tertiary care facility central to the trauma system.

Key elements of a Level I trauma center include 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, and critical care. Other capabilities include cardiac, hand, microvascular surgery and hemodialysis.

A Level I trauma center also provides leadership in prevention, public education and continuing education of trauma team members, and is committed to continued improvement through a comprehensive quality assessment program and an organized research effort to help direct new innovations in trauma care.
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