Those who typically only set foot in a hospital as a patient or visitor may be unaware of the many external inspections, accreditations, and verifications that hospitals must regularly undergo. All hospital employees, both clinical and non-clinical, are all too familiar with these visits and have their hospital’s Command Center phone number memorized. Thanks to a few useful acronyms, they are ready to recite the hospital’s fire safety policy and procedures to a surveyor.
One such visit that hospitals go through is when they seek verification as a trauma center. State government authorities create the regulations for designating trauma centers; however, many have opted to follow the American College of Surgeons (ACS) – Committee on Trauma’s standards and verification process. The ACS’ “Resources for Optimal Care of the Injured Patient (2022 Standards)” establishes the criteria for trauma centers, including resources, performance improvement and patient safety processes, data collection, protocols, research, and education. Many state governments require hospitals seeking trauma designation to undergo a site visit and receive verification from the ACS Verification, Review, and Consultation (VRC) Program. This program assists hospitals in the evaluation of trauma care and provides an external review of institutional capability and performance. The ACS verifies a facility as a Trauma Level I, II, or III, each level having a specific set of standards.
Facilities seeking initial verification, restoring verification after a lapse, or upgrading their current verification level must undergo a verification site visit. Established trauma centers looking to maintain their current trauma level must undergo a re-verification site visit. If no criteria deficiencies are found during the site visit, the ACS will issue a verification certificate to the trauma center, valid for three years.
Before the site visit, facilities must submit a Pre-Review Questionnaire based on the “Resources for Optimal Care of the Injured Patient (2022 Standards)“. This helps the reviewer understand the hospital’s current trauma capabilities and performance. Within the Performance Improvement and Patient Safety (PIPS) section of the questionnaire, there are questions related to the use of evidence-based medicine in the hospital’s practice. These questions assess the implementation of clinical practice guidelines, protocols, and algorithms derived from validated resources, as well as the presence of a manual for evidence-based trauma guidelines and protocols. The facility is also asked if any evidence-based trauma guidelines and protocols have been instituted since the last review.
According to Dr. Timothy Ryken, former Chief of Neurosurgery at Dartmouth-Hitchcock Medical Center, “bedside decision support can demonstrate to the ACS a hospital’s commitment to improving consistency of care between providers, as well as their adherence to evidence-based treatment guidelines.”
Qmetis is a healthcare technology company grounded in the science of evidence-based care, building decision-support tools that aid hospitals in best practice compliance and consistency of care. Qmetis’ traumatic brain injury tool, TBIQx, instantly assesses a patient’s current condition and treatment plan and generates a report immediately on the screen, indicating compliance with the latest evidence-based treatment guidelines. Qmetis’ reporting module, RM25, charts areas of guideline variance, enabling administrators to identify any consistent gaps and initiate performance improvement projects in specific areas of care. To find out more about TBIQx and how it might help with your next ACS reverification, take a self-guided tour of TBIQx by visiting qmetis.com/tour or contact Qmetis’ Director of Operations, Caroline Eagan, at email@example.com.