Level I trauma centers, besides having acute care responsibilities, are teaching hospitals which have the responsibility for conducting research and providing injury prevention programs and system leadership. They also undergo a verification process every three years whereby the American College of Surgeons Committee on Trauma (ACS-COT) evaluates each center for the resources needed at various levels of facilities to provide optimal care. They are regulated under California Code of Regulations, Title 22, Division 9, Chapter 7. These are definitive care facilities that together provide a spectrum of care for all injured patients. The San Diego County trauma system includes six trauma centers. After the system was in place, the number of patients who received sub-optimal care dropped to 4.2 percent, and preventable deaths dropped to 2.7 percent. A subsequent more stringent study examined the outcome changes before and after institution of the trauma system, and revealed that before implementation, the care of major trauma victims was sub-optimal in 32 percent of cases with preventable deaths at 13.6 percent. In 1984, the trauma system was approved by the San Diego County Board of Supervisors. The resulting report, known as the Amherst Study, revealed that 46.9 percent of trauma patients studied received sub-optimal care and that 21.2 percent of the deaths were either frankly or potentially preventable. The system began in 1982 when the local Hospital Council commissioned an assessment of the need for a trauma system in San Diego. Optimal allocation of pre-hospital emergency medical services (EMS) throughout county.Monthly medical audit committee meetings between representatives from all centers.Trauma center-specific catchment areas with shared jurisdiction over international border regions.San Diego’s trauma system is considered to be one of the finest in the United States, and the Mercy Hospital Trauma Service has played an important part in it since its inception.
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