University of Florida Health Shands Children’s Hospital has been verified by the American College of Surgeons as a Level 1 pediatric trauma center, one of fewer than 20 in the nation to earn the distinction. The verification means that the hospital meets the ACS’s highest standards for staff, resources and equipment to optimally handle a child’s life-threatening injuries.
The designation comes after a five-year, large-scale effort the UF College of Medicine Department of Surgery’s pediatric surgery division led to add crucial staff and design evidence-based treatment protocols.
UF Health Shands Children’s Hospital has long had a state-issued designation as a Level 1 trauma center, meaning it handles the most complex pediatric injury cases. The ACS verification delves much deeper into the inner workings of a trauma center, including how it executes continuous quality improvement and has an array of specialists available.
“This means that every child who comes to our hospital is getting nationally recognized, high-level trauma care,” said Shawn D. Larson, M.D., the interim chief of pediatric surgery who led the verification effort.
For parents, the ACS verification means that a hospital adheres to detailed, nationally accepted standards of trauma care. There are just four ACS-verified Level 1 pediatric trauma centers in Florida and only 18 nationwide.
“Every single patient is part of a quality-improvement process that we use to make things better all the time. When their child arrives in a trauma bay, there’s a pediatric surgeon standing there. They’re being cared for by a board-certified pediatric critical care physician and pediatric-specific anesthesiologist when they go to the operating room,” Larson said.
To earn the group’s verification, Larson and his colleagues focused on a variety of enhancements, including designating a medical director (Larson), hiring a pediatric program trauma manager and adding a process improvement nurse. Liaisons with neurosurgery, radiology and other pediatric medical specialties were assigned. Patient data were parsed and delivered to the ACS.
The team closely examined various aspects of care, such as how major blood transfusions were being administered in children. That resulted in more efficient, weight-based use of transfused blood while assuring patients got the exact care they needed in a timely fashion, Larson said.
The ACS verification reassures parents that the pediatric trauma program, including its facilities and integrated care, functions optimally with exceptionally high standards, said Rashmin C. Savani, M.B., a professor and chair of the College of Medicine’s department of pediatrics. The verification is the result of meticulously considering virtually every aspect of pediatric trauma care, he said.
“This is an affirmation of our entire surgical enterprise, as well as intensive care and the emergency department. There’s an enormous amount of multidisciplinary interactions that go into becoming such an incredible program. It gives parents an extra level of assurance that their child will be getting the highest quality of care possible,” Savani said.
Gaining ACS verification also involved more than just treating critical injuries. The pediatric trauma team also hired an injury prevention specialist to review pediatric trauma data and recommend initiatives. That has led to the addition in some local schools of an instructional ACS program that trains people how to stop bleeding in a severely injured person.
Larson said the successful ACS verification was made possible by many people, including Pediatric Trauma Program Manager Amy Berger as well as strong support from UF Health and hospital leaders.
Going forward, the verification also creates incentives for trauma programs to maintain their high standards. Every program is reverified periodically by the ACS.
“You have to follow a defined, very detailed quality-improvement process,” Larson said. “We look at every single aspect of the trauma process and ask, ‘Are there little things or big things we can improve?’ And that happens with every trauma patient who comes through the door.”