![]() However, verification is an expensive and resource-consuming process. Perceived advantages of verification include strengthening partnerships with stakeholders, engagement and commitment, team work, and the identification of improvement opportunities and priorities. During the process, a center is evaluated according to its designation level. ĪCS verification is generally accomplished in two steps: (1) hospitals submit a prereview questionnaire, which allows site reviewers to have a preliminary understanding of the trauma care capabilities, and (2) a peer review team nominated by the College conducts an on-site review of the hospital. Designated hospitals may then seek verification with organizations such as the ACS, which assess adherence to recommended care related to resources, commitment, readiness, policies, patient care, and performance improvement. Designation criteria and procedures may vary from state to state and are typically outlined through the legislative or regulatory authority. Trauma center designation is conducted by a regional or provincial health authority at a local or state level. Generally, hospitals are designated as trauma centers before applying for verification. We will hereafter use the term “verification” to refer both to accreditation and verification. Trauma center accreditation is a similar process. Many injury organizations, most notably the American College of Surgeons (ACS), provide consensus-based recommendations on the structure of trauma systems, and there is a growing trend towards verification of hospitals within trauma systems to determine if they meet criteria for optimal care. The implementation of trauma systems in many high-income countries over the last 50 years has led to important reductions in injury mortality, disability, and overall costs in many healthcare jurisdictions. They are the leading cause of death under 40 years of age in North America. Injuries represent an estimated 15% of the global burden of disease. ![]() Results will be published in a peer-reviewed journal and presented at an international clinical conference. Results could reinforce current verification modalities and may suggest ways to optimize them. This review will provide a synthesis of the body of evidence on trauma center verification effectiveness. We will evaluate the quality of cumulative evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group methodology. We are planning to conduct a meta-analysis if feasible based on the number of included studies and their heterogeneity. We will assess the methodological quality of studies using the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) assessment tool. We will search CINAHL, EMBASE, HealthStar, MEDLINE, and ProQuest databases, as well as key injury organization websites for gray literature. We will perform a systematic review of studies evaluating the association between trauma center verification and hospital mortality (primary outcome), as well as morbidity, resource utilization, and processes of care (secondary outcomes). The objective of the study described in this protocol is to systematically review evidence on the effectiveness of trauma center verification for improving clinical processes and patient outcomes in injury care. In Canada for example, it is called accreditation, but it has the same objective and very similar modalities. This process may be labeled differently across jurisdictions. Many hospitals treating trauma patients seek verification to demonstrate that they meet these recommendations. Injury organizations including the American College of Surgeons and the Trauma Association of Canada as well as the World Health Organization provide consensus-based recommendations on resources and processes for optimal injury care. ![]() The implementation of trauma systems in many high-income countries over the last 50 years has led to important reductions in injury mortality and disability in many healthcare jurisdictions. ![]()
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