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Controversy surrounding the number and location of designated trauma centers in the U.S. has led to much discussion and the emergency of two camps: one in favor of restraining the proliferation of centers and one in favor of allowing individual institutions to decide for themselves whether to pursue designation.

Following the convening of a consensus conference that reviewed the principles for trauma center designation and arrived at a set of practical methods and metrics for use in a needs based assessment, the American College of Surgeons Committee on Trauma this month released the ACS Needs Based Assessment of Trauma Systems (NBATS) tool. The tool is designed “to evaluate the need within a particular geographic area, termed a trauma service area (TSA)…[and] the number of centers needed within the TSA,” say the authors of an article about the tool in the ACS Bulletin (V101 No 9).

Incorporating critical data elements used in other system benchmarking efforts, the ACS NBATS assigns points based on population, transport time, community support and the number of severely injured patients discharged. While there is no clear evidence supporting the use of any of the specific measures proposed, “all the recommendations reflect the expert opinion of the convened group, as derived through a deliberative process,” according the Bulletin article.

The ACS COT is now circulating the tool to stakeholder groups for testing and validation. To participate in the process of review and refinement, contact Maria Alvi, Manager of Trauma Systems and Quality Programs at