Community Hospitals Have Improved the Care They Provide to Their Community, the Critically Injured are Transferred to Appropriately Staffed Trauma Centers

December 19, 2011

Dear Hospital Administrator:

In 1994, New York State began to analyze and publish statewide trauma outcome data. This has been a landmark effort for the United States. The only national registry, The National Trauma Data Bank (NTDB), was developed by the American College of Surgeons. The two data sets are quite different. New York State's registry contained both trauma center and community hospital data. The NTDB contains only trauma center data. Through analysis of New York State data, we have been able to demonstrate that community hospitals have improved the care they provide to their community and that critically injured patients are transferred to an appropriately staffed trauma center. Data has been used by trauma centers to improve the care they provide. This data is released publically in the NYS Risk Adjusted Mortality Rate (RAMR) Report.

Title 10 NYCRR Part 708 (5) detail regulations which pertain to trauma. Section 2 (vi) states "Each hospital within a region will have a written agreement to cooperate with a regional trauma center in a quality assurance program for the regional trauma system". Toward that end, each area of the state has a Regional Trauma Advisory Committee (RTAC) which helps coordinate trauma data collection, through the regional trauma center, from all of the hospitals in their catchment area. This data is then analyzed and utilized for quality improvement efforts in the region. RTACs meet several times throughout the year, and it is expected that area trauma centers and community hospitals will participate in order to strengthen their region's trauma system and improve the care they themselves provide. Presently, the regional trauma centers in Suffolk County, Central New York and Western New York have been able to continue to collect community hospital data and have utilized this to provide feedback to their region and strengthen their trauma system.

In the ensuing months, the Department will be transitioning the State Trauma Registry to a new repository with a new vendor. This change will enable us to also link pre-hospital care data with hospital data, enabling analysis of the entire continuum of care. Hospitals can continue to submit their trauma data utilizing their current vendors. This change will ultimately enable the RTACS to customize reports for their region to further enhance their quality assurance activities based on the data they receive. This will also enable regions to view their data in context with the rest of the state. In order to accomplish this, ALL hospitals in the state need to submit their trauma data to their regional trauma center.

The Department, in conjunction with the State Trauma Advisory Committee (STAC), asks that you work with the RTAC in your region of the state to facilitate community hospital data collection. While much of the community hospital data has been abstracted from SPARCS, you are aware of the limitations of this data set. SPARCS does not have physiologic data and this can alter performance analysis. Your efforts in this regard will not only strengthen the trauma system in your region, but will assist you in strengthening the systems in your hospital and local community.

We would ask that you please cooperate with RTAC when they contact your hospital.


Lee Burns
Acting Directors
Bureau of Emergency Medical Servicess
NYS Department of Health
William H. Marx, DO, FACSs
State Trauma Advisory Committee