In this era of health care reform, the discussion about how to provide high-quality, affordable, effective, and equitable care to severely ill patients has assumed center stage. As technology advances, older and much sicker patients survive longer, forcing the health care system to provide highly complex interventions, often requiring emergency surgical interventions in a critical care environment.
How to effectively meet this challenge remains unclear. It is not surprising that the trauma system is being looked to for answers and leadership. The United States arguably has one of the best trauma systems in the world. Injured patients receive coordinated, seamless, and expertise-driven care, delivered by an integrated system that spans the entire care spectrum (prevention, prehospital care, acute management, and rehabilitation). The United States enjoys a large network of trauma centers that are carefully accredited and certified according to strict guidelines.1 Development of trauma systems has placed the care of the severely injured patients into the hands of specialists, with a dramatic improvement in outcomes.2