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11/19/19 news article

Dayton Children’s verified as a Level 1 Pediatric Trauma Center by the American College of Surgeons

attaining the highest level possible highlights commitment to best care in the toughest circumstances

The American College of Surgeons (ACS) officially verifies Dayton Children’s Hospital as a Level 1 Pediatric Trauma Center on November 6, 2019. This is the highest level attainable, proving once again to parents that they can rely on Dayton Children’s to provide the best care for their child, even in the toughest circumstances.

“This verification highlights the extreme commitment that Dayton Children’s trauma team, led by Jeffrey Pence, MD, trauma medical director and Lisa Schwing, RN, trauma program manager, has to every level of care in some of the most critical circumstances,” says Deborah Feldman, president and CEO for Dayton Children’s. “They not only treat the injuries, but provide long lasting healing for body and soul.   The emotional damage for both child and family can be significant so we work with the community to prevent children from getting hurt in the first place. Our trauma providers live our mission of the relentless pursuit of optimal health for every child within our reach.”

The American College of Surgeons verifies the presence of the resources for optimal care of the injured patient.  These 302 specific criteria outlined in a 70-page questionnaire, are grouped into areas that include commitment, readiness, resources, policies, patient care and

performance improvement. A few elements include:

  • Continuous coverage by pediatric surgeons, and prompt availability of care in pediatric specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial and critical care
  • Continuing education of the trauma team
  • Organized teaching and research effort to find new innovations in trauma care
  • Prevention and public education programs for the community

There is a two-day site visit from surveyors who review charts and documentation for accuracy and best practices. “They also meet with leadership and interview department leaders involved in the trauma process,” says Tami Wiggins, RN, BSN, director of emergency and trauma services. “Overall, it's a 14-month process to apply through the ACS. The surveyors were quite pleased with everything we showed them and said it was one of the most organized and smoothest site reviews they have ever done."

what does it take to be a level 1?

The criteria are stringent and ensure the very best care is delivered. "One ACS requirement is our surgeons must be in the Soin Pediatric Emergency and Trauma Center room within 15 minutes of a top tier trauma patient’s arrival, more than 80 percent of the time," says Lisa Schwing, RN, trauma program manager. "I'm proud to say that our surgeons respond within 15 minutes, every single time." 

Another example of ACS level I trauma center requirements is a minimum of 10 peer-reviewed,    research projects published in professional journals during each 3-year review cycle. Dayton Children’s exceeded this goal with 13 published projects including a study on timely recognition of child abuse injuries, streamlining trauma team activation and a joint study with Wright State University and Wright-Patterson Air Force Base using the first 3T MRI in the region to develop a protocol for real-time functional MRI neuro-feedback training.

As part of the site visit, the previous surveyors asked the team to present a patient case of which they are exceptionally proud. "We shared the story of Miracle Max, who was in an ATV accident with horrific injuries, including internal decapitation and a broken jaw,” says Schwing. “He came to our emergency department in November 2015, and four years later, Max is thriving.”

it is more than just medical care for kids

Kids are incredibly resilient, but a trauma in their life can leave a mark, and not just physically. The trauma program at Dayton Children’s includes a dedicated social worker who focuses on the emotional needs during and after the event. Screening for post-traumatic stress disorder (PTSD) occurs not only in the child but in the parent as well.  Follow-up continues weeks later after discharge to ensure proper healing.

“A great example of this is how we help children who have suffered a severe and traumatic dog bite,” says Schwing. “When the child is ready, we can bring in pet therapy dogs who are the gentlest animals you will ever find. This exposure can help overcome the memory of the trauma, replacing it with better experiences.”


surveyors comments

Some of the strengths the surveyors pointed out include:

  • excellent orthopedic and neurosurgical commitment to the trauma program
  • having a dedicated trauma social worker
  • outstanding external trauma education for nursing and emergency medical services
  • extensive partnerships with EMS and nursing schools


fast facts:

  • 989 pediatric trauma patients in 2018
  • On track to exceed 1,100 pediatric trauma patients in 2019
  • Top cause of trauma – falls (but the trauma service cares for a significant number of children from car crashes, bike crashes, and child abuse)
  • 53 level 1 pediatric trauma centers nationwide
  • Dayton Children’s is the fourth level 1 pediatric trauma center in Ohio
  • Ohio has a significant commitment to pediatric trauma, making up 8.5% of all pediatric trauma centers nationwide

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