American College of Surgeons awards division of pediatric surgery trauma verification

Currently, the American College of Surgeons possesses a number of different verification processes to recognize exceptional patient care. The trauma category contains both adult and pediatric categories — each with its own stringent standards programs must meet in order to be considered, let alone approved.

Now, after a collective, collaborative effort that spanned years, UF Health Shands Hospital for Children, led by efforts of the Division of Pediatric Surgery, has received its Level 1 pediatric trauma verification from the American College of Surgeons.

“In order for the verification to become synonymous with best practices, the standards must be high across the board,” said Shawn D. Larson, M.D., interim chief of pediatric surgery at the UF College of Medicine. “This symbolizes numerous people who have done their best to achieve the best possible care we can provide to pediatric trauma patients in every capacity.”

In 2018, the hospital had a consultative visit to move forward with pediatric trauma verification. At the time, there was slight, if any differentiation between adult and pediatric patients who were treated for trauma, Larson explained. The consult pointed to 40 critical deficiencies, and 16 weaknesses.

Larson and his team addressed every single one. They hired a pediatric trauma program manager, process improvement nurse, identified a designated medical director, and, perhaps most importantly, came together to collectively design specific, evidence-based protocols and policies for pediatric trauma patients and their families.

“We built the program from the ground up,” Larson said. “In my eyes, that’s kind of where we were really making a differentiation between adult patients at this hospital and pediatric patients.”

Some of these initiatives and their success even surpassed the pediatric trauma program — like the massive transfusion protocol. Now, the entire children’s hospital has access to it.

“The pediatric verification means a lot to our program,” Larson said. “But it’s doubly meaningful that other groups around the hospital can benefit and see improved care, too.”

Another part of the success hinged on the team’s collective investment in improving the quality of the care provided. In 2020, they joined the American College of Surgeons Pediatric Trauma Quality Improvement Project Database, where pediatric trauma surgeons across the country can voluntarily submit data. Then, the data is analyzed to identify different trends against which hospitals can compare their programs.

“A key function of this database and others like it is helping programs identify areas they can improve care,” Larson said. “For example, ‘hey, maybe we need to be better at X, what can we do to get better at X?’ And through careful data analysis we are better able to refine our care processes.”

Even after receiving verification, the pediatric trauma team’s best practices are constantly looking for ways to improve. After all, the process of taking care of a pediatric trauma patient is one of the most multidisciplinary in the children’s hospital, Larson said.

“At any given pediatric trauma patient intake, we may need to take them to the pediatric intensive care unit, which will involve pediatric critical care medicine doctors who are in the Department of Pediatrics,” Larson said. “Or they might end up in a more general area of pediatrics. There are consulting services. There could be social workers. It’s always a lot of moving parts, and always in the best interests of our patients.”

The verification is a symbol of not just Larson’s commitment to his patients, but also that of every team member that has helped along the way — and continues to by asking one question, every day: How can I make this better?

“It’s a short question, but we’re always striving to answer it,” Larson said. “Then, when we go back and look at this, that we know that everything was done at the right time for the right patient to get the best outcome possible.”