Level 4 trauma centers must provide 24/7 emergency physician coverage under new standards promulgated by the American College of Surgeons. The American College of Emergency Physicians wants this requirement for all hospitals, not just level 4 trauma centers.
The American College of Surgeons Committee on Trauma released the updated level 4 standards July 30. The manual runs 30 standards across seven areas, from institutional commitment and staffing to patient care protocols and performance improvement. For the first time, it calls for continuous emergency department physician coverage, 24/7/365.
Level 4 centers are often the first, or only, source of immediate trauma care in rural and remote communities, according to Michael Person, MD, Rural Program Area Chair of the ACS Committee on Trauma.
The standards are meant to complement state designation criteria, as the ACS does not itself verify level 4 centers.
The American College of Emergency Physicians, which advocated for the change, framed it as bigger than trauma designation. ACEP said it worked with the surgeons’ group to affirm that emergency physician training cannot be substituted with other providers — and argued the principle should reach every ED, not only trauma centers.
“We made it clear that all patients, regardless of whether you’re cared for in a level 1 academic urban trauma center or a level 4 rural one, deserve to have an emergency physician taking care of them,” ACEP President Anthony Cirillo, MD, said in an Aug. 3 statement.
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