Arkansas Department of Health

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Trauma Center Designation Process

Hospital Listing

Below is a listing of hospitals by region with designation intent levels reflected.  This listing includes contact information for the ADH Trauma Nurse Coordinator for each region.  As hospitals go through the process and are designated, they will be added to the Designated Trauma Centers listing.

Downloads

Hospital listing (by Region with Trauma Nurse Coordinators)

Documents

Below are documents that outline the trauma center designation process.  Some are designed specifically for hospitals, some for Trauma Reviewers, and some are applicable to both.  The intent of these documents is not only to establish the designation process but to make clear the roles and responsibilities of both hospitals and Trauma Reviewers within the overall process. This information is useful not only immediately before and during hospital designation site surveys, but also as a learning tool for hospitals and Trauma Reviewers as they prepare for the surveys.   

Hospital Documents

• TS-01 Designation Process
• TS-02 Designation Criteria
• TS-03 Site Survey Guidelines for Hospitals (Levels I and II) 
• TS-03 Site Survey Guidelines for Hospitals (Level III)
• TS-03 Site Survey Guidelines for Hospitals (Level IV)
• TS-07 FAQs Regarding Rules
• TS-07-2 FAQs Affecting Multiple Sections
• TS-09 Hospital PRQ (Levels I and II) 
• TS-09 Hospital PRQ (Level III and IV) 
• TS-14 Hospital Confirmation Letter
• TS-15 Hospital Intent Application 
• TS-16 Process for Re-Designation of Arkansas Trauma Centers
• TS-17 Re-Designation Dates for Arkansas Trauma Centers
• TS-18 Hospital Administration/Trauma Staff Change Notification Form
• Surgeon Evaluation-Score Cards – Level I
• Surgeon Evaluation-Score Card Template – Levels II, III, and IV
• Surgeon Evaluation – Score Card Template – Neurosurgeon
• Surgeon Evaluation – Score Card Template – Orthopedic Surgeon
• Clinical Practice Management Guidelines - Open Fracture Management
• Clinical Practice Management Guidelines - Geriatric
• Clinical Practice Management Guidelines - Anticoagulant Reversal TB
• Clinical Practice Management Guidelines - TBI

Trauma Surveyor Documents

• TS-01 Designation Process
• TS-02 Designation Criteria
• TS-04 Site Survey Guidelines for Surveyors (Levels I and II)
• TS-04 Site Survey Guidelines for Surveyors (Level III)
• TS-04 Site Survey Guidelines for Surveyors (Level IV)
• TS-05 Trauma Surveyors Credentialing
• TS-06 Trauma Surveyors Affidavit 
• TS-07 FAQs Regarding Rules
• TS-10 Surveyor’s Checklist (Levels I and II)
• TS-10 Surveyor’s Checklist (Levels III and IV)
• TS-11 Surveyor Statements-Full
• TS-11 Surveyor Statements- Provisional
• TS-12 Chart Review Template
• TS-13 Executive Summary Template
• Over Per Diem Travel Form
• Payment Request Form
• Training Payment Signature Form