How does UCLA ensure that trauma patients receive the highest quality of care? As a Level 1 center, we collect specific data for every trauma patient that comes through our door and submit those data to the National Trauma Data Bank for benchmarking at the system, regional and national levels. We have a robust multidisciplinary committee at UCLA that meets monthly to compare what’s happening in our trauma center with other centers within Los Angeles County, discuss problems and outliers and initiate quality-improvement processes when necessary. We also participate in the American College of Surgeons’ National Trauma Quality Improvement Program, which is a risk-adjusted database established in the past five years that includes approximately 250 trauma centers across the country. We are proud that our results compare favorably to other leading trauma centers for a variety of outcomes — brain injuries, hemorrhagic shock, infection, fractures, etc. What changes have you seen over time in the way trauma services are delivered? We have been on the leading edge of trauma care both technologically and scientifically and our patients are benefiting from an evolution of small steps that have coalesced in many different areas. For example, we have immediate access to computed tomography, magnetic resonance imaging and interventional-radiology techniques that, in many circumstances, have dramatically improved our ability to very quickly determine exactly what is wrong with the patient. When we know exactly what’s wrong, we can figure out exactly what to do to fix it. We also have advanced capabilities in minimally invasive fracture management, endoscopic repair of internal organs and intravascular repairs. In the old days, we had to open the chest emergently and find the injured blood vessel and sew it up or put in a graft. Today, we can place a stent in the blood vessel using catheter-based technology and seal a hole from inside. Many patients now receive life-saving procedures and are out of the hospital in one-to-two days instead of one-to- two months. Additionally, our neuro and trauma intensive care unit is equipped with all of the most advanced technology and is staffed 24 hours per day with highly trained neurointensivists and surgical intensive care doctors. What is your vision for UCLA’s trauma program over the next five-to-10 years? We want to continue to work on the boundary areas between good outcomes and great outcomes, particularly after the patient leaves the hospital. Trauma is not only the leading cause of death in the United States for people ages 1-to-44 years but also a major cause of disability. Once we have saved the patient’s life and they leave the hospital, a lot of work still needs be done to get them back to normal. We want to break down some of the barriers to care and communication so that patients are returned to their pre-injury health status. UCLA collects specific data for every trauma patient that comes through the door and submits it to the National Trauma Data Bank for benchmarking. “We have been on the leading edge of trauma care both technologically and scientifically and our patients are benefiting from an evolution of small steps that have coalesced in many different areas.” 7 UCLA Physicians Update