Article by Sarah Craig, Director of Health System Innovation, South Carolina Office of Rural Health

In South Carolina (SC) there are currently sixteen hospitals designated as a Level I, II or III Trauma Center. The Level I Trauma Centers include:

  • Grand Strand Regional Medical Center;
  • Greenville Health System Greenville;
  • Medical University of South Carolina;
  • Palmetto Health Richland;
  • Spartanburg Regional Medical Center.

The Level II Trauma Centers include:

  • McLeod Medical Center Florence;
  • Trident Medical Center.

The Level III Trauma Centers include:

  • AnMed Health Anderson;
  • Carolina Pines in Hartsville;
  • Carolina Medical Center Florence;
  • Conway Medical Center;
  • East Cooper Medical Center;
  • Lexington Medical Center;
  • The Regional Medical Center,
  • Self Regional Medical Center;
  • Piedmont Medical Center.

To become a designated Level I, II or III Trauma Center in South Carolina, hospitals must comply with the Optimal Care of the Injured Patient requirements established by the American College of Surgeons (ACS). Following a ACS hospital survey, the ACS results are sent to the Trauma Advisory Council (TAC) at the SC Department of Health and Environmental Control (SC DHEC). The hospital’s deficiencies are reviewed and a final vote from TAC regarding the Trauma Center designation is established. Hospitals must re-designate every three years to maintain their Trauma Center status.

At the latter end of 2017, TAC nominated a subcommittee to begin work around establishing a Level IV Trauma Center designation in South Carolina. The Level IV Trauma subcommittee established Level IV Minimum Standards, a Level IV Pre-Review Questionnaire and Level IV Site Survey Guidelines. In April 2018, the Level IV Trauma Center was established as a designation by the TAC. Hospital interested in this designation level will coordinate with the Trauma Division Director at SC DHEC, complete the Level IV pre-review questionnaire, and compete a site survey with two out-of-state surgeons. Similar to Levels I, II, and III, Level IV deficiencies are reviewed and a final vote from TAC regarding the Trauma Center designation is established. Level IV trauma designation is also a three-year designation.

This new level of trauma designation will address lower acuity trauma cases on-site while rapidly stabilizing and transferring higher acuity trauma patients to an appropriate hospital within the trauma system. Level IV Trauma Centers must have specified staff to oversee the trauma program, be able to provide certain treatment within a specified timeframe, develop and maintain relationships with higher acuity trauma centers (Level I, II and III), and continually work to improve the quality of care they offer to their trauma patients. The addition of Level IV Trauma Centers will increase the access of care for trauma patients by allowing smaller and more rural facilities to join the trauma system creating a more wide-ranging network of coverage. Development of a more inclusive and comprehensive trauma system is an important step in increasing the care provided to trauma patients throughout South Carolina.

For additional information, please reach out to Sarah Craig, Director of Health System Innovation at craig@scorh.net.