Summary: Public General hospitals in Israel must provide Emergency and Trauma care 24/7 without bias or connection. Hospitals differ in their ability to provide trauma care for different types of injuries, availability, infrastructure, services, and manpower. The MOH established a Trauma Committee to apply trauma care standards according to universal standards; hospitals are classified into three levels of trauma care: a Level One Trauma Center, a Regional Trauma Center, and a Local Trauma Hospital. The criteria include specialist physicians, nurses, nurse coordinators, other supporting medical and paramedical teams, Trauma Unit capacity and capabilities, Trauma Registration as part of the national system, standard medical equipment in the ED’s trauma Unit, Internal guidelines and procedures, Quality Assurance of care for the injured, research, and Trauma Education. Six of the twenty-eight hospitals assessed by the committee were recognized as Level One Trauma Centers; one medical center was required to complete deficiencies and is in the re-evaluation process. Seven Medical Centers were approved as Regional Trauma Centers. Three medical centers were required to complete deficiencies and participate in the re-evaluation process. Six hospitals are approved as local trauma hospitals, but another six do not meet the requirements, and their recognition has been delayed. At this point, some hospitals do not meet the required standard due to a lack of motivation to promote their system and blame it on a lack of budgets, the need for preparation, appointment of positions, and commitment. The committee’s hands are tied because it cannot oblige hospitals to fulfill the recommended standards. In the absence of the ability to “punish,” it is possible that some hospitals will not be part of the standard Trauma care in the national trauma system. Moreover, their Trauma Care standard may be inadequate. The committee needs to have the legal authority to enforce its recommendation.
Goren et al. (Sun,) studied this question.