Abstract
How the trauma center in the US is managed is not fully understood by the majority of Japanese trauma surgeons and emergency physicians. I visited seven major trauma centers throughout the US, in 2002. I observed the PIPS program of each trauma center and interviewed the Trauma Medical Directors and the Trauma Program Managers about how they manage their trauma centers. In this article, I described the purpose of the PIPS program and how it should be managed. The trauma centers are verified by the American College of Surgeons-Committee on Trauma based on "Resources for Optimal Care of the Injured Patient" and designated by the government of each State. The PIPS program is a major component of the trauma program and every trauma center should have appropriate human resources and organized committees in charge of quality improvement. The trauma registry is a key tool in the PIPS program, and much effort in maintaining the quality of data input is necessary. The cost of maintaining the trauma registry is large, and there is no subsidization from the state government. Maintaining the designation as a trauma center is very important in terms of hospital financing.
