Preparing Kentucky's emergency departments for a comprehensive trauma care system: the Kentucky Hospital Association emergency department survey.

Kentucky continues to lag in development of a statewide trauma care system, and objections to implementation have arisen from hospital emergency departments. In order to clarify these issues, the Kentucky Hospital Association conducted a statewide survey. Respondents represented 95% of the state's general acute care hospitals. A large majority (78%) reported that they could not meet the American College of Surgeons' (ACS) standards for verification as a trauma care facility at any level, and a similar number (81%) opposed requiring verification for facilities providing trauma care. Staffing deficiencies (particularly surgical specialists) were the primary reason cited for facilities' inability to meet ACS standards, while objections to requiring ACS verification were based on concerns about the ability of EMS to transport patients to definitive care in a timely enough manner. Recommendations included improvements in emergency department (ED) facilities and staffing as well as EMS capacity and training. Improvements in Kentucky trauma care will require additional funding to increase the number of verified facilities and enhance coordination among providers and facilities.