Geriatric trauma is changing. The number of older adults requiring trauma care is increasing, but more importantly, trauma programs are developing a better understanding of the complexity of caring for these patients. Geriatric PI should evolve with that understanding.

Building geriatric trauma capability doesn't have to begin with a new service line, a large committee, or an expensive program. Start with the data, identify the problems, intervene, and measure results.

The trauma surgeon still needs to be the expert in trauma. What may need to change is the composition of the team around that surgeon.

Hospitals must design geriatric trauma care so that high-quality care and financial sustainability reinforce each other.

An increase in the number of geriatric trauma patients appearing in trauma data likely reflects both a real increase in the burden of injury and changes in how injured older adults are identified and counted.

As the trauma population ages, trauma centers will need to evolve from a model focused primarily on treating injuries to one that also accounts for frailty, function, cognition, comorbidities, goals of care, and the patient's ability to return to their previous life.

Somewhere near the bottom of the job description for a Trauma Program Manager you will find the familiar phrase: “Other duties as assigned.” What are those duties?

Hospitals that intentionally invest in APP recruitment, training, and integration today will be better positioned to meet the growing demands of trauma care tomorrow.

PRMCE has invested in a model where surgeons are physically present in the hospital around the clock and focus exclusively on acute care surgery during their shifts.

At its core, trauma designation and verification are not about earning a certificate on the wall. They exist to answer one question: If a critically injured patient arrives at your hospital, will every system function exactly as it should?

A mock survey should provide a clear roadmap that helps the trauma program prioritize improvements, assign responsibilities, and establish realistic timelines before the official designation or verification visit.

Sometimes the biggest advances in trauma care don't come from a new device or a groundbreaking procedure. Sometimes they come from something much simpler: knowing and trusting the person standing next to you.

Trauma centers need staffing plans that grow with patient volume—not just enough to meet ACS or state requirements. Relying on minimum FTEs can lead to delayed registry work, weaker performance improvement, staff burnout, and turnover. By defining clear volume thresholds for adding trauma program, registry, PI, education, and outreach staff, hospitals can support quality care, maintain compliance, and ensure long-term program sustainability.

Hospital leaders make difficult decisions in rural communities when assessing capacity to provide trauma, stroke, and cardiac care.

Obstetric trauma is not uncommon, but extreme OB trauma with emergency c-section is extremely rare, emotionally overwhelming, and clinically complex. Guidelines are essential in these rare situations.

Key strategic considerations for hospitals considering a new trauma program.

The tragedies in Waco, Oklahoma City, Columbine, and Boston have had profound impacts on trauma care.

Proactively Communicate Wishes Through Advanced Directives, POSTs, and Code Status

Some things I learned when I was a fake trauma patient.

A decision tree helps hospitals determine if they can use the 068x trauma charge.