When Dr. Shannon Longshore, the medical director of the pediatric trauma program at ECU Health Medical Center, first joined the hospital, the James and Connie Maynard Children’s Hospital at ECU Health Medical Center wasn’t a verified pediatric trauma center. Now, Maynard Children’s Hospital is one of only four Level I Pediatric Trauma Centers in North Carolina and the only one serving the East.

“It is incredibly fulfilling to reflect on the growth we have experienced over the years, to now achieving verification as Level I Pediatric Trauma Center,” Dr. Longshore said. “Our teams across ECU Health have dedicated their work to constantly improving our care over the course of many years. From prevention, to treatment, and being entrusted to provide critical care at the highest level, this verification is a testament to the mission-driven work that defines our hospital and health system.”

The American College of Surgeons’ (ACS) Verification, Review and Consultation (VRC) Program is designed to assist hospitals in the evaluation and improvement of trauma care and provide objective, external review of institutional capability and performance, accomplished by an on-site review of the hospital by a peer review team experienced in the field of trauma care. There are three levels of ACS trauma center verification, with Level I being the highest verification a trauma center can achieve.

Level I Trauma Centers must be capable of providing system leadership and comprehensive trauma care for all injuries and have adequate depth of resources and personnel. These centers play an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research.

Recognizing excellence in pediatric trauma care and community outreach

Dr. Longshore herself has been instrumental in Maynard Children’s Hospital’s continued growth as a trauma center through her research and presentations at national conferences and her work with the Eastern Carolina Injury Prevention Program (ECIPP).

The ACS surveyors noted the value of ECIPP, which aims to create a safer environment, change behavior and change policy to improve the quality of life in eastern North Carolina. Sue Anne Pilgreen currently serves as the executive director of the Safe Communities Coalition and the manager of ECIPP, which has been around since 1995. Between 2020 and 2023, ECIPP was awarded more than $1 million in grant funding, which has supported work in areas such as teen driver safety, suicide prevention, firearm safety, and child passenger and bike safety.

“The surveyors were especially impressed with our work around firearm safety and suicide prevention,” said Pilgreen. “We utilize the pediatric trauma registry data, and that is what drives our work.”

Pilgreen was quick to commend ECIPP team’s work in all areas to prevent injuries, and she highlighted that while most trauma programs have one injury prevention person, ECU Health has an entire team. That enables the program to reach out to rural communities and establish new injury prevention processes.

“Even with our incredible injury prevention team, we recognize that injuries will happen,” said Pilgreen. “To have this Level I Trauma Center with the best of the best gives the opportunities for the best outcomes.”

Other specific strengths noted during the pediatric program’s survey included the addition of two pediatric orthopedic surgeons and a pediatric neurosurgeon; outreach clinical simulations in the region; the collaboration among the pediatric orthopedic surgeon, the neurosurgeon and the Pediatric ICU (PICU); and the recent renovation of the PICU to establish a family-friendly place to care for patients. Of note, a large strength also lauded was the academic research and a collaboration with the Brody School of Medicine at East Carolina University’s Department of Pediatrics.

This expansion of the pediatric trauma research footprint was accomplished through more than 10 publications in nationally recognized journals. Both Erika Greene, manager of the pediatric trauma program, and Elizabeth Seawell, manager of the adult trauma program, credited the collaboration with Brody to produce research and get articles accepted to journals.

“That was a big win for us,” Greene said. “We have an academic medical center with the resources and processes in place to care for injured patients, and we’ve done an amazing job to achieve Level I for pediatrics. We have the capabilities to take the best care of those patients to the highest level of the accrediting body.”

Sustained excellence in adult trauma care

The pediatric trauma center’s new Level I verification accompanies the ECU Health Medical Center’s adult trauma center re-verification of Level I, a title they have proudly held for 40 years.

“We were one of the first Level I Trauma Centers in North Carolina, and we were verified by the American College of Surgeons in 2005,” said Seawell. “We are recognized nationally for how we care for patients in a rural area.”

This recent re-verification was made possible in part due to the resources available to the program including neurosurgical, interventional radiology, orthopedic trauma neurology, and vascular resources, operating room capabilities and blood access, as well as a trauma team of 11 surgeons.

“We are the only Level I Trauma Center for 29 counties, and to reach that far and care for that many patients – we served more than 4,000 patients last year – we have to rely on local community hospitals and emergency response teams to ensure timely transfers and communication,” said Seawell.

Seawell noted that ECU Health Medical Center and Maynard Children’s Hospital have a 60 percent transfer in rate, when the national average is 30 percent, which means they work closely with local EMS agencies, regional transfer facilities, other ECU Health organizations and non-affiliated organizations to serve patients from all over the region.

“The role of our trauma program is to not transfer patients but to have all the resources we need. It provides excellence in patient care and helps keep our patients local,” said Seawell.

Dr. Eric Toschlog, medical director of the adult trauma program, emphasized the tremendous preparation required to achieve Level I. He noted that there are more than 100 standards to prepare for, including paperwork, infrastructure, teamwork and more.

“The visit from ACS is a two-day adventure in stress and anxiety,” Dr. Toschlog said. But at the conclusion, he felt immense pride. “This visit was my seventh in 24 years at ECU Health, and it was clearly our best; we were found to have no deficiencies, and the reviewers used words such as ‘exemplary’ and ‘blown away’ regarding multiple aspects of the trauma center.”

Having two Level I Trauma Centers at ECU Health is no small thing, and both centers achieving the highest level of care is due to the dedication of the trauma center teams.

“I am surrounded by brilliant, compassionate, hardworking, mission-driven individuals who share a singular vision of saving the lives of the patients we have the honor to care for each year. Our success is owed to those truly extraordinary people,” Dr. Toschlog said.