The Bureau of Emergency Medical and Trauma Services (BEMTS) collaborates with Iowa’s 120 hospitals to enhance the health and safety of all traumatically injured patients across the state. The State Trauma Program leverages trauma registry data, injury prevention initiatives, hospital verification processes, and performance improvement resources to support Iowa’s hospitals and emergency care facilities in optimizing the care of injured patients. These efforts aim to improve patient outcomes and reduce morbidity and mortality resulting from traumatic injuries.
According to the most recent CDC WISQARS data, approximately 2,500 Iowans died from injuries and violence in 2023. This includes 397 deaths from motor vehicle crashes, 749 from falls, and 504 from suicides. Trauma continues to be a significant public health issue affecting the well-being of Iowans statewide.
State of Iowa Plan for Trauma System Development 2022-2027
BEMTS staff along with many contributors dedicated to improving the lives of individuals and families in Iowa collaboratively developed the 5-year State of Iowa Plan for Trauma System Development 2022-2027.
This plan will:
- Guide comprehensive system development
- Address system operational requirements
- Allow for local trauma system variations based on assessment results
- Reflect inclusiveness of the operational components as they fall under assessment, policy development, and assurance
- Demonstrate an all-encompassing methodology, ranging from injury prevention activities to prehospital trauma care, acute care facilities, and post-acute care rehabilitation
- Reflect integration with the State Health Plan and with the State’s Emergency Response Plan
- Allow for a dynamic process that will evolve with changing injury epidemiology and resource availability – both human and financial
The ultimate evaluation outcome of trauma system implementation is a reduction in morbidity and mortality. Iowa will accomplish this goal by planning and implementing a care improvement process, enhancing system performance, using evidence-based research, developing and implementing targeted injury prevention programs, and revisions to trauma system plans based on system assessments and data-based needs.
Iowa Trauma System Consultation
In 2015, The American College of Surgeons Committee on Trauma, Trauma Systems Evaluation and Planning Committee, evaluated the Iowa Trauma System as part of a consultative effort to improve the quality of the trauma program in Iowa. The report points out that, "Iowa has a long history of participation in organized trauma care as one of the first states to fully embrace an inclusive trauma system model that provide(s) a role for all acute care facilities, regardless of geographic location or hospital capabilities." The trauma program remains committed to the inclusive trauma system model. The recommendations outlined in the consultative report for improving the trauma program in Iowa remain the focus of work of the Iowa Trauma Program and the Trauma System Advisory Council and while many recommendations have been achieved, there is still ample room for continued growth and improvement. The full report can be read at the link directly below.
Verification Criteria
The Iowa Department of Health and Human Services (HHS) is the designated lead agency responsible for developing, coordinating, and monitoring the statewide trauma system, including the categorization and verification of all hospitals. The Trauma System Coordinator oversees verification for all Level III and IV trauma centers, except in cases where a Level III center chooses to obtain verification through the American College of Surgeons (ACS). Level I and II trauma centers are required to be verified by the ACS.
Trauma centers must follow the appropriate national standards based on their verification level:
- Level I, II, and III trauma centers:
- Level IV trauma centers:
The Trauma Program Manager Manual is a comprehensive resource for trauma program management. It outlines the core responsibilities of the Trauma Program Manager (TPM), details verification requirements, offers links to external education and training resources, and includes tools to support success in the TPM role. While the manual is not intended to replace a hospital’s internal TPM orientation, it is designed to complement and enhance that process.
Trauma Systems Administrative Rules and Statute
Iowa Code Chapter 147A – Emergency Medical Care – Trauma Care
This statute governs the statewide trauma system. The associated Administrative Rules provide detailed guidance to help facilities and providers comply with the law.
641—134: Trauma Care Facility Categorization and Verification
This rule provides a structured system for ensuring hospitals and emergency care facilities meet defined trauma care standards, with the goal of ensuring consistent, high-quality trauma care across Iowa. It includes the adoption of the 2022 ACS Resources for Optimal Care of the Injured Patient ("Gray Book") for Level I, II, and III trauma centers, while continuing to use the 2014 ACS Criteria ("Orange Book") for Level IV centers.
641—135: Trauma Triage and Transfer Protocols
This rule aligns Iowa’s EMS trauma triage and transfer decisions with the 2021 National Guideline for the Field Triage of Injured Patients, replacing Iowa's 2013 Adult and Pediatric Out-of-Hospital Trauma Triage Destination Decision Protocols (OOHTTDDP). It provides EMS personnel with updated guidance for determining the most appropriate trauma destination based on injury severity and available resources—while still allowing real-time judgment and flexibility during emergencies that strain resources.
This rule establishes the framework for maintaining Iowa’s statewide trauma registry, requiring trauma care facilities to submit standardized patient data. It supports statewide trauma surveillance and system improvement through medical record reviews and ongoing data validation. Notably, it removes reference to a specific version of the Iowa Trauma Patient Data Dictionary, giving the Bureau of Emergency Medical and Trauma Services (BEMTS) the flexibility to update data standards more efficiently as reporting needs evolve.
641—137: Trauma Education and Training
This rule ensures that healthcare professionals involved in trauma care receive initial and continuing education aligned with nationally recognized standards. Trauma team members must meet requirements based on their facility’s verification level: Levels I–III: Education must follow the 2022 ACS Standards ("Gray Book"). Level IV: Education must follow the 2014 ACS Standards ("Orange Book").
641—138: Trauma System Advisory Council (TSAC)
This rule has been rescinded. The TSAC will now operate under its established bylaws (see below), rather than being governed by administrative rule.
Trauma System Advisory Council (TSAC)
The Iowa Trauma System Advisory Council advises the Iowa HHS Bureau of Emergency Medical and Trauma Services (BEMTS) on issues and strategies to achieve optimal trauma care delivery throughout the state.
The committee meets quarterly, on the 3rd Tuesday of the month at 1:00 p.m. The meetings are held virtually via Microsoft Teams. You may request the meeting link and previous meeting minutes by contacting the Trauma System Coordinator.
FY 24-25 Membership List
- Chair: Carlos Pelaez, MD, FACS – American College of Surgeons, Iowa Chapter
- Co-Chair: Michele Lilienthal, RN – Urban Trauma Program Manager, Iowa Hospital Association
- Anthony Camodeca, DO – American College of Emergency Physicians, Iowa Chapter
- Veronica Fuhs – Rural Hospital Administrator, Iowa Hospital Association
- Sarah Solt, Paramedic – EMS Provider, Iowa Emergency Medical Services Association
- Jennifer Rouse, PT, DPT – American Physical Therapy Association, Iowa Chapter
- Jennifer Lefeber, RN – Rural Trauma Program Manager, Iowa Hospital Association