What It Takes to Be Level I – Inside OU Health’s Trauma Verification Process

For the most critically injured patients, the difference between life and death often comes down to the readiness and expertise of the trauma team where they receive treatment. Not all hospitals are equipped to handle severe, complex trauma. Even among trauma centers, not all are created equal.

That’s why OU Health’s Level I Trauma Center is more than just a title, it’s a commitment to excellence, earned through rigorous national standards, constant evaluation, and a team that never stops improving.

But what does it take to be Level I? And why does this verification matter for Oklahomans? It's not just a fancy title that any hospital can claim. In fact, earning and maintaining Level I status requires extraordinary dedication, resources, and expertise

What Is a Level I Trauma Center?

When OU Health says they're a Level I Trauma Center, it has earned two critical stamps of approval. First, they've received state-level designation, meeting Oklahoma's specific requirements for the highest level of trauma care. Additionally, they have been ranked by the American College of Surgeons (ACS) on a Level I to Level V scale, with Level I being the highest and most comprehensive. ACS verification is widely recognized as the nation's most rigorous trauma assessment.

To earn Level I verification, a trauma center must meet strict national criteria and undergo comprehensive on-site evaluations by trauma care experts every three years. This verification is not permanent. It must be proven and re-earned ensuring the highest standard of care is continuously met. It's like having medicine's most demanding judges come to inspect every aspect of your performance, from your equipment to your team's skills.
 

This process examines every aspect of trauma care, from patient outcomes to specialty coverage, ensuring the center remains at the forefront of life-saving treatment. It ensures Oklahomans receive the highest possible level of trauma care as evaluated and endorsed by the nation's leading surgical authorities.

Most Level I centers are part of academic health systems, where continuous learning, teaching, and innovation drive excellence in care. OU Health is no exception. In Oklahoma, it is the only Level I Trauma Center verified for both adults and children, a distinction few institutions hold even outside of the state.

“It’s not just about saying you’re a trauma center,” OU Health Level I Trauma Center Director Dr. Alisa Cross, M.D., FACS, associate professor in the Department of Surgery at the University of Oklahoma College of Medicine. “It’s about meeting and maintaining the highest national standards every single day.”

How OU Health Earns and Maintains Level I Status

So, what exactly goes into earning – and keeping – Level I verification?

• 24/7 In-House Trauma Surgeons: A trauma surgeon must always be at the hospital, ready to respond within 15 minutes – day or night.
• Specialist Availability Within Minutes: Critical specialists, including neurosurgeons, orthopedic trauma surgeons and anesthesiologists, must be available around the clock and able to arrive within 30 minutes for the highest-level emergencies.
• Dedicated Trauma Operating Rooms: OU Health maintains trauma-dedicated operating rooms that are always ready, ensuring that patients don’t wait for life-saving surgery.
• A Full Range of Specialists: Beyond trauma surgeons, a Level I Trauma Center must have specialists in nearly every field of emergency medicine, including:
  • Neurosurgeons for brain injuries
  • Orthopedic trauma surgeons for complex fractures
  • Interventional radiologists to stop internal bleeding without open surgery
  • Burn specialists to handle severe thermal injuries
  • Trauma anesthesiologists for high-risk procedures
• Mass Casualty & Disaster Preparedness: A Level I trauma center must be capable of mobilizing hundreds of medical professionals in the event of a mass casualty incident, such as a tornado, explosion, or multi-vehicle crash.
• Advanced Blood & Transfusion Capabilities: OU Health has the capacity to deliver over 50 units of blood to a single patient in critical cases, an ability that most hospitals simply do not have.
• Trauma Education Leadership: Unlike lower-level Trauma Centers, Level I facilities must conduct trauma research and education and train the next generation of trauma surgeons.
• Proven Excellence Through Patient Outcomes: Every procedure, response time, and patient outcome is tracked, reviewed, and analyzed to ensure that OU Health is continuously improving.

“We've had to prove we can do what we say we can do. That’s why ACS verification matters; it’s an external validation of our capability,” said Dr. Cross.

Beyond the Checklist: What This Means for Oklahoma Patients

For trauma patients, Level I verification isn’t just about meeting requirements, it’s about survival. Here’s what it means in real terms:

• Faster Access to Life-Saving Care: Trauma surgeons and specialists are already at the hospital, meaning no delays when seconds count.
• Immediate Blood Transfusions: Patients in severe hemorrhagic shock (life-threatening blood loss) receive massive transfusions in minutes, preventing fatalities.
• No Need for Transfers: Lower-level trauma centers often lack the resources to treat the most severe cases, meaning patients must be transferred to OU Health, thus wasting critical time. At OU Health, everything needed is already in place. We accept transfers from other facilities when patients need a higher level of care, even if those are lower-level traumas. 
• Unmatched Expertise in Complex Injuries: From traumatic brain injuries to multi-system organ failure, OU Health specializes in the most serious and complex cases, treating patients that other hospitals aren’t equipped to handle.

The Real-World Impact: How Level I Trauma Care Saves Lives

The true impact of OU Health's Level I Trauma Center isn’t measured in numbers but in the lives forever changed by the care provided.

Recently, a patient struck by a vehicle defied the odds and walked out of the hospital, something unimaginable when they first arrived in critical condition. Their family never left their side as the trauma team worked relentlessly to save them. When they finally took those first independent steps, the entire team gathered to celebrate another incredible recovery.

One former trauma patient, once facing a devastating brain injury, has since gone on to pursue a career taking care of others. Another young child arrived with life-threatening injuries, leaving the team uncertain of the outcome. Today, thanks to immediate, specialized care, they are making remarkable strides in rehabilitation.

These stories represent just a fraction of the approximately 9,000 trauma patients treated each year. For every story shared, there are countless other individuals quietly returning to their lives, forever grateful for the expertise and compassion that met them in their moment of need.

Why OU Health Stands Alone in Oklahoma

For over 20 years, OU Health has been the only ACS-verified Level I Trauma Center in the state. This isn’t just a title. It’s a responsibility that ensures:

• Every patient receives the highest level of trauma care available
• Oklahoma remains prepared for mass casualty events and disasters
• Specialized trauma training continues to advance the field

Though voluntary, OU Health's pursuit and maintenance of this verification demonstrates an unwavering commitment to trauma care excellence.

As the state’s only Level I Trauma Center, OU Health is on the front lines of emergency care, ready for any challenge—from the every day to the unthinkable—because every patient deserves the best chance at survival.

Dr. Cross sums it up best:

"We care for Oklahomans in their worst moments. That’s why maintaining Level I verification is so important – it ensures that we are always ready,” she said.

Learn more about trauma and injury care at OU Health’s Level I Trauma Center.