Regional Hand Trauma Center Network

Please provide the following information regarding your Hand Trauma Center.

Your participation in the Regional Hand Trauma Center Network of the American Society for Surgery of the Hand means that you are part of the first regionalized network of hand trauma centers in North America! Your center will be part of a network designed to elevate the care of hand trauma cases nationwide by facilitating transfers where appropriate.

Please provide the data below to indicate that you meet the requirements:

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* 1. Name of Center

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* 2. Your Name

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* 3. Your Preferred E-Mail Address

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* 4. Lead Surgeon (if not yourself)

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* 5. E-mail of Lead Surgeon

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* 6. Administrator Name

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* 7. Administrator E-Mail

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* 8. Contact for Referrals (for display on public site)

Name (if applicable)

Phone Number

Address

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* 9. Physical Address

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* 10. Is your Center:

Private Practice

Academic Medical Center

Other (please specify)

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* 11. The following criteria have been proposed for participating Centers. Please confirm that your Center meets these qualifications:

1. All Hand Trauma Centers are available 24/7/365 for hand trauma emergencies that include revascularization, replantation, and mutilating hand injuries.
2. A specific call list is available of Physicians on call.
3. A center may include residents and fellows from Plastic Surgery, Orthopaedics and General Surgery
4. The Hand Trauma Center does NOT have to be a Level I ACS designated center as long as criteria #1 is fulfilled.
5. A director of the Hand Trauma Center (or co directors) is needed to verify data and report data with regards to treatment (number of patients seen, injury patterns, etc)

My Center meets all of these qualifications

My Center does not meet all of these qualifications (please provide details below)

Please provide details

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* 12. How long has your Center been in operation? (Please provide year of origin)

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* 13. Please provide the names of additional Center faculty and their specialty training.

Faculty Member and Specialty Training:

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* 14. Please provide information on additional Center support:

Number of Residents:

Number of Fellows:

Number of PAs:

Number of NPs:

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* 15. Is the Center available 24/7/365?

Yes

Comments

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* 16. Were surgeons paid to take call in 2019?

Yes (please provide details below)

If you answered yes, how much were surgeons paid in 2018 per night to take call?

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* 17. How many neighboring Level I centers refer patients to your Center?

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* 18. Do you have transfer agreement(s) in place with any other Level I centers?

Yes (please provide details below)

Please provide additional information about transferring institutions and the agreement(s).

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* 19. Of patients transferred, what percentage of transfers are appropriate?

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* 20. Why did you self-identify as a Hand Trauma Center?

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* 21. How do you expect this regionalization program to help your Center?

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* 22. Are you willing to provide data on replants, revascularizations, and mutilating injuries on a monthly basis?

Yes