• Kevin M Ban, Francesco Mannelli, David P Mooney, Simone Lazzeri, Leonardo Bussolin, Roger Barkin, Antonio Messineo, Stefano Masi, and Monica Frassineti.
• Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. kban@bidmc.harvard.edu
• J Trauma. 2011 Nov 1;71(5):1442-6.

BackgroundTrauma is the leading cause of death and disability in Italy among patients aged between 1 year and 19 years. To transform its fragmented regional pediatric trauma system to a more organized and efficient spoke and hub model, Tuscany has developed a partnership with physicians from the United States to facilitate the process and to implement a series of strategic system changes to create the first pediatric trauma center in Italy.MethodsAfter establishing a multidisciplinary and institutional task force, a rigorous needs assessment was conducted to evaluate resources and develop a strategic timeline with specific project goals. Once an intensive educational program was completed, a series of system changes were made in Tuscany to create a full-service pediatric trauma center. Once accomplished, regional changes were enacted to divert the most severely injured children to the new center.ResultsIn <3 years, a full-service pediatric trauma center was developed and ingratiated into the adult trauma system. All these changes were achieved through relentless administrative support, creation of a strong sense of urgency, and empowerment of innovators and early adopters to effect change.ConclusionThrough a comprehensive process including early extensive system analysis leading to educational interventions and organizational changes, the Anna Meyer Children's Hospital has developed the first Italian pediatric trauma center.

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