The Office of Care Integration (OCI) ensures that Maryland’s trauma and specialty care centers are properly designated, adhere to necessary standards, and maintain high levels of quality in patient care. OCI provides on-site verification of programs and ensures that they operate per their designation (e.g., Level I, Level II, Level III) and meet the criteria necessary to maintain their designation(s). Designation and verification processes for trauma and specialty referral centers require continuing evaluation to ensure compliance with the Code of Maryland Regulations (COMAR 30.08 et seq.) and ensure ongoing quality assurance and monitoring of Maryland’s trauma and specialty care systems. Periodic reviews are done with a growth-oriented mindset where OCI leadership provides coaching, mentoring, and education.
MIEMSS staff conducted 64 in-person site visits to 16 trauma centers for planned Quartey reviews, with 52 additional hospital onsite coaching visits; provided consultation through two visits with Children’s National Hospital Burn/Trauma Center; two visits with MedStar Washington Hospital Center; two visits with ChristianaCare; presented 21 lectures (13 lectures in-state, three lectures at National Conferences, and five Grand Rounds at outof-state trauma centers); and mentored 11 EMS agencies. In addition to serving the trauma centers, the team remains focused on staying current with best practices and educating the community through presentations and workshops at local, regional, and national conferences.
The Maryland Trauma System
The Maryland trauma system is organized regionally to ensure accessible care throughout the state and is tiered to match patients with the appropriate level of care based on injury severity. Maryland has nine designated adult trauma centers and five types of specialty trauma centers: pediatric trauma, adult and pediatric burn, eye trauma, and hand/upper extremity trauma. (A complete list of Maryland’s trauma and specialty centers, including out-of-state hospitals with MOUs to receive Maryland trauma patients, is available on page 21. All Maryland adult and pediatric trauma centers submit data to the National Trauma Data Bank (NTDB). This data is used to assist trauma centers with comparative data for benchmarking against a national scale. The Office of Care Integration (OCI) collaborates with trauma centers in Maryland to provide a statewide quality comparison with national trauma centers.
Trauma and Specialty Referral Centers Page
Trauma Care Improvement
The Maryland Trauma Quality Improvement Committee (TQIC) is composed of trauma program managers and directors, trauma performance-improvement staff, trauma registrars, trauma quality improvement, and injury prevention and education staff. This group reviews, monitors, and trends statewide compliance using metrics such as emergency department documentation of patients’ Glasgow Coma Scale, emergency department documentation of patients’ pain assessment, unplanned visits to the operating room, trauma bypass hours per month, and eight other criteria.
In collaboration with ESO Solutions, Inc., registries for trauma, head, eye, hand, and upper extremity injuries have been integratedwith eMEDS® patient care records to enhance the accuracy of patient information. The Maryland Burn Collaborative analyzes burn data submissions, standard audit indicators, and performance improvement. A Maryland Burn Center scorecard tracks and trends statewide compliance using quality indicators such as the percentage of patients with a burn Total Body Surface Area (TBSA) greater than 10% admitted within six hours of injury or interhospital transfer, and the percentage of deaths with less than 10% TBSA. In conjunction with the State EMS Medical Director, the collaborative significantly influences the development of The Maryland Medical Protocols for Emergency Medical Services, on such matters, for example, as decisions pertaining to high-flow oxygen versus hyperbaric oxygen. This reporting year, the TQIC and Burn Collaborative utilized the Maryland Trauma Registry to identify injury prevention needs across the state. Beyond regional initiatives, all trauma, burn, hand, and eye designated centers discussed statewide injury prevention. These presentations included: Stop the Bleed®; falls; gun violence; pedestrian/scooter injury; bicycle injury and burn injury.
Designated Stroke Centers
The Office of Care Integration (OCI) strives to ensure stroke centers evolve in line with new research and best practices in stroke care. In FY 2025, the Stroke Quality Improvement Committee (Stroke QIC), consisting of Maryland hospitals’ stroke program coordinators and stroke program medical directors, focused on ongoing initiatives for improving stroke care in Maryland. This work led to COMAR regulation updates for acute stroke-ready. primary, thrombectomy-capable, and comprehensive stroke center designation. In FY 2025, two primary stroke centers and one comprehensive stroke center renewed their designations. In total, Maryland now has 31 primary stroke, one acute stroke ready, three comprehensive stroke, and four thrombectomy-capable primary stroke designated centers.
Maryland’s stroke centers submit data monthly to the American Heart Association (AHA) Get with the Guidelines® stroke registry. OCI uses this data to monitor compliance with AHA and American Stroke Association (ASA) standards. By evaluating core performance measures, OCI benchmarks Maryland’s compliance rates and compares them to national standards. For CY 2024, Maryland achieved a compliance rate of 93% or higher for each core performance measure, significantly surpassing the AHA/ASA minimum compliance rate of 80%. This high compliance reflects improved patient outcomes and demonstrates that Maryland’s stroke care exceeds national benchmarks.
Maryland stroke centers use Get with the Guidelines® data to refine stroke alert protocols, enhance response times, and share best practices. In FY 2024, this data helped improve door-to-Intravenous tissue Plasminogen Activator (IV t-PA) times. Early treatment with t-PA is known to improve patient outcomes. The AHA/ ASA Target Stroke Program sets a minimum standard requiring that 75% of eligible stroke patients receive t-PA within 60 minutes of arriving at the hospital. For CY 2024, Maryland’s median doorto-t-PA time was 42 minutes, and 87.3% of eligible acute ischemic stroke patients received t-PA within the 60-minute standard.
During this reporting period, OCI leadership partnered with designated centers and conducted approximately 201 on-site visits to coach, mentor, and identify ways to improve and maintain stroke status and better inform the public. The stroke team regularly attends local, regional, and national conferences to gain information to disseminate best practices for stroke care in the Maryland community, and presented on learned lessons and experience at state, regional, and national conferences.
Designated Stroke Centers Page
Cardiac Intervention Centers
Hospitals that meet state standards for treating ST-Elevation Myocardial Infarction (STEMI) are designated as Cardiac Intervention Centers. In Maryland, 24 hospitals and four out-of-state hospitals serving Maryland patients hold this designation. A STEMI is a life-threatening coronary artery blockage leading to death of heart muscle. Timely treatment to relieve the blockage improves heart muscle recovery. Primary percutaneous coronary intervention (pPCI) is recognized by the American College of Cardiology and the American Heart Association (AHA) as the preferred treatment for STEMI due to its association with fewer complications and better outcomes.
All Cardiac Intervention Centers submit data quarterly to the AHA Get with the Guidelines® Coronary Artery Disease Registry. MIEMSS uses this data to evaluate and compare STEMI care in Maryland against national benchmarks. For CY 2024, Maryland achieved the target of 90 minutes or less for first medical contact (FMC) to cardiac catheterization lab (“device”) intervention in 76.2% of STEMI cases transported by EMS, a 3.3% improvement from CY 2023. Additionally, the median FMC-to-device time for CY 2024 was 79 minutes, six minutes shorter than in CY 2023. In FY 2025, six application and site reviews resulted in six redesignations in Maryland. During this reporting period, OCI completed 23 visits to cardiac intervention centers for coaching, mentoring, improving patient care, and preparing centers for redesignation. OCI continues to assist cardiac centers through partnering with their teams in quality improvement projects to facilitate guideline-directed evidence-based practice adoption.
To enhance integration with EMS, OCI continues to encourage cardiac intervention centers to engage EMS participation in annual check-in visits, as well as monthly program meetings. In June 2025, OCI surveyed all jurisdictions regarding the use of the optional supplemental protocol for EMT 12-lead ECG acquisition. The responses help the OCI team communicate how EMS resources are operationalized to cardiac centers.
OCI continues to partner with the Maryland Cardiac Center Consortium (MC3). The consortium meets quarterly and includes representatives from each cardiac center, the American Heart Association, and the Maryland Health Care Commission (MHCC). OCI also represents MEIMSS at the Maryland Cardiac Data Coordinators meetings and the Maryland Cardiac Advisory Steering Committee hosted by the MHCC.
Designated Cardiac Intervention Centers page
Freestanding Emergency Medical Facilities
Freestanding Emergency Medical Facilities (FEMF) are licensed facilities that are structurally separate and distinct from a hospitaland provide emergency care. FEMFs differ from hospitals in that they do not provide inpatient care. FEMFs are required to have specific medical equipment and staffing available for trauma care.
- UM Bowie Health Center • Adventist HealthCare Germantown
- UM Shore Emergency Center at Queenstown
- UM Laurel Medical Center • TidalHealth McCready Pavilion
- UM Shore Medical Center at Cambridge
- UM Upper Chesapeake Health at Aberdeen
- LifeBridge Grace Medical Center
Perinatal and Neonatal Programs
The Maryland perinatal and neonatal systems follow the care standards set by the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), which range from Level I (basic care) to Level IV (high-risk care). MIEMSS oversees Levels III and IV perinatal and neonatal referral centers in Maryland. This oversight includes 15 hospitals providing obstetric services, of which 13 are Level III centers and two are Level IV centers.
Levels III and IV perinatal referral centers provide annual reports that go beyond mortality statistics, focusing on clinical excel- 23 lence, patient safety, and reliability. Their goal is to eliminate preventable adverse outcomes. The data, both regional and national, helps track maternal and infant health indicators. The MIEMSS Perinatal Advisory Committee meets quarterly to identify areas for improvement and establish best practices.
To address adverse perinatal outcomes and reduce preventable deaths, perinatal programs have developed EMS-specific education centered on culturally responsive care for the state’s diverse maternal population. Since over half of preventable maternal deaths occur after delivery and hospital discharge, MIEMSS emphasizes the importance of preparing EMS clinicians in recognizing lifethreatening perinatal conditions while also providing culturally competent care to effectively communicate with all patients.
This reporting period, MIEMSS and perinatal and neonatal program leadership created and published an EMS educational video and education module (in Online Learning Center), completed 28 on-site visits to perinatal programs for the purpose of coaching, mentoring, improve patient care, and prepared centers for redesignation. In FY 2025, perinatal program leadership attended four conferences with national reach and presented 12 times at regional and national events.
Perinatal and Neonatal Page
Updated 10-1-25