LITTLETON, NH – For decades, Littleton Regional Healthcare (LRH) has been a leader in healthcare through investments in modern technology, continuous process enhancement, recruitment of qualified medical professionals, ongoing quality improvement measures, and growth in services aligned with the region’s needs. The latest marker indicating LRH’s leading position is the recent designation as a Level III Trauma Center for adults by the State of New Hampshire Department of Safety’s Division of Fire Standards and Training and Emergency Medical Services (FSTEMS). The distinction is the culmination of extensive evaluation by a multi-disciplinary FSTEMS team led by trauma surgeons, a trauma-expert registered nurse, and paramedics to ensure LRH provides prompt emergency assessment, resuscitation, and treatment of injured patients. LRH is the only hospital in northern New Hampshire to receive the Level III Trauma Center certification for adults and joins only a small number in the entire state.
Trauma Center certification is designed to aid prompt treatment of an injured person by matching medical needs with hospital resources. Level III certification indicates that a hospital has 24-hour in-house emergency physician coverage and rapid availability of both general surgery and anesthesiology services. As a formal member of the statewide Trauma System, Level III trauma hospitals are required to have transfer agreements with Level I and/or II trauma hospitals for patients requiring more extensive care. Other requirements include comprehensive quality and performance improvement programs, trauma-specific continuing education for physicians, nurses, and allied personnel, and an active injury prevention and outreach program.
This designation ensures the 24/7 availability of specially trained emergency physicians and surgeons. It also requires a framework of detailed data compilation that is kept for continuous improvement in trauma care going forward.
“Very few hospitals in rural areas receive this level of trauma designation, and LRH is the only Critical Access Hospital in the state to receive this recognition,” explained LRH Board of Trustees Chair Ashley Garrison. “I speak for the entire Board when I express my most profound appreciation for the work put forth by the team at LRH. We are all incredibly proud of this accomplishment and what it means for the communities LRH serves,” she added.
“Where you live should not dictate the availability or quality of healthcare you have. At LRH, we felt it was essential and mission-aligned that our region has access to high-quality trauma care, and we dedicated ourselves to building resources and systems to accomplish that,” noted LRH’s President and Chief Executive Officer, Robert Nutter. “We are proud to be the region’s Level III Trauma Center,” he added.
LRH’s trauma designation has been years in the making. A multi-disciplinary team led the efforts, but accomplishing this distinction required, and will continue to require, the dedication of the entire organization. Dr. Jonathan Klinger, FACEP, emergency physician, and Dr. Daniel Underbakke, FACS, general surgeon, serve as LRH’s Trauma Medical Directors.
LRH reported there were 2,526 trauma-related visits to its Emergency Department in 2024. The outdoor recreation opportunities available in the region can lead to blunt trauma injuries from falls and accidents. Unintentional injuries, such as falls, accidents, drowning, or violence, are the leading cause of death for ages 0-44 nationwide.
LRH continues to experience drastic growth in its Emergency Department year after year, not just in patient volume, but in the acuity level of the patients seen. As a result of this and growth throughout the entire organization, LRH is expanding its medical staff by adding surgeons qualified in trauma care, such as general surgeons and in orthopedics.
“As a Level III Trauma Center, an attending surgeon with experience in trauma care will be present to join our already present emergency physicians within 30 minutes of a patient’s arrival,” shared Dr. Edward Duffy, FACEP, LRH’s Chief Medical Officer and Executive Vice President. “This reflects our commitment to provide a high level of care by evaluating and treating trauma as quickly as possible. This also highlights the rigorous standards we will be held to as an organization with this designation and why a Level III trauma designation is difficult to achieve,” he added.
The inclusion of LRH as a Level III Trauma Center within the NH Trauma System will ensure a formal, programmatic elevation of the care given to victims of trauma in our region. Going forward, patients in the northern part of the state can remain local while they receive specialty care for traumatic injuries. Now more than ever, local Emergency Medical Services (EMS) and hospitals in nearby communities can look to LRH for resources to support trauma cases and support patients throughout the region with a higher level of care.