Collaborative Centers Review Process

Collaborative Centers Review Process

Please contact Chest Wall Injury Society with any questions (information@cwisociety.org)
Hospitals/Health systems that are interested in participating as a Collaborative Center should email the Chest Wall Injury Society to indicate their intent to submit an application as early as possible in the preparation process. Once all criteria are met, submit the application form below - and you will receive a confirmation of receipt and follow-up from a member of the CWIS team.

If your application is approved, you will receive exclusive resources including logos, custom branded patient education materials, etc. Additionally, you will be honored at the 2022 CWISummit in Salt Lake City, Utah.

The term of approval is for two years – and then (if applicable) a center would have the opportunity to engage in subsequent re-application cycle(s).
Name for main point of contact *
Complete name + credentials (e.g., Mickey Mantle, MD)
Preferred email for main point of contact *
example@example.com
Name for secondary point of contact (if applicable)
Complete name + credentials (e.g., Mickey Mantle, MD)
Preferred email for secondary point of contact
example@example.com
Complete name of the applying hospital/health system *

Patient Care and Access
Patient Care and Access

One element required
Indicate which criterion/criteria your facility has achieved. *

At least one specialist with interest in chest wall injury Site champion must be an active CWIS member Site champion must have clinical availability to evaluate and manage patients
Please explain your answer above. *

Rigorous Research
Rigorous Research

One element required
Indicate which criterion/criteria your facility has achieved. *

Contribute patients to Chest Injury International Database (CIID) or a local patient repository of surgical and non-surgical patients that will retrospectively contribute data to CIID at least annually Act as a contributing center for a CWIS-approved study Minimum of 2 peer-reviewed journal articles per application cycle with a chest wall focus Presentation at a CWIS educational activity at least annually
Please explain your answer above. *

Education and Networking
Education and Networking

One element required
Indicate which criterion/criteria your facility has achieved. *

Participation in the CWIS Mentorship program (as either a mentor or a trainee) Participation in a CWIS based course (when available) as either an instructor, curriculum developer, or participant Participation in a Ribinar, Ribcast, Case Review Series, or Journal Club Series as a presenter, discussant, or moderator Participation in a publication project (Practice guidelines, patient education materials, video series) Participation on a CWIS committee, task force, or workgroup
Please explain your answer above. *

High-Quality, Team-Based, Evidence-Based Care
High-Quality, Team-based, Evidence-Based Care

One element required
Please confirm this required criterion. *

Have a minimum of ONE non-surgeon member of CWIS
Please provide name(s) of member(s). *
Indicate which criterion/criteria your facility has achieved. *

Adherence to society demonstrated recommendations/best practices/guidelines Sharing of site-specific practices and protocols with other institutions (community/ multi-disciplinary outreach presentations) Use of Slack social media to contribute to the greater shared knowledge of the society
Please explain your answer above. *

Final Review
Attestation

By electronically signing my name below, I am indicating the above documentation is the full and complete representation for my hospital/health system.
Signature

Clear
Date

Month Day Year
Date
If you have any questions, please contact the
Chest Wall Injury Society via email at information@cwisociety.org.

To advance the care of the patient with chest wall injury through rigorous research, promotion of patient access, navigation and advocacy, coordination of education and networking, and practice of high quality, evidence-based, cost-effective care.
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Patient Care and Access