Abstract
In 2003, key stakeholders came together to begin the development of a Minnesota trauma system. These 15 leaders, representing the diversity of a largely rural state, reflected upon past efforts to create a system that would see the reduction of morbidity and mortality from trauma. They realized that crucial components in the implementation of this system were the need to ensure hospitals and emergency medical services providers that patient flow would not be limited to a select few hospitals and that robust performance improvement would be key to the effectiveness of the program.