Nurses have expertise in wellness, health promotion, delivery of acute care, and rehabilitation. As the venture into healthcare reform deepens, nurses must take a more proactive role in redirecting the delivery of trauma care in such a way that optimal provision of healthcare services is maintained while costs of providing care are reduced across the continuum of care. Efforts must focus on preventing traumatic injuries, restructuring healthcare delivery systems to meet the needs of patients with traumatic injuries, and reducing healthcare expenditures. Table 3 outlines strategies used by our facility to decrease cost without compromising patients' care. The current era is fraught with rapid changes that necessitate a creative, rational, and organized approach to making decisions about the delivery system for patient-focused care. Nurses are in an optimal position to develop and implement interdisciplinary, creative strategies that will maximize the delivery of trauma care services to the community. Each institution must evaluate the processes involved in its delivery of trauma care services. Strategies to contain costs must focus on processes implemented to achieve optimal outcomes of patients' care. The economic marketplace will evaluate care on the basis of outcome statistics and cost analysis. Thus, nurses must continue to be critical evaluators of nursing practice, always striving for the best healthcare delivery system possible during these turbulent economic times.

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