Quality Burn Care in Jeopardy In the U.S.

Written by Amy Acton, RN, BSN

Executive Director, Phoenix Society for Burn Survivors


The announcement that Shriners Hospitals for Children is contemplating the consolidation of two of their four burn hospitals for children is another blow to burn care in the United States. It’s alarming news, especially for those of us who relied on a burn center team while undergoing our own acute care and years of reconstructive surgeries.

Burn care professionals have long been fighting hospital administrators for the survival of the burn center. Though it is a high-cost center, burn patients are some of the most complicated cases they will treat. 

A regional system of burn centers has emerged, with each burn center covering large geographic areas and some covering several states. In 1976, there were 180 burn centers in the US. By 2011, that number dwindled to just 123. Many of those remaining are just a shell of what they used to be as resources are reallocated or cut, leaving only 60 burn centers verified by the American College of Surgeons and the American Burn Association; of these, only 37 are verified to care for both adults and children. 

As the number of burn centers continues to decline, quality acute care will become much harder to access, and long-term care will be a privilege for few.

What will become of comprehensive, quality burn care? How will we support burn care that not only helps people survive but empowers them to thrive after a burn injury?

For decades, Shriners Hospitals for Children has been a hub of burn care research, developing life-saving protocols for treating burns in children and caring for some children throughout the first 20 years of their lives.

Because of these dedicated burn centers and specially trained teams, our ability to survive a burn injury has improved to an amazing 96 percent...but only if you are treated in a U.S. burn center. As people survive severe burn injuries, they require access to lifelong support and years of rehabilitation care.

Still, hospitals without burn centers often choose to keep burn patients. Clear guidelines for transfer are ignored. These hospitals lack the understanding of long-term care needs (or are more focused on revenue than patient outcomes).

Where would you want to be treated? Where would you want your child treated?

We must not allow burn care to move backward to a time when a burn patient was isolated on a critical care unit, waiting to die. Not when we know that, given access to proper care and long term support, those with burn injuries can thrive. 

The system of burn care is a national issue. We shouldallbe concerned that burn care and professional expertise is disappearing – especially when misinformed politicians and code officials are lumping fire safety measures in their effort to roll back building regulations and standards. Though burn injuries have declined over the years, I expect we’ll see those numbers rise again. In new homes being constructed today, you have only three to six minutes to escape, down from 18 minutes in legacy homes. Still, life safety codes are being dismantled.

We must not become complacent in our fight for quality burn care and burn prevention. The general public must not wait until they are in need of acute care to raise the alarm about the state of burn care in the U.S., or they may find that quality care no longer exists.

Within the burn profession, we must work together to assure ongoing research and access to quality burn care is an agenda we can all sign onto. And those of us who have survived due to quality care must stand up. We must be active in assuring we continue to improve access to care – because we know the consequences if we don’t. 



American College of Surgeons 


Amy Acton has dedicated her career to advocating for the expansion of burn recovery services and resources for burn survivors and their loved ones. She served as a burn nurse and later nurse manager at the Spectrum Health Regional Burn Center, where she was treated at the age of 18 for an electrical burn injury. Since 1998, she has served as the Executive Director of Phoenix Society for Burn Survivors, the leading non-profit dedicated to supporting burn survivors and their families.

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