A trauma center will usually be served best by one surgeon's being designated as the Chief of Orthopaedic Trauma, in charge of administrative issues and quality assurance for orthopaedic trauma care. This individual may or may not be the hospital's Chief of Orthopaedic Surgery. He/She must be one of the on-call orthopaedic trauma surgeons. It is essential that the Chief of Orthopaedic Trauma work closely and effectively with the Trauma Medical Director (The surgeon in charge of the General Surgery Trauma Service).The orthopaedic Performance Improvement (PI) program must be a part of that of the Trauma Service as a whole, since so many issues of orthopaedic trauma care interface directly with all other aspects of the injured person's care. While reports from the orthopaedic PI program must be submitted to the overall trauma PI program. However, the Trauma Medical Director needs support from the Chief of Orthopaedic Trauma, because, being a general surgeon, he/she does not have expert qualifications in the field of orthopaedic traumatology.