This presentation will

•  Summarize the changes in clinical practice at one trauma center which led to improve outcomes in TBI

•  Describe the application process and challenges in bringing the initiative to three trauma centers

•  Identify the steps in recruiting champions to change processes at these hospitals,

•  Integrate the EBL and monitoring technologies into hospital based protocols

•  Review the triumphs and challenges to introducing change in practice at three Level I trauma centers.