**7.1 Access center/system**

In a multiple hospital system of care, there is not generally a need for more than one ECMO center for the system to accommodate the needs for non-CT surgeryrelated ECMO support. A helpful resource to assure patients have rapid transfer to the ECMO program from other hospitals, it is useful to set up a access center process to assure a standardized approach to hand-offs, transport, and tracking of patient movement. Call system personnel trained in the indications for ECMO can assist critical access and other facilities in routing possible ECMO patients for evaluation at the Center of Excellence. Early coordination with the call center leadership will allow them time to develop protocols, education, and coordination with transport services to assure smooth operations when the first patient call is received (**Figure 2**).
