Three “hub” hospitals for major trauma were identified in the region, where all trauma activities that could not be postponed were concentrated. The three hub hospitals guarantee 24/7 acceptance of emergency cases, and they were chosen on geographical bases, by covering roughly one third of Lombardy territory each, divided into western, central, and eastern. The other hospitals were assigned to one of the three hubs as “spokes.” A fourth hub hospital, the regional centre for paediatric major trauma, has been re-allocated for urgent paediatric patients coming from all the other hospitals of the region.