The NorthStar Trauma Network (NSTN) launched an initiative in 2018 to address systemic and local hospital challenges in the delivery of fracture care across a metropolitan area with a population of about 3 million. This regional fracture care model has expanded, serving seven hospitals in three health systems by 2023, including five participating community hospitals with level 2 or 3 trauma care centers and one level 1 pediatric hospital, all anchored by a level 1 university teaching trauma center. Recruitment and culture have been built around shared academic values, inclusive of investigation and education, promoting a surgeon retention rate of 100% for the first 6 years while sharing learned information and innovation that helps to drive impact in the local and larger community. Three aspects of the NSTN model, which is part of the HealthPartners system, differentiate it from other specialty or trauma care models; these are related to staffing, mission, and access. First, the NSTN model is designed to build trauma programs for hospitals rather than just providing call coverage; these programs are distinguished by their commitment of dedicated trauma-trained staff to network-member hospitals, which may be owned and operated by a variety of different — even competing — health systems. Second, the NSTN is anchored by one leadership team that promotes a collective academic mission among members; this is galvanized by the activities of the NorthStar Trauma Society, a related 501(c)(3) nonprofit organization focused on research, education, and innovation. Third, the NSTN model emphasizes subspecialist-level orthopedic trauma care (generally only seen at level 1 trauma centers) at level 2 and 3 trauma center hospitals, as well as level 1 pediatric hospitals, which expands access to care. This documentation of the evolution and methods of the NSTN may serve as a helpful example for other metropolitan communities with hospitals and health systems that seek to improve the quality of specialty-specific trauma care, the alignment of surgeons, and growth in surgical care.