Improper transfer rate of trauma patients in the pre-hospital trauma care was 50.7% and the transfer rate to the level of appropriate hospital within 30 minutes was 46.6% in South Korea. For this reason, the quality management of prehopital care in korea are required. The Purpose of this study is intended to improve the trauma care process of ems in pre-hospital in korea. The research subjects are the trauma patients transferred by Gang-won 119 Fire Department Ambulance in 2013. The methods are the data that is analyzed using the 119 ambulance recording sheets of trauma patients including structural indicators, process indicators and outcome indicators that reflect the process map (VSM: Value Stream Map) developed and analyzed. All transferred patient to the hospital emergency room in Gang-won Province during the entire year of 2013 results 66,282 and trauma patients were 30,887. Types of occurred accidents in trauma patients are 16,200 (53.0%), MVA (motor vehicle accidents) 8,789 (29.0 %), and others 5,593 (18.0 %), respectively. This study results the step-by-step problems and improvements occurring the report stage, mobilization phase, the field phase, transfer phase, the hospital phase in pre-hospital.