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Ever since Ernest A. Codman first advocated measuring outcomes of patients through End Results Cards,1 the goal of surgical quality has been to study the results of operative intervention and improve those results through systematic analysis. The article by Massarweh et al2 clearly documents that the Veterans Administration (VA) Surgical Quality Improvement Program and, with a nod to Codman, the American College of Surgeons National Surgical Quality Improvement Program have systemically advanced the quality of care for millions of surgical patients both in and outside of the VA.
Johanning JM, Arya S. Codman, Hawthorne, and End Results of a Watched System. JAMA Surg. Published online September 21, 2016. doi:10.1001/jamasurg.2016.2901