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Invited Critique
February 1, 2008

Moving Beyond Personnel and Process—Invited Critique

Arch Surg. 2008;143(2):120. doi:10.1001/archsurg.2007.30

The measurement of patient outcomes should be the paramount component of any verification process. The authors' statement in the article that the trauma center verification process measures resource availability but not patient outcomes is alarmingly inaccurate.

The verification process of the ACS does, indeed, incorporate patient outcome measures. The random review or “sampling” of patient medical records to conduct a comprehensive analysis of patient outcomes (eg, unexpected deaths) has been an integral part of the verification process. The trauma center slated for review is required to provide medical records needed at the time of the visit. The specific request, which is received by the hospital 2 to 3 weeks before the site visit, includes a description of the medical records needed to conduct the site visit. The clinical outcomes are assessed by various methods.

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