Abstract
The trauma program manager's (TPM's) documentation and demonstration of adequate loop closure are often one of the most difficult aspects of the American College of Surgeons verification visit. Loop closure is a key component for any trauma performance improvement and patient safety program. Loop closure is a vaguely defined process that is often subjectively evaluated by the site surveyors as either adequate or inadequate. The key to effective loop closure is to assign problem to categories and to have a database that allows for tracking and trending of these categories. This makes it possible for the TPM to identify recurring problems that action plans were designed to address. Effective loop closure requires the patience and tenacity of a TPM to monitor and readdress every recurrence of the issue. The TPM's approach to loop closure must be creative and multifaceted. Effective loop closure requires a commonsense approach to problem solving.