Don't Go Golfing During Your Trauma Center Verification Survey (and Other Advice from Dr. McGonigal)

When I think of the name mostly commonly mentioned as an American College of Surgeons (ACS) site reviewer, one name comes to mind: Dr. Michael McGonigal. The Trauma Pro and Emeritus Director of Trauma Services at Regions Hospital in St. Paul, Minnesota. Among other things, Dr. McGonigal is an educator, public speaker, blogger, and life-long learner. [Also, he's the self-declared (and parodied) most educational trauma surgeon in the world.] Since he has conducted over 400 trauma center verification reviews for the American College of Surgeons and state trauma systems, there is a high probability you have met him during one of your trauma center's verification visits!

Having had the pleasure of experiencing two ACS site reviews under his supervision and having worked with countless trauma centers who have been reviewed by him, Dr. McGonigal has been my primary teacher of verification visit conduct and how to demonstrate success to the ACS.

We spoke recently about his most notable experiences as a reviewer and advice he has for trauma centers preparing for an ACS review.

Guaranteed Way to Fail a Trauma Center Verification Review: TMD Doesn't Show Up

"I have two notable memories," Dr. McGonigal shared with me. "A number of years ago we were conducting a review at a Level 3 trauma center. When we showed up for the tour on Day 2, the Trauma Medical Director was not present. He went golfing! Another time, we were conducting a visit in a bigger city. I received a call from the CEO on the morning of Day 2 and was told that the Trauma Medical Director had resigned. In both instances, we terminated the reviews early."

ACS Reviews Shine a Light on Blind Spots

As a long-time Trauma Medical Director himself, Dr. McGonigal has also been on the receiving side of the verification review 24 times. He says he always appreciates the feedback he receives from reviewers.

"When you are immersed as the leader of the program, it is easy to have blind spots. And when the Trauma Program Manager has the same blind spots, you can overlook something important. The review provides an opportunity to have fresh eyes on your program."

Advice for Trauma Centers Preparing for an ACS Review

So what advice does this esteemed reviewer have to trauma centers preparing for an ACS review?

1. Read the Gray Book, Page by Page. "We can read the gray book countless times and still find content that surprises us or can be interpreted differently," McGonigal explains. "It is important to identify every detail that may generate a question or scrutiny during the review."

   
   

2. Educate Your C-Suite. "In many hospitals, the c-suite is insulated from the day-to-day happenings of the trauma program and may approach the upcoming visit with rose-colored glasses," he explains. Dr. McGonigal advises trauma leaders to meet with their executive leaders early and inform them of how they expect the review to go. "Alert them to potential deficiencies so they are not caught off-guard in an exit interview."

   
   

3. Partner with an Experienced Review Veteran. If you are preparing for your first visit and/or you are not a seasoned TMD or TPM, you should partner with someone who has more experience. This could be someone within your health system at a different trauma center or a consultant who specializes in trauma center development and verification preparation. "You may think you understand the gray book, but someone with more experience can coach you on the nuances and ways to demonstrate compliance."

   
   

4. Invest in the Consultative Visit. If your trauma center is preparing for its first visit, take the extra time and make the financial investment in a consultative visit with the ACS. Dr. McGonigal knows that sometimes hospitals will skip this step because it adds another year to the process and comes at an additional expense, but the consultative visit is essential. "This not only helps you identify deficiencies and opportunities for improvement, but it also allows for connections with experienced reviewers who can provide examples and support."

More Advice to Come in Upcoming Blog Posts

Anyone who has read Dr. McGonigal's blog knows he has expertise or something to say about almost every topic related to trauma care. As of the time of writing this post, he has published 543 posts in 16 years; his blog posts are well-regarded for their breadth, thoroughness, and insightfulness.

In future posts, we will share Dr. McGonigal's perspectives on trauma finance, gray book requirements, and trauma center red flags.