The ACS Quality Verification Program™ (ACS QVP) standards manual, Optimal Resources for Surgical Quality and Safety, 2021 ACS QVP Standards, details the 12 salient elements of surgical quality. These elements were adapted from the Optimal Resources for Surgical Quality and Safety—also known as the "Red Book"—into standards that form the foundation of the ACS QVP. These standards span all surgical specialties to provide a blueprint for hospitals and hospital systems to build a successful surgical quality program by establishing, measuring, and continuously improving their surgical quality infrastructure.