Any ambulance operation can claim it is delivering quality service, but the accredited agency can prove it through its written or documented procedures, systems, and reports. An accredited agency will have proven Medical Director involvement in all matters that affect patient care, from protocol development to vehicle equipment, education programs, training, quality improvement, and response time standards. The accredited agency will have a written continuous quality improvement program tied to its continuing education for all staff. Reports will show when problems arise, define what they are, and show how they are resolved through retraining in the agency’s CQI program. The agency will further show how it tracks these developments for trends and how they analyze them for planned improvements. The accredited agency will track clinical training and certification of each patient care professional. Response time standards will be defined in writing and will be captured in daily, weekly, monthly, and annual reports. Pre-hospital providers will be properly credentialed for each medical transport run. The accredited agency will have strict procedures for safe handling of patients and their property, for accurate documentation of all patient care, for proper maintenance of all vehicles and medical equipment, for proper cleaning of vehicles and equipment, and for exacting decontamination when required. The accreditation process requires an agency to look closely at every aspect of its operation and to demonstrate through its policies and record keeping that it does as it says.