Looking forward – January 2013

As I have reported previously in this column and in other communications with the Fellows, the staff of the American College of Surgeons (ACS) has been engaged in an ongoing performance improvement process for approximately 18 months. This effort has been conducted in cooperation with consultants from GE Healthcare and was initiated to help ensure that the ACS has a world-class workforce dedicated to helping you provide high-quality care to the surgical patient.

The current phase of this process is focused on defining our organizational values. To set the stage, ACS Executive Staff and our consultants developed a list of five organizational values to which all College employees should aspire, including Professionalism, Excellence, Innovation, Introspection, and Inclusion—or what I call PEI3.

After developing this list of values, we called upon staff from throughout the organization to help better define these values and determine what actions ACS employees could take to better uphold these principles. We agreed that their efforts to achieve these objectives should involve clear communication and a sense of fun.
The remainder of this column discusses each of the five values, the rationale for making them priorities, and the behaviors associated with achievement of these principles.


Professionalism is demonstrated through accountability, honesty, responsibility, loyalty, and respect. Professionals take actions and make decisions that are in the best interests of the organization. They maintain confidentiality and remain emotionally neutral while still demonstrating concern for coworkers’ welfare. They are devoted and committed to the organization and its values. They resolve conflict through “natural” collaboration and respect other points of view.

ACS staff must maintain a high level of professionalism because this organization serves the consummate professional—the surgeon. A professional attitude affects one’s ability to fulfill work responsibilities and the joy of working. It is integral to creating a conducive and supportive work environment.

We determined that to achieve the College’s standard of professionalism, staff must respect each other’s expertise and responsibilities, set goals and guidelines for the timely and effective completion of work, and respond to coworkers and ACS members regardless of circumstances or workload. Professionals should display a positive demeanor in the workplace and make decisions based on the best interests of the Members and staff. They should incorporate best practices from the field, recognize conflict, and work toward a reasonable resolution of problems.


Excellence involves aspiring to and working to exceed internal and external standards. Excellent performers have a “can do” attitude, accept accountability for the work they produce, take initiative, are self-aware, and are committed to delivering high-quality products and services.

We determined that ACS staff should strive for excellence because the work we do affects surgeons and their patients, which means mediocrity is not an option. Furthermore, working toward excellence promotes a positive, meaningful work environment. Excellent performance helps to foster a sense of pride and confidence, which often leads to further consistently strong performance.

Excellence, we determined, is achieved when staff members see work through from start to finish and strive to go above and beyond the day-to-day expectations. Excellent performers actively listen and answer questions, they establish expectations, use their own skills and those of their colleagues to increase productivity and ensure that customers are satisfied, and create and adjust benchmarks for performance. They review and document processes for improvement and ensure quality of work is consistent with current industry standards.


The ACS has defined innovation as profound, forward-thinking, transformative ideas and contributions that are likely to advance our organizational goals and individual effectiveness. Innovation is marked by a willingness to take appropriate risks, creativity, and imagination. Innovators question the status quo and are open to new challenges.

Innovation is included in the College’s set of values because without it, the organization will stagnate and become obsolete. Furthermore, it provides employees with new opportunities for growth and thereby gives them a sense of empowerment and excitement.

Individuals and organizations are seen as innovators when they seek out process enhancements that will improve efficiency and effectiveness—because it’s the “right” thing to do. They assess and identify the needs of customers and community in order to provide relevant products and services and define and implement groundbreaking ideas. They actively participate in the development of new systems, processes, values, and solutions.


The ACS has defined introspection as recognizing the importance and need for continuous self-improvement through professional training and self-assessment. Introspective individuals and organizations are open to feedback and confident in their abilities yet aware of their own strengths and weaknesses. They display emotional intelligence, are motivated to grow professionally, and are able to tap into their own resources and creativity.

Introspection was identified as an ACS value because it facilitates the continuous improvement process, encourages change and growth, and helps us all address challenges.

Individuals demonstrate introspection in the workplace when they acknowledge their personal limits and are willing to ask for assistance. They recognize areas for self-development and display a willingness to remain current in their areas of expertise. They seek and are open to constructive criticism and address change in a balanced way.


Inclusion involves creating an atmosphere that allows the organization to harness the staff’s collective intelligence. It involves proactive collaboration with appropriate stakeholders, teamwork, and communication. It calls for weighing a diverse range of perspectives and skills.

We determined that inclusion is an ACS value because it builds loyalty and trust, makes use of everyone’s talent, promotes better outcomes, decreases duplicative efforts, and encourages mutual support and commitment.

Individuals can be said to have achieved an inclusive approach to work when they encourage teamwork/collaboration throughout the organization, seek input from and consider the expertise of other staff, and share work-related information with coworkers outside of their immediate area in order to broaden perspectives.

Continued growth

In addition to setting benchmarks for achievement of the College’s organizational values, participants in this process set standards for individuals who exceed our expectations. Over time, we would expect many staff members to become exemplars of these attributes.

The key reason for taking the ACS staff through this performance improvement process is to ensure that the College can provide the services and products you need to offer high-quality care to surgical patients. As we move forward and begin educating staff on how to cultivate our organizational values, we ask that our Fellows share their views on staff performance and hold us accountable for upholding the highest standards of PEI3: Professionalism, Excellence, Innovation, Introspection, and Inclusion.

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