Executive Director’s annual report

As the American College of Surgeons (ACS) concludes its Centennial celebration, College Fellows and staff can take pride in the many achievements the organization has made both in the last 100 years and the last 365 days. Highlights from October 2012 to October 2013 follow.

Advocacy and Health Policy

The ACS presented the second annual Advocacy Summit in Washington, DC, in April. Advocacy staff, political insiders, health care experts, and members of Congress provided details on the future of health care to more than 200 attendees. A total of 186 of these participants met with their U.S. legislators and congressional staff to advance the College’s advocacy agenda. Other highlights included:

  • A keynote address by Bob Woodward, Pulitzer Prize-winning journalist for The Washington Post
  • A political luncheon featuring Politico’s chief White House correspondent and author of the Politico Playbook, Mike Allen
  • Addresses by U.S. Reps. Kevin Brady (R-TX), Chair, House Ways and Means Health Subcommittee; Larry Bucshon, MD, FACS (R-IN); and Ami Bera, MD (D-CA)

Physician payment continues to be of great concern to the College. Congress again postponed repeal and permanent reform of the flawed sustainable growth rate (SGR) formula used to calculate reimbursement when it passed the “fiscal cliff” legislation on January 1, stalling the 27 percent cut in Medicare reimbursement and freezing payment through December 31. The ACS has continued to lead efforts to eliminate the SGR and is one of the few physician organizations to have testified before the three congressional committees with jurisdiction over Medicare: Senate Finance, House Energy and Commerce, and House Ways and Means. At those hearings, in meetings with committee staff, and in written correspondence, the College has advocated for implementation of a Value-Based Update (VBU) proposal—a patient-centered model aimed at improving quality while controlling spending.

The ACS also commented on multiple drafts of a joint proposal put forth by the House Ways and Means and Energy and Commerce Committees. The plan would start with elimination of the SGR followed by a period of stability and incremental change. This summer, the Energy and Commerce Committee unanimously approved an iteration of the proposal—the Medicare Patient Access and Quality Improvement Act. At press time, the House Ways and Means and Senate Finance Committees had yet to weigh in on the proposal or offer an alternative.

On November 1, 2012, the Centers for Medicare & Medicaid Services (CMS) released the final rules on the 2013 Medicare physician fee schedule (MPFS) and the 2013 outpatient prospective payment system (OPPS) for hospitals and ambulatory surgical centers (ASCs). Under the final MPFS, without congressional action on the SGR, payments to physicians would have been reduced by 26.5 percent. Other changes in the final MPFS call for reviewing the evaluation and management portion of global surgical payments and finalizing the physician valued-based payment modifier, which, starting in 2015, will pay groups of 100 or more physicians based on the quality and cost of care. The final MPFS also modified aspects of the Physician Quality Reporting System (PQRS), the e-Prescribing (eRx) Incentive Program, and the Physician Compare website.

The ACS, in collaboration with other surgical professional societies, submitted comments on the MPFS final rule supporting the inclusion of the Consumer Assessment of Healthcare Providers Survey (CAHPS) for Surgery as a measure to be reported for the PQRS group practice reporting option and posted on Physician Compare.

Under the OPPS/ASC final rule, CMS increased hospital outpatient payments by 1.8 percent and ASC reimbursement by 0.6 percent. CMS solicited and received comments on how to determine whether a patient’s status is designated as outpatient or inpatient but made no policy changes. CMS also finalized a list of 25 procedures for inclusion in the ASC list of covered surgical procedures. In May, the ACS submitted a letter to CMS requesting that eight laparoscopic colectomy-related codes be added to the list of procedures that must be performed on an inpatient basis to qualify for Medicare reimbursement.

The College continues to encourage physician participation in CMS’ PQRS, electronic health records (EHR), and eRx programs. The fiscal cliff legislation discussed previously would allow physicians to meet PQRS requirements through participation in specialty registries beginning in 2014. In a related effort, the ACS responded to provisions in the Tax Payer Relief Act on the use of clinical quality measures reported under PQRS and the EHR Incentive Program, offering support for the expanded use of specialty registries for participation in these programs.

Rep. Diane Black, RN (R-MI), introduced legislation in November to address concerns regarding the EHR Incentive Program. H.R. 6598 would create a hardship exemption for small practices and physicians in and near retirement to avoid workforce shortages, shorten the gap between the performance period and the application of the penalty, expand options for participation in the Incentive Program, and establish an appeals process.

In December 2012, the College commented on physician training before the recently formed Institutes of Medicine Committee on Governance and Financing of Graduate Medical Education, chaired by Donald Berwick, MD, and Gail Wilensky, PhD. Among other topics, the ACS addressed shortages and maldistribution of surgeons and the effects of the 80-hour workweek on the readiness of surgeons emerging from training. A follow-up letter was mailed in January.

A special issue of the Bulletin featured articles drawn from the College’s Medical Liability Reform Summit in October 2012. Advocacy staff have been sharing these articles with congressional offices and using them in discussions aimed at jumpstarting action on liability reform. In addition, the ACS Legislative Committee formed a Liability Reform Subcommittee.
Other Advocacy and Health Policy highlights include:

  • The ACS issued two policy-related primers: Surgeons as Institutional Employees: A Strategic Look at the Dimensions of Surgeons as Employees of Hospitals, which mailed with the February Bulletin, and Surgeons and Bundled Payment Models: A Primer for Understanding Alternative Physician Payment Approaches, which is accessible via the ACS Web portal.
  • Now in its third year, the Chapter Lobby Day Grant Program provided funding to the following ACS chapters: Alabama, Brooklyn/Long Island, Northern California, Connecticut, Florida, Georgia, Illinois, Indiana, Kansas, Massachusetts, Metro Chicago, New York, Ohio, Oregon, Tennessee, and Virginia.
  • The 2013 Coding Workshop series began January 24. Course instructors have focused on simplifying the complexities of office and surgical coding as well as effective billing and collection processes.

Education

The ACS remains at the forefront in establishing benchmarks and standards for surgical education, training, validation, credentialing, and accreditation. Special attention is being directed at gaps, transitions, and vulnerabilities in the professional careers of individuals and within systems of care.

The ACS is advancing simulation-based surgical education and training and has been recognized for its innovative contributions to the field. The College played a pivotal role in the National Simulation Summit of the Council of Medical Specialty Societies in November 2012, during which participants established a framework for collaboration. Best practices are being identified and will be used in future efforts. Furthermore, the ACS contributed to the inaugural American Society of Anesthesiologists Simulation Education Network Meeting, and activities of the Consortium of ACS-Accredited Education Institutes continue to advance simulation-based education and training.

The College also has played a critical role in addressing the transition from residency to practice and from medical school to training. In the aftermath of the July 2012 National Invitational Conference on Transition from Residency Training to Independent Surgical Practice, a committee was appointed and charged with designing a model for a one-year Transition to Practice Program in General Surgery. The education, training, and accreditation model for this program is in development. The program will launch in 2014.

The ACS has been collaborating with the Association of Program Directors in Surgery (APDS) and the Association for Surgical Education (ASE) to develop a Resident Prep Curriculum. Pilot testing of modules began in 2013, and the curriculum is being tested at 20 U.S. medical schools; another 20 will be added in 2014. The goal is to launch the final curriculum in 2015. Additionally, the College participated in a summit that the American Board of Surgery (ABS) convened to address preparation for surgical residency.

The ACS and ASE have developed a Medical Student Simulation-Based Surgical Skills Curriculum to train medical students to perform essential procedures. Modules have been developed for the first three years of medical school, and all 25 modules were released in April.

To address transitions during the five years of surgery residency training, the ACS/APDS National Surgical Skills Curriculum has been developed. Phase I modules addressing basic surgical skills and tasks are being revised, and valid and reliable assessment tools and new videos are being added. Phase III modules that address team-based skills are under review.

A number of educational programs and products are available for practicing surgeons. The 2013 Clinical Congress comprised 25 tracks and 11 Named Lectures, 105 Panel Sessions, and 28 Postgraduate Courses, as well as 37 Meet-the-Expert Luncheons and 12 Town Hall Meetings. New Postgraduate Courses focused on health care systems, non-technical skills for surgeons, and Maintenance of Certification (MOC). Two new sessions, 10 Hot Topics in General Surgery and What’s New in Advocacy and Health Policy: Top 10 Advances in the Past Year were added to the program. Original scientific work was presented at the Scientific Papers, Owen H. Wangensteen Surgical Forum, and Poster Presentation Sessions.

Approximately 1,700 speakers and faculty participated in the 2013 Clinical Congress. Webcasts of selected sessions became available following the Clinical Congress. In addition to continuing medical education (CME) certificates and certificates for participation in patient safety, trauma, and ethics sessions, certificates of verification based on the Division of Education’s five-Level Verification Program are available to Postgraduate Course participants, and Self-Assessment Certificates are available to individuals who attended designated Panel Sessions.

The 2013 Clinical Congress was supported with an enhanced app that allowed attendees to more easily manage their schedules on handheld devices. Also, electronic evaluations replaced paper evaluations for certain sessions with the goal of having an entirely electronic process in place for 2014.

The ACS has been designing training programs for acquisition and maintenance of skills in new procedures and technologies. Systematic reviews of new technologies from the literature have been posted on the Division of Education Web page through the efforts of the Committee on Emerging Surgical Technology and Education in collaboration with the Australian Safety and Efficacy Register of New Interventional Procedures—Surgical.

Updates on other ACS educational programs for practicing surgeons are as follows:

  • Surgical Education and Self-Assessment Program 15 was released at the Clinical Congress.
  • The ACS Comprehensive General Surgery Review Course attracts more than 200 attendees annually.
  • Selected Readings in General Surgery (SRGS) currently has 2,500 subscribers. An ACS Practice Guidelines Program has been added to SRGS and launched at the 2013 Clinical Congress.
  • The 9th Annual Surgeons As Leaders Course took place in May, and the 19th Annual Surgeons as Educators Course was presented in September 2012.

The College offers several programs for surgery residents and medical students, in addition to the innovative curricula mentioned previously, including:

  • Fundamentals of Laparoscopic Surgery™, a collaborative program between the Society of American Gastrointestinal and Endoscopic Surgeons and the College
  • Essential Skills for Surgical Practice: A Primer for Residents presented at the Clinical Congress
  • The Residents As Teachers and Leaders Course
  • The Resident Award for Exemplary Teaching
  • The Medical Student Program at the Clinical Congress, which features a competitive poster session

The Surgical Patient Education Program supports active involvement of patients and their families in health care, particularly postoperative care. The program includes the Home Skills Training Kits; Education for Better Recovery; Informed Surgical Prep brochures and e-learning materials; and a new professional training program.

The Program for Accreditation of Education Institutes continues to receive national and international acclaim for simulation-based education. There are 78 ACS-Accredited Education Institutes: 68 comprehensive and 10 focused. The Consortium of ACS-Accredited Education Institutes continues to pursue collaboration in curriculum, research and development, simulation and new technologies, and administration of simulation centers. The Sixth Annual Meeting of the Consortium of ACS-Accredited Education Institutes convened in March.

The Accreditation Standards and Criteria for the ACS Program for Accreditation of Education Institutes have been revised, and the new standards have been implemented. Also, the Criteria for the Accreditation of Fellowships within the Consortium of ACS-Accredited Education Institutes were developed.

The “My CME” program includes systems for tracking CME and other credits required by various regulatory bodies. A newly developed system allows ACS members to seamlessly transfer CME credits directly to the ABS. In 2012, the ACS accredited 1,844 activities that provided 24,000-plus credits to more than 140,000 physicians.

CQI

The College’s Continuous Quality Improvement (CQI) programs have experienced significant growth. More than 500 hospitals participate in the College’s National Surgical Quality Improvement Program (ACS NSQIP®), and collaboratives in Tennessee, Florida, and British Columbia continue to show improvement. ACS NSQIP presented its largest annual conference in July 2013 with more than 1,000 participants. Next year’s meeting will take place in New York, NY.

The ACS NSQIP Surgical Risk Calculator now can be accessed at riskcalculator.facs.org. CMS has offered preliminarily acceptance of the risk calculator as a PQRS measure, and the College is working to incorporate ACS NSQIP variables into EHR with a focus on quality improvement.

The ACS continues to work with the American Society for Metabolic and Bariatric Surgery to further develop the joint Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. More than 700 facilities participate in the program. Newly revised standards for accreditation have been released and a national strategy for quality improvement as reflected in a reduction in readmissions for bariatric surgery patients is under development.

The ACS Surgeon Specific Registry (SSR) has been endorsed for use in the PQRS. The ACS and ABS worked together to develop new PQRS measures, which CMS has preliminarily accepted. The College is progressively implementing these new measures into the SSR and plans are under way to develop the next set of measures for MOC and PQRS. Furthermore, after discussions with The Joint Commission, the College is evaluating the development of standard Ongoing Professional Performance Evaluation and Focused Professional Performance Evaluation reports.

Six Clinical Scholars are working on the next iterations of ACS programs, including developing individual surgeon metrics, generating “cost” and “value” metrics, leading pilot consortium/collaborative QI programs, merging different data sources, and producing educational materials.

Lastly, a quality manual is in development. An outline has been completed, and standards are in development.

Trauma

The Trauma Quality Improvement Program (TQIP®) launched successfully and now has 182 participants. Another 34 centers have applied for enrollment, and 38 centers are participating in a pediatric pilot. Furthermore, the ACS is working on a model for collaborative participation, which will include a contract addendum to define data sharing among participants.

The National Trauma Data Bank (NTDB®) now houses information on 837,391 patients. The NTDB has completed the transition to a quarterly data collection model, which will allow for more contemporary TQIP reports and data validation efforts. The National Trauma Data Standard (NTDS) for 2014 was released this year and includes new fields for Pediatric TQIP.

NTDB benchmark, pediatric benchmark, and data quality reports for 2011 and 2012 admissions were released in September/October 2012 and 2013, respectively. TQIP has delivered the following risk-adjusted benchmark reports:

  • October 2012: All Patients, Elderly, Penetrating, and Blunt Multisystem Injuries
  • December 2012: Georgia Report on All Patients, Elderly, Penetrating, and Blunt Multisystem Injuries
  • April 2013: Traumatic Brain Injury (TBI) and Shock Patients
  • May 2013: Georgia Report on TBI and Shock Patients

In addition, TQIP has shifted to hierarchical modeling and added two new outcomes: major complications, and major complications and death. TQIP also released Guidelines for Geriatric Trauma Patients and Guidelines for Transfusion at its November 2013 conference.

Trauma Systems Evaluation and Planning Program consultations were completed in Arizona, Florida, Massachusetts, and Ohio. The ACS completed a consultation for Solano County, CA, to select a Level II trauma center and completed an international consultation in Doha, Qatar. We conducted follow-up interviews with 16 states and are collaborating with Wake Forest University, Winston-Salem, NC, to develop trauma system metrics. The ACS has verified 111 Level I, 152 Level II, and 58 Level III trauma centers and has approved 41 Level I and 33 Level II pediatric trauma centers.

Over the last year, the ACS has presented 2,099 Advance Trauma Life Support (ATLS®) courses, which have trained 35,262 students throughout the world. The ATLS app has been downloaded 44,535 times in 150 countries, and the ATLS e-learning project is expected to launch in spring 2014. The ATLS course management system is being enhanced to accommodate the Advanced Surgical Skills for Exposure in Trauma (ASSET) Program. Over the last year, 57 ASSET courses have been presented, training 507 students.

In addition, 89 Advanced Trauma Operative Management courses have been presented in 10 countries since August 2012 with more than 376 students trained, and the Rural Trauma Team Development Course has been offered 86 times with 1,312 students trained.

The Committee on Trauma (COT) sponsored several sessions at the Clinical Congress and presented its 91st Annual Meeting, with more than 200 members and guests in attendance.

The COT played an integral role in the development of the revised ACS Statement on Firearm Injuries issued earlier this year in response to the increasing number of mass-casualty events. In related activity, the College played a leadership role in forming a Joint Committee to Create a National Policy to Enhance Survivability from Mass-Casualty Shooting Events, which developed two reports that which have been published in the Bulletin.

The COT received the American College of Surgeons Professional Association’s award for its advocacy activities. The COT also participated in the first meeting of The Way Forward Project, which is studying how military and civilian surgeons can collaborate to reinforce education, research, and systems-based practices.

On the international front, the COT became a member of the World Health Organization’s Global Alliance for Care of the Injured, and the International Injury Care Committee was formally launched.

Lastly, the COT presented the 2013 Meritorious Achievement Award to Ricardo Sonneborn, MD, FACS, and the 36th annual Residents Trauma Papers Competition was held in March 2013.

Cancer Programs

The Commission on Cancer (CoC) has accredited 1,507 cancer programs that provide care to 71 percent of all newly diagnosed cancer patients in the U.S. and Puerto Rico. The CoC conducted 433 cancer program surveys this past year, and 27 new cancer programs joined the accreditation program. A total of 79 cancer programs received the Outstanding Achievement Award.

One of the CoC’s most significant accomplishments this year involved working with consultants to develop a framework for Oncology Medical Home (OMH) standards for large group practices. A component of this accreditation is focused on data to measure OMH performance against 19 clinically based performance measures. We have requested more than $1 million in grant funding from the Center for Medicare and Medicaid Innovation to support development of the accreditation model.

The CoC and other stakeholders also have developed an initial framework for health care system standards, which will form the basis for a system accreditation model. In addition, the CoC plans to establish a cross-functional pediatric work group to evaluate existing standards and develop an enhanced set of performance measures.

The National Cancer Data Base (NCDB) added 7.3 million new and updated reports in January; 1.3 million were for cases diagnosed in 2011 representing 1.2 million deduplicated cases. The NCDB is approaching 30 million cases diagnosed between 1985 and 2011.

In September 2012, the NCDB released estimated performance rates to CoC-accredited programs through Cancer Program Practice Profile Reports (CP3R) for three new breast measures. The Quality Integration Committee at the May meeting approved eight additional measures for production in 2014. In July, the CoC and the Pennsylvania Health Care Quality Alliance (PHCQA) began working together to post CP3R performance measures on the PHCQA website. The primary purpose for this project is to provide more comparable information to patients. To date, nine of the 72 programs have agreed to participate in public reporting through the PHCQA Web page.

The format for the Cancer Quality Improvement Program (CQIP) has been completed. PowerPoint presentations are now available to help introduce this initiative to interested parties.

The CoC released the beta Participant User File (PUF) data last year to researchers at accredited programs. The PUF data have resulted in 22 publications and presentations at national forums. In February, the CoC began accepting requests for PUF data from all accredited programs; 178 requests for applications were submitted, and 155 were approved. PUFs will be released electronically to the awardees.

The Prospective Payment System (PPS)-exempt contract was received in October 2012, and staff began work in November. In April, the Alliance of Dedicated Cancer Centers hosted Rapid Quality Response System (RQRS) training for the 11 PPS-exempt centers. The first submission for their estimated performance rates was scheduled to occur November 15, 2013. As of August, 536 programs are participating in RQRS.

The National Cancer Institute, the American Cancer Society, and RTI International use the RQRS to identify patients treated at the National Cancer Institute National Community Cancer Centers Program hospitals to collect self-reported symptoms and side-effects during the first course of treatment. To date, approximately 5,000 surveys have been received.

The CoC sent 1,261 surveys to Cancer Liaison Physicians (CLPs) regarding the construct and operational aspects of their Multidisciplinary Team Planning program; 797 surveys were returned for a response rate of 63.2 percent. The Cancer Liaison Program continues to support the network of 62 CoC State Chairs and their activities. The ACS has processed more than 500 CLP appointments and reappointments.

Since its launch in September 2008, the National Accreditation Program for Breast Centers (NAPBC) has accredited more than 500 breast centers in 48 states. The NAPBC projects 80 new accreditation applications in the coming year and 148 applicants for reaccreditation. A survey was sent to 918 physicians at breast centers in 43 countries and to all international Fellows to measure interest in the program outside of the U.S. The responses were overwhelmingly supportive. As a result, the NAPBC has identified three pilot sites (Montreal, QC; London, UK; and Dubai, UAE).

The NAPBC Standards and Accreditation Committee developed a new standard for Breast Cancer Survivorship Care, and edits are being made to the current standards to strengthen requirements and improve quality. The NAPBC also developed three breast-specific quality measures that were vetted through the CoC and the NQF.

A May NAPBC workshop, Pursuing Excellence through Accreditation, sold out, and a two-day conference last November, Lead Your Breast Program to Excellence, was successful. The NAPBC has organized a logo recognition campaign to begin in conjunction with Breast Cancer Awareness Month. The ACS has contracted with a vendor to provide merchandise to accredited centers that will bear the NAPBC logo and emphasize that “Accreditation Makes a Difference.”

The ACS Clinical Research Program (ACS CRP) sponsored several sessions at the 2012 and 2013 Clinical Congresses and five surgical investigator meetings this past year to promote clinical trials. The ACS CRP continues work on the Surgical Standards Manual, which will outline operative standards for Alliance clinical trials, surgical practices, and CoC accreditation programs. The manual will include text covering oncologic principles, operative techniques, and surgical checklists. The target date for completion is March 1, 2014.

As of August 15, approximately 1,100 patients were enrolled in the ACS CRP ProvenCare Lung Cancer Collaborative. A proposal to expand the collaborative has been submitted to the Agency for Healthcare Research and Quality.

The American Joint Committee on Cancer (AJCC) has developed a new logo, tagline, and brand story and added a new Clinical Scholar-in-Residence in July 2013. The AJCC has begun work on the eighth edition of the Cancer Staging Manual. The AJCC also has completed a Cancer Staging Content Transformation Project to develop the infrastructure for electronic delivery of AJCC content, which will launch this month. The second edition of the Cancer Staging Atlas is now available.

The CoC has developed a Web page that contains communications, tips, and resources that accredited programs may use to market their accreditation status. Using data from the American Hospital Association, we are developing state profiles that include the number of accredited and non-accredited programs in a state and the number of cancer cases diagnosed at each program. For the initial test, we are looking at three states—Florida, Pennsylvania, and Texas. The goal is to increase the number of programs by 8 percent per state.

Other highlights for ACS Cancer Programs are as follows:

  • The ACS has evaluated the current CoC and NABPC advertising focus and has placed ads in Coping, The Patient Resource Guide, Hospitals and Health Networks, Crain’s Cancer Supplement, and The Patient Resource Women’s Cancer Guide.
  • An eight-member CoC delegation attended the One Voice Against Cancer Lobby Day in Washington, DC, and participated in inaugural meetings of the Patient Quality of Life Coalition.
  • A total of 19 papers were submitted for the 2013 CoC Paper Competition. The winner: Liam Smith, MD, Norfolk, VA, presented Gastrointestinal Cancers in Young Survivors of Lymphoma: Implications for Earlier Screening at the Clinical Congress.
  • More than 300 staff from CoC-accredited programs attended the Survey Savvy: Enhance Quality—Commit to Patient-Centered Care conference in June.
  • The CoC released 28 videos on YouTube.com and on the College website covering the key points of select CoC standards. The College also launched the new ACS Cancer Programs Online Education Portal.

Member Services

The College is exploring a lifetime membership program and has updated and revised international Fellowship requirements. To enhance recruitment, the ACS has reached out to other organizations that have agreed to disburse membership information. The College is focusing on increasing Canadian membership and is working on a campaign to attract young surgeons. We are engaging Governors and chapter leaders more fully in recruitment efforts and developing new membership brochures targeted at distinct demographic groups.

The Board of Governors (B/G) worked throughout this past year to explore the role and responsibilities of Governors and the selection criteria for nominating members of the B/G. Key elements of the redesign were finalized and implemented following the B/G Executive Committee meeting at the 2013 Leadership and Advocacy Summit. Central to the redesign are five Pillars based on the ACS Divisions. The newly formed Pillars and their Executive Committee Leads are as follows:

  • Member Services: Fabrizio Michelassi, MD, FACS
  • Education: Lorrie Langdale, MD, FACS
  • Advocacy and Health Policy: James Denneny III, MD, FACS
  • Quality, Research, and Optimal Patient Care: Sherry Wren, MD, FACS
  • Communication: Gary Timmerman, MD, FACS

The Advisory Council for Rural Surgery has established a rural surgery presence at the Clinical Congress and is conducting preliminary work on a set of rural surgery standards and guidelines. Plans for 2014 include a Rural Surgery Symposium. The one-and-one-half-day program will include topics on advocacy, practice issues, and clinical practice. Plans also are under way to establish a Rural Surgeon Ambassador Program with Council members speaking to chapters, medical students, and residents on issues in rural surgery. In addition, the Council has been using a robust listserv to relay information to targeted ACS members.

The Advisory Council for Otolaryngology has developed specialty-specific newsletters, and other Advisory Councils intend to follow suit. Discussions are under way to restructure the Advisory Councils to reorganize and more tightly coordinate Advisory Council activities with other areas of the ACS.

The Young Fellows Association (YFA) has increased its visibility among ACS Initiates through heightened publicity and increased personal contact with members of the YFA Communications Committee. The YFA has conducted a comprehensive review of all ACS committees to identify YFA demographic appointees and is in ongoing conversations with similarly structured groups internationally. The YFA Mentorship Program continues to grow in interest and participation.

The Resident and Associate Society (RAS) sponsored several programs at the Clinical Congress, including the annual Symposium and an expanded Surgical Jeopardy session, featuring a team of international residents. In addition, RAS participation on ACS councils and committees has expanded.

The College is seeking to expand its international vision. ACS leaders and members of the International Relations Committee (IRC) met in the spring to discuss plans to retool the IRC. In addition, an International Surgical Leaders Forum took place in July at the College’s Washington Office. The IRC was active in planning and presenting this session, which attracted 19 presidents of large international surgical societies. Agenda items aimed at discovering areas of intersection and the prospect of forming a global surgical coalition gradually emerged. Further discussion occurred during Clinical Congress.

Several Middle Eastern and Eastern European nations have expressed interest in forming ACS chapters, and the College has re-established contact with long-dormant chapters. The ACS is working with each chapter to develop strategic planning goals and expectations. A process for objectively assessing each chapter began this fall, with a dashboard created for feedback centrally and to individual chapters.

Other Member Services activities include:

  • The Central Judiciary Committee reviewed 15 new cases and made six recommendations for disciplinary action.
  • The ACS has been managing the Society of Surgical Chairs (SSC) for two years. The SSC now has 164 dues-paying members.
  • More than 300 chapter officials and young surgeons participated in the Leadership Conference this year.
  • Operation Giving Back (OGB) continues to assist surgeons who are interested in participating in global outreach. Additionally, OGB is working with Trauma Programs to provide ATLS materials in resource-poor countries.

Integrated Communications

A significant amount of planning and work has gone into the redevelopment of the College’s Web properties. The process began with more than a dozen stakeholder meetings with consultants and staff to assess the background, goals, and expectations for the project. Some of these meetings also covered how best to integrate the content currently accessible through the members’ portal into the public website and what software should be selected to provide members with a state-of-the-art online physician community. Several focus groups were convened during the Clinical Congress to help ensure the new site’s widespread appeal. The new site is expected to launch in May 2014.

Growing ACS media presence

Social media
outlet
Post-Congress 2010
(10/12/2010)
Post-Congress 2011
(10/28/2011)
Pre-Congress 2012
(8/27/2012)
Pre-Congress 2013
(8/23/2013)
Facebook 0 “Likes”
(no page yet)
250 “Likes”
(new page 10/7/11)
1,717 “Likes” 4,860 “Likes”
Twitter 907 followers 2,972 followers 6,063 followers 10,675 followers
YouTube 11 videos
1,150 views
7 subscribers
40 videos
45,809 views
90 subscribers
76 videos
94,956 views
217 subscribers
140 videos
187,814 views
462 subscribers
LinkedIn N/A N/A N/A 1,914 followers

As the data in the table on this page demonstrate, the College has made considerable progress in creating a strong social media presence.

The ACS and its various programs have been widely covered in the media. A total of 19,841 media hits were tracked over 11 months.

In December 2012, the College hired a marketing manager. To date, this individual, in concert with other staff, has contributed to efforts to more effectively market the Clinical Congress and ACS membership.

This year, the ACS hosted nearly 500 health care leaders at six Inspiring Quality Tour events across the country. The forums were widely promoted via social media and yielded media coverage. The forums have generated leads for potential ACS partnerships and opportunities to implement ACS NSQIP in additional U.S. hospitals. Post-event surveys of forum attendees showed demand for ACS quality programs increased among audience members, generating additional leads and interest for ACS quality programs.

In April, the College published ACS Inspiring Quality Tour: Lessons Learned in the Pursuit of Quality Surgical Health Care, which summarizes best practices and case studies gleaned from the forums. Six additional ACS Inspiring Quality Tour stops are planned in 2014.

The Journal of the American College of Surgeons (JACS) launched the JACS Twitter feed @JAmCollSurg to promote featured articles, JACS in the news, and important articles in press. Two new applications have been developed to provide easy access to JACS on handheld devices, and a mobile-friendly JACS CME website has launched. The JACS impact factor remains 4.5, ranking it seventh out of 198 surgery journals. The number of original scientific articles submitted to the journal has doubled since 2008, and accepted but not yet published manuscripts are posted on the JACS website within two weeks of acceptance.

ACS Foundation

Unrestricted gifts to the ACS Foundation increased by 65 percent in FY 2013, and total contributions increased more than 68 percent. Current contributions combined with past philanthropy from ACS restricted funds provide nearly $4 million to the College for current needs as well as for meritorious programs and emerging opportunities.

In FY 2013, 25 ACS chapters and affiliated societies made donations. ACS Foundation volunteer representatives attended 25 chapter meetings as well as the Southeastern and Southwestern Surgical Congress meetings. The ACS Foundation has undertaken an initiative to recruit local volunteers who can promote and explain the role of philanthropy in the College.
Milestones achieved this year include securing funding for the following:

  • The Jameson L. Chassin, MD, FACS, Fund for Professionalism in General Surgery
  • The Olga M. Jonasson, MD, FACS, Lectureship
  • The Thomas R. Russell, MD, FACS Scholarship
  • The Carlos A. Pellegrini Fellowship of the China-Hong Kong Chapter
  • The Kankuben B. Gelot Scholarship
  • Patient education, scholarly opportunities for international surgeons, and a CoC Scholar-in-Residence

A highlight of the last year was establishment of the 1913 Legacy Campaign in honor of the College’s Centennial and to benefit The Surgeon, The Profession, and The Societal Good.

During the past fiscal year, several major bequests were received, and total enrollment in the Mayne Heritage Society is now at 57. The goal is “100 by 100” by October 2014 in recognition of the ACS Centennial.

With the goal of expanding the engagement of Fellows as partners with the Foundation and raising the profile of philanthropy, the Chapter and Affiliate Relations Committee has recruited 32 volunteers from 24 chapters to act as Philanthropic Champions and promote the Foundation at chapter meetings.

The Foundation has created a Young Fellows Leadership Circle—a donor recognition program to encourage giving among members of the YFA. Nearly 50 Young Fellows have made entry-level gifts.

The June Bulletin featured an article on past recipients of ACS scholarships, showing the return on philanthropic investments. Five Fellows who received ACS research scholarships attested that ACS awards help set them on a path toward discovering surgical breakthroughs.

PI/HR

Many areas of the ACS are engaged in performance improvement (PI) activities. One major College-wide undertaking involved establishing and training staff in the ACS Values of Professionalism, Excellence, Innovation, Introspection, and Inclusion.

In addition, we put together a yearlong leadership training initiative that includes five two-day sessions with analysis of behavioral characteristics and emotional intelligence, personal development, and personal coaching. This effort will conclude next June.

We launched a Change Acceleration Process (CAP), training 92 staff members in the concepts and strategies of creating change. We also trained five Master Change Agents who will work with the PI Professionals (PIPs) to facilitate projects and PI training and developed a two-hour CAP orientation for all ACS staff. Furthermore, we have designed CAP/PI sharing sessions for sharing PI success stories and peer project problem solving and are planning to offer CAP tool refreshers for Change Agents.

Additional movement in this area is as follows:

  • Conducted a strategic planning session to establish ACS objectives and projects that align with those goals
  • Identified 258 projects to undertake; 189 are under way, and 25 have been completed
  • Began 12 projects facilitated by the PIPs and the PI Director; three have been completed, nine are under way
  • Conducted monthly UConnect sessions with Human Resources (HR) for managers/supervisors, which center on employee benefits and policy discussions, CAP tool tips, and presentations from project teams for ACS managers and supervisors
  • Developed index of expectations of volunteer PI professionals and the PI team is reviewing the PIP curriculum to train another cohort of PIPs

HR has been working with consultants and the PI team to develop new job pillars and is benchmarking approximately 200 positions. The College has developed new recruitment tools. We have created a new employment brand for the ACS, launching a LinkedIn recruiting page, posting staff videos on YouTube, and developing a new benefits summary sheet.

Convention and Meetings

Convention and Meetings had a productive year. As of August, the exhibits team was responsible for 12 internal and external client meetings, and the Association Management Services program had contracts with 17 clients. Registration Services managed 24 meetings and approximately 32,000 registrations, and Travel Services booked 3,863 tickets. Meeting Services successfully coordinated more than 1,500 internal meetings, 73 external meetings, and 10 client association meetings.

The 20 F Street NW Conference Center in Washington, DC, hosted 183 meetings from August 2012 to August 2013—a 20 percent increase from the previous year. Roof Terrace bookings for the property doubled from last year due to the installation of the South Terrace tent.

Conclusion

The ACS continues to undergo transformative changes aimed at ensuring the College Fellows can continue to provide optimal care to their patients now and for the next 100 years. As always, the staff and leadership of this organization welcome your ideas for how we can help you better serve your patients and grow professionally.

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