Looking forward – December 2013

David B. Hoyt, MD, FACS

As the New Year approaches, Fellows and staff of the American College of Surgeons (ACS) can look back at 2013 and take pride in the achievements that have occurred over the past year. Details of these accomplishments are summarized in the Executive Director’s annual report, but for those of you who are time-pressed, I would like to provide this brief overview.

Advocacy and Health Policy

Congress again postponed repeal and replacement of the flawed sustainable growth rate (SGR) formula used to calculate Medicare physician payment. 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.

Payment reform and the VBU were widely discussed at the College’s second annual Advocacy Summit this past spring in Washington, DC. More than 200 ACS members attended, and most of these participants met with their U.S. legislators and congressional staff to advance the College’s advocacy agenda.

In addition, the College published several important advocacy and health policy resources.

A special issue of the Bulletin (March 2013) focused on liability issues, drawing from discussions that occurred at an October 2012 Medical Liability Reform Summit. The ACS also issued two policy-related primers—one on surgeons as institutional employees and one on emerging payment models.

Education

This year, the College’s educational initiatives have centered largely on addressing gaps, transitions, and vulnerabilities in the profession. For example, the College has played a critical role in helping to ensure that graduating residents are adequately prepared for independent practice. To this end, the College has begun pilot testing a one-year Transition to Practice Program in General Surgery.

The ACS also is helping surgeons to meet Maintenance of Certification (MOC) requirements. As part of this effort, at this year’s Clinical Congress, the College issued not only continuing medical education (CME) certificates, but also certificates for participation in patient safety, trauma, and ethics sessions; verification of participation in Postgraduate Courses; and Self-Assessment Certificates for individuals who attended designated Panel Sessions.

In addition, two important resources were introduced at the Clinical Congress: Surgical Evaluation and Self-Assessment Program 15 and a new practice guidelines program known as Evidence-Based Decisions in Surgery.

Research and Optimal Patient Care

The College’s National Surgical Quality Improvement Program (ACS NSQIP®) presented its largest annual conference in July and recently introduced a surgical risk calculator for assessing the likelihood of a patient experiencing complications. Another ACS quality improvement tool, the ACS Surgeon Specific Registry, has been endorsed for use in the Centers for Medicare & Medicaid Services Physician Quality Reporting System.

The Committee on Trauma played an integral role in development of a revised ACS Statement on Firearm Injuries issued in response to the increasing number of mass-casualty events. In related activity, the College helped to lead the formation of a Joint Committee to Create a National Policy to Enhance Survivability from Mass-Casualty Shooting Events, which has issued two reports known as the Hartford Consensus I and II.

Earlier this year, the National Accreditation Program for Breast Centers (NAPBC) announced that it had accredited more than 500 breast centers in 48 states. The NAPBC projects 80 new accreditation applications in the coming year and plans to expand its reach to international centers, starting with pilot sites in Montreal, QC; London, UK; and Dubai, UAE.

The ACS Clinical Research Program continues work on the Surgical Standards Manual, which will outline operative standards for clinical trials, surgical practices, and CoC accreditation programs. The manual also will cover oncologic principles, operative techniques, and surgical checklists.

Member Services

The Board of Governors (B/G) finalized a plan aimed at revitalization. Central to the redesign is a focus on leadership in advancing the five Pillars of the ACS: Member Services; Education; Advocacy and Health Policy; Quality, Research, and Optimal Patient Care; and Communication. Likewise, the College intends to re-activate and better coordinate the chapters.

To expand the College’s global outreach, the International Relations Committee played an instrumental role in presenting an International Surgical Leaders Forum in July at the College’s Washington (DC) Office. This conference attracted 19 presidents of large international surgical societies, who discussed areas of mutual concern and the prospect of forming a global surgical coalition.

Integrated Communications

ACS staff and consultants have been working diligently to redevelop the College’s Web properties, convening more than a dozen stakeholder meetings to assess the background, goals, and expectations for the project. Some of these meetings centered on integrating the content currently accessible through the Web portal into the public website to provide members with a state-of-the-art online physician community. Several focus groups convened during the Clinical Congress to help ensure widespread appeal. The new website is scheduled to launch in May 2014.

In April 2013, 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 ACS Surgical Health Care Forums. These forums have proven invaluable in terms of increasing awareness about the College’s commitment to quality improvement and enhancing our influence in health policy circles.

Other activities

The ACS Foundation continued to seek out innovative ways to recognize individuals who provide financial support for the College’s scholarship programs. 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 (see related news story).

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.

The ACS continues to undergo transformative changes aimed at ensuring that College Fellows can continue to provide optimal care to their patients now and in the future. We look forward to building on the momentum of the Centennial into the New Year and the next century.

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