Board of Governors pillars improve productivity, communication: An update

The Board of Governors (B/G) of the American College of Surgeons (ACS) recently underwent a major reorganization. Formerly, Governors served on a range of ACS committees, which often led to disparity, confusion, and organizational inertia, resulting in a limited number of recommendations and fewer issues reaching appropriate College divisions and leadership. In 2012, the Executive Committee of the B/G, under the vision and leadership of Immediate Past-Chair Lena Napolitano, MD, FACS, completed a redesign of the entire B/G committee structure. This effort resulted in the creation of five pillars—Communications, Education, Advocacy and Health Policy, Member Services, and Quality—each correlating to a division of the College and thus enabling the Governors to work toward a common goal with the divisions and Regents.

A total of 13 workgroups populate the pillars, providing ample opportunity for Governors to participate in the areas that complement their strengths and interests. Rolled out in the fall of 2013, the new pillars and workgroups have sparked enthusiasm, participation, and relevance for the Governors and their work. The following information details the first year’s (2013–2014) accomplishments for the workgroups and their respective pillars. With gratitude, I acknowledge the extraordinary efforts of the pillar leads and the workgroup chairs and vice-chairs.

Communications Pillar

Joseph J. Tepas, MD, FACS, Pillar Lead

The Communications Pillar has worked on the following initiatives throughout 2013–2014:

  • Development of better communication between the ACS leadership and grassroots Fellows and rapid feedback from grassroots to leadership
  • Discussion led by Ali Kasraeian, MD, FACS, with the Young Fellows Association regarding the use of broadcast technology to enhance communication exchange with younger Fellows
  • Proposed development of slides for Governors and Fellows to use to illustrate the history and status of the U.S. health care system, proposed legislative solutions, and opportunities for surgeons to serve as leaders in the quality and patient advocacy arenas
  • Solicited articles and information for inclusion in the Bulletin
  • Suggested enhancement of the ACS website

The Board of Governors Communications Pillar comprises two workgroups:

  • Newsletter Workgroup (Michael Sarap, MD, FACS, Chair, and John Kortbeek, MD, FACS, Vice-Chair)
  • Survey Workgroup (Mark Puls, MD, FACS, Chair, and Nicholas Vedder, MD, FACS, Vice-Chair)

Newsletter Workgroup

  • The B/G publishes a quarterly newsletter, which includes human interest stories, pillar updates, and other timely topics.
  • Columns published in the newsletter include:
    • “International Café,” which focuses on international Governors/Fellows
    • “Fascinating Facts,” which provides details on little-known facts about the ACS
    • “On the Shoulders of Giants,” which highlights the achievements of surgical pioneers

Survey Workgroup

  • Conducted the annual Governors survey. Concerns raised in the survey responses are addressed by the College’s leadership.

Education Pillar

Karen J. Brasel, MD, FACS, Pillar Lead

The Education Pillar has worked on the following initiatives throughout 2013–2014:

  • Assessed on an ongoing basis the College’s educational programs, leading to recommendations on how these offerings can be enhanced to make them more relevant to surgeons
  • Conducted surveys to gain feedback on what’s working with respect to education and what may be needed in the future
  • The Education Pillar comprises three Workgroups:
  • Continuing Education Workgroup (Mark Watson, MD, FACS, Chair, and Daniel Dent, MD, FACS, Vice-Chair)
  • Patient Education Workgroup (Rebecca Sippel, MD, FACS, Chair, and Edward Raab, MD, FACS, Vice-Chair)
  • Surgical Training Workgroup (Fred Luchette, MD, FACS, Chair, and Carol Scott-Conner, MD, FACS, Vice-Chair)

Continuing Education Workgroup

  • Worked on concepts that address continuing medical education (CME) statewide and across states, and issues of self-assessment CME as they relate to state requirements
  • Discussed the possibility of creating a legacy depository for various state topic requirements, such as pain management, ethics, and palliative care
  • Considered the expansion of the My CME page on the ACS website to include information on state-level CME requirements, as well as licensure mandates

Patient Education Workgroup

  • Conducted a patient education survey in conjunction with the ACS Committee on Patient Education to get feedback regarding surgical patient education practices and needs and to help determine how the ACS can enhance surgical patient education programs

Surgical Training Workgroup

  • Jeffrey Bumpous, MD, FACS, is leading efforts to construct a standardized Letter of Recommendation form for fourth-year medical students entering surgery.
  • David Berger, MD, FACS, is leading an effort to offer ACS chapters educational talks/seminars similar to those presented in the Surgeons as Educators Course. This information has been shared with John P. Rioux, MD, FACS, Chair of the Domestic Chapter Activities Workgroup for potential chapter collaboration.

Advocacy and Health Policy Pillar

James C. Denneny III, MD, FACS, Pillar Lead

The Health Policy and Advocacy Pillar has worked on the following initiatives in 2013–2014:

  • Worked closely with the ACS Division of Advocacy and Health Policy (DAHP) to raise awareness and spread the word among ACS members about vital policy issues that affect surgeons.
  • Sent e-mails to surgeons with information about how they can get involved in advocacy and how to contact their representatives and senators to make them aware of the issues facing surgical practice and patient care.
  • Promoted discussion on the ACS’ role in coordinating registries and databases, both for quality and proliferation.

The Health Policy and Advocacy Pillar has two workgroups:

  • Coalition Workgroup (Dr. Denneny, Chair, and Susan Mosier, MD, FACS, Vice-Chair)
  • Health Policy and Advocacy Workgroup (Nipun Merchant, MD, FACS, Chair, and David Adams, MD, FACS, Vice-Chair)

Coalition Workgroup

  • Committed to fight for common issues
  • Noted that attempts to address the flawed sustainable growth rate formula that Medicare uses to calculate physician payment demonstrated the remarkable combined effects of surgical/medical societies working toward a common goal and should be sustained
  • Worked with the ACS DAHP to assemble multispecialty advocacy teams to meet with legislators while in their home districts

Health Policy and Advocacy Workgroup

  • Worked on tort reform and legislative attempts to remove caps on noneconomic damage awards in several states
  • Developed a white paper on the topic of instruments to measure and report on patient satisfaction

Member Services Pillar

Fabrizio Michelassi, MD, FACS, Pillar Lead

The Member Services Pillar has worked on the following initiatives throughout 2013–2014:

  • Strengthened existing chapters and providing resources and mentors to those chapters that request the College’s assistance
  • Encouraged international chapter members and Governors to become more involved, both with their chapters and at a national level
  • Publicized the awards program to generate increased awareness about the program and continued to attract applicants

The Member Services Pillar comprises three workgroups:

  • Chapter Activities Domestic Workgroup (Dr. Rioux, Chair, and S. Rob Todd, MD, FACS)
  • Chapter Activities International Workgroup (Raymond Price, MD, FACS, Chair, and Jamal Hoballah, MD, FACS, Vice-Chair)
  • Surgical Volunteerism and Humanitarian Awards Workgroup (Kevin Behrns, MD, FACS, Chair, and Francis Ferdinand, MD, FACS, Vice-Chair)

Chapter Activities Domestic Workgroup

  • Four subcommittees have been working on a variety of projects:
    • Subcommittee for Best Practices Presentation/Event at Clinical Congress, Anthony R. Vigil, MD, FACS, Chair: Presenting an hour-long panel discussion of success stories and how to run a chapter followed by a one-hour reception at the 2014 Clinical Congress.  The program will be called Setting Conditions for Chapter Success: A Panel and Reception for Domestic and International Chapters. Scheduled panelists include ACS Governors John H. Armstrong, MD, FACS; Dr. Rioux; and Dr. Price.
    • Chapter Advisory Subcommittee, Frank T. Padberg, Jr., MD, FACS, Chair: Organizing stronger chapters to advise others when requested for help and best practices.
    • Subcommittee on Centralization of Chapter Dues Collection, S. Rob Todd, MD, FACS, Chair: Researching centralization of dues for chapters (that is, have the College collect chapter dues and forward them to the chapters). Dr. Todd is working on several models to vet this opportunity. The final recommendation will be offered to the Member Services Liaison Committee.
    • Subcommittee to Develop a Domestic/International “Chapter Partner Program,” Dr. Price, Dr. Rioux, and Donna Tieberg, ACS Chapter Services Manager: Working with the International Chapter Activities Workgroup on a Chapter Partner Program.

Chapter Activities International Workgroup

  • Developed a schedule of the best times to conduct conference calls so international Governors can participate.
  • Divided the workgroup into four regions, similar to the trauma region model, and region chiefs are inviting Governors to meetings and communicating ideas via e-mail. All region chiefs know with whom to communicate and the new Governors in their region. Updated Excel spreadsheets of contacts are sent to Dr. Price and the region chiefs as needed.
  • Defined the benefits of ACS membership for international surgeons.
  • Met with chapter leaders at Clinical Congress.
  • Received Board of Regents approval in February for the establishment of the UAE (United Arab Emirates) Chapter and presented the chapter with their official charter from the College. The newest chapter to be approved is Bolivia, with Esteban Foianini, MD, FACS, as the new Governor. Regents approved the Bolivia Chapter at their June meeting. A Guam chapter is under consideration.
  • Worked with the Domestic Chapters Activities Workgroup on a Chapter Partner Program.

Surgical Volunteerism and Humanitarian Awards Workgroup

  • The awards review system has been restructured and streamlined.
  • The Workgroup received 16 applications in 2014.
  • Applicants were reviewed and selected during a conference call in April.
  • Efforts will be made to continuously publicize the program by:
    • Keeping in touch with past applicants
    • Having unselected applicants be considered for two to three years
    • Advertising the awards in ACS Surgery News, the Bulletin, and at Clinical Congress

Quality Pillar

Sherry M. Wren, MD, FACS, Pillar Lead

The Quality Pillar has worked on the following initiatives throughout 2013–2014:

  • Collaborated with the ACS Division of Research and Optimal Patient Care
  • Established and revised surgical guidelines
  • Addressed issues such as the aging surgeon and fatigue mitigation
  • Created programs for the Clinical Congress on the topic of electronic health records

The Quality Pillar comprises three Workgroups:

  • Best Practices Workgroup (Joseph Minei, MD, FACS, Chair, and Brian Harbrecht, MD, FACS, Vice-Chair)
  • Physician Competency and Health Workgroup (Roger Perry, MD, FACS, Chair, and Vice-Chairs Christian de Virgilio, MD, FACS, and Michael Vezeridis, MD, FACS)
  • Surgical Care Delivery Workgroup (Steven De Jong, MD, FACS, Chair, and Vice-Chairs Christopher McHenry, MD, FACS, and Danny Robinette, MD, FACS, Vice-Chair)

Best Practices Workgroup

  • Continued to work with Evidence-Based Decisions in Surgery publications and with the ACS National Surgical Quality Improvement Program® to create one or two guidelines annually regarding common problems in surgery. The first guideline is “The Prevention and Treatment of Ileus in Surgery.”

Physician Competency and Health Workgroup

  • Addressed issues related to the aging surgeon and fatigue mitigation. This group has an enormous task to evaluate data, guidelines, and expert input from consultants. The work product will be a white paper ready for publication after approval from the Regents and a Panel Session at the 2014 Clinical Congress.

Surgical Care Delivery Workgroup

  • Coordinated with Clifford Ko, MD, MS, MSHS, FACS, Director of the ACS Division of Research and Optimal Patient Care, a session on electronic health records for both workflow and quality data extraction.
  • Has revised several guidelines and position statements.

The new Board of Governors pillar structure has had a profound impact on the development of meaningful products and worthwhile projects, not only for the Governors, but also ACS Fellows in general and the patients we serve. The ACS Advisory Councils are considering adopting a similar pillar structure, which serves to provide vertical and horizontal communication and effort across the many divisions and committees of the College. This opportunity for crosstalk enables the College to effectively communicate its mission and goals with all of its members.

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