Report on ACSPA/ACS activities, October 2015

The Board of Directors of the American College of Surgeons Professional Association (ACSPA) and the Board of Regents of the American College of Surgeons (ACS) met October 3 at the Hilton Chicago, IL. The following is a summary of their discussions and actions.

ACSPA

At the time of the meeting, the ACSPA’s political action committee (ACSPA-SurgeonsPAC) had raised $390,337 (including both personal and corporate funds) from 1,132 members of the College and staff, with the average contribution totaling $345. Of this amount, $358,003 is personal (hard) dollars and $32,334 is corporate (soft) dollars.

Thus far in the 2015−2016 election cycle, SurgeonsPAC has disbursed $334,340 to 96 individual candidates, leadership PACs, and party committees. In alignment with congressional party ratios, 60 percent of these funds went to Republicans and 40 percent to Democrats, with more disbursements planned.

ACS

The directors of the ACS divisions provided updates on their activities. Following are highlights from their reports.

Division of Education

The ACS Division of Education and the MacLean Center for Clinical Medical Ethics at the University of Chicago recently established a new Fellowship in Surgical Ethics. The purpose of the program is to prepare surgeons for careers that combine clinical surgery with scholarly studies in surgical ethics. The inaugural fellow, Regan Berg, MD, entered the program in July 2015. Dr. Berg completed his general surgery training at Queen’s University, Kingston, ON, and then completed three fellowships at the University of Southern California, Los Angeles—the first in surgical critical care, the second in trauma surgery, and the third in hepatobiliary and pancreatic surgery. He is assistant professor of surgery, trauma, acute care, and critical care at Case Western Reserve University, Cleveland, OH.

Dr. Berg’s ethics interest area is futility of care, and he will continue in the fellowship program through June 2016. The Fellowship in Surgical Ethics encompasses research, teaching, and clinical ethics consultations and includes bimonthly surgical ethics case conferences, participation in the surgical ethics curriculum, and mentored research in surgical ethics.

Division of Member Services

As of September 1, 2015, the College had 78,623 members: 64,890 Fellows (58,000 U.S., 1,364 Canadian, and 5,526 International); 2,327 Associate Fellows; 9,473 Resident Members; 1,664 Medical Student Members; and 269 Affiliate Members.

The 2015 Initiate class totaled 1,679, including 1,228 U.S., 34 Canadian, and 417 International. A total of 354 women and 1,325 men were initiated. Initiate class size continues to rise and is at its highest point since 2001.

The Board of Regents accepted resignations from 18 Fellows:

  • One cardiothoracic
  • Two colorectal
  • Three general
  • One gynecology (oncology)
  • One obstetrics and gynecology
  • One orthopaedic
  • Five otolaryngology
  • One pediatric
  • Three urologic

The B/R also approved a change in status from Active (dues paying) to Retired for 65 Fellows, and from Senior (non-dues paying) to Retired for 69 Fellows, for a total of 134 Fellows.

Recruitment and retention activities

  • Networking events are planned for Philadelphia, PA, and Seattle, WA, to engage and recruit young surgeons. A successful event took place in Sacramento, CA, hosted by the University of California- Davis, with 45 attendees representing general surgery, otolaryngology, orthopaedics, neurosurgery, obstetrics/gynecology, ophthalmology, urology, cardiothoracic surgery, and pediatric surgery.
  • The design and implementation of a specialty-by-specialty recruitment campaign including “Top 10 Benefits” flyers for each specialty, specialty-specific Web pages, and targeted recruitment communications to specialty program directors and ACS specialty Fellows, has been completed.
  • A new Bulletin column, “Your ACS benefits,” debuted in June to highlight the value of ACS fellowship. This column was created in response to feedback from a member survey conducted in November 2014.
  • A new international dues structure, which will take effect in 2016, was developed to respond to concerns that the current application fees and dues structure may be inhibitory to surgeons in low-income countries who would like to become Fellows of the College. The B/R approved the new dues structure in June 2015. A communication was sent to all Fellows in mid-September outlining the new dues and fees.

Chapters

Chapter Services continues to provide guidance and assistance to the College’s 108 chapters, of which 67 are domestic and 41 are international.

Two new international chapters joined the ACS in 2015—Jordan and Nigeria. Other countries exploring chapter formation include Iraq, the Dominican Republic, Sweden, and Bahrain. Successful regional chapter meetings were held in April with participants from the Latin American countries and in August with the Middle East.

A detailed domestic chapter-by-chapter needs assessment to guide strategic plan development for each chapter is in progress. To further assist the domestic chapters, an association management services pilot program has been launched with several chapters to determine the level of interest in having the ACS assist in administrative matters. Planning also is under way for a Chapter Leader Training Program that will be offered annually beginning in 2016.

Operation Giving Back (OGB)

Primary initiatives include redesign of the OGB website and creation of an Advisory Committee.

Girma Tefera, MD, FACS, OGB Medical Director, is reevaluating and reestablishing OGB partnerships and creating new direct relationships with surgical groups in developing countries, nongovernmental organizations that are involved in global outreach programs, and strategic partnerships with organizations such as the World Health Organization. Furthermore, the ACS has completed a member survey to assess engagement and needs relative to volunteerism activities and to develop disaster management, international or domestic volunteerism opportunities, and advocacy rosters. New program areas, such as development of domestic volunteer opportunities, establishment of a humanitarian volunteer boot camp, and collaboration with the military in areas of mutual interest, are priorities.

Advisory Councils

The Advisory Councils have been restructured to include pillars aligned with the divisions of the College—Membership, Communications, Advocacy, Quality, and Education. An inaugural meeting of the Advisory Council pillars was convened at the 2015 Leadership & Advocacy Summit, and members of the pillars met again at the Clinical Congress. Initial meetings have focused on identifying leadership and establishing goals for each pillar.

The Advisory Council for Rural Surgery will host a symposium in April in Chicago. The theme will be Surgical Care of Rural America: Quality Care in the Right Place at the Right Time.

Member benefit flyers for the 12 specialties plus rural surgery were completed earlier this year, and specialty-specific Web pages have been created to include information about the value of membership.

Board of Governors

At present, 273 individuals serve on the ACS Board of Governors (B/G), including 147 Governors-at-Large representing U.S. states and territories and Canadian provinces, 83 specialty Governors representing surgical associations and societies, and 43 international Governors.

The B/G Workgroup on Physician Competency and Health developed a Statement on the Aging Surgeon. The B/R approved the statement at its October meeting.

Military Health System Strategic Partnership

David B. Hoyt, MD, FACS, ACS Executive Director, and Jonathan Woodson, MD, FACS, Assistant Secretary of Defense for Health Affairs, signed an agreement at Clinical Congress 2014 in San Francisco, CA, under which the military health system (MHS) and the ACS agreed to share information about the following topics:

  • Training and sustainment of trauma surgical skills for military surgeons
  • Preparation for disasters and humanitarian missions
  • Review of the Department of Defense Combat Casualty Research Program and trauma registry
  • Systems-based practice related to surgery in military treatment facilities
  • Quality initiatives and databases, including the ACS National Trauma Data Bank®, the Trauma Quality Improvement Program, and the ACS National Surgical Quality Improvement Program (ACS NSQIP®)

The charter outlined the key members of the Executive Leadership Group, to be co-chaired by U.S. Navy Captain Eric Elster, MD, FACS, and Dr. Hoyt. The members of the Executive Leadership Group include key military surgeons; the ACS Governors of the U.S. Army, Navy, and Air Force; and Directors of the ACS divisions most affected by the new charter, including Member Services, Advocacy and Health Policy, Education, and Research and Optimal Patient Care.

This group met for the first time in March 2015 and through a series of brainstorming sessions identified three subcommittees and the focus areas for each panel for the first year’s efforts, as follows.

Education and Training: Co-Chairs Eric A. Ritter, MD, FACS, and Ann G. Rizzo, MD, FACS

  • Undertake a needs assessment and codify/memorialize the lessons learned from the previous engagement
  • Construct metrics for skills acquisition to measure readiness and effectiveness
  • Build on existing efforts to develop a standardized curriculum
  • Accredit centers of excellence in education for military, disaster response, and humanitarian efforts

Quality Initiatives: Co-Chairs Paul R. Cordt, MD, FACS, and Pierre F. Saldinger, MD, FACS

  • Create a collaborative between the ACS and the MHS that focuses on a shared agenda
  • Integrate ACS NSQIP and other ACS quality measurement tools into the MHS
  • Develop a culture of quality and refine/implement a leadership skill set in collaboration with the Uniformed Services University of the Health Sciences, Bethesda, MD

Joint Trauma System: Co-Chairs Jay A. Johannigman, MD, FACS, and Jeff A. Bailey, MD, FACS

  • Perform a formal ACS Committee on Trauma (COT) systems evaluation of the military’s Joint Trauma System (JTS)
  • Codify JTS lessons learned and translate applicable lessons to the civilian sector
  • Create a proposal for long-term durability of the JTS

In addition, an Excelsior Surgical Society Committee was formed under the leadership of Gordon G. Wisbach, MD, FACS and Yong U. Choi, MD, FACS. The society held its inaugural meeting at Clinical Congress 2015.

Division of Research and Optimal Patient Care

At present, 664 hospitals participate in ACS NSQIP, of which 591 sites participate in the Adult option. The Essentials option, which is the conventional sampling frame, has the highest enrollment of the adult participation options; however, the Procedure Targeted option is experiencing the highest level of growth. The Pediatric option represents almost 11 percent of overall participation. The following is a breakdown of participating sites by ACS NSQIP option:

  • Small and rural: 46
  • Procedure targeted: 246
  • Essentials: 276
  • Measures (National Quality Forum (NQF)-endorsed measures only): 13
  • Florida Surgical Care Initiative: 9
  • Pediatric: 74

The 2015 ACS NSQIP National Conference took place in July 2015 in Chicago. This was the 10th anniversary of the conference with a record attendance of approximately 1,400 attendees, representing 676 medical institutions and 15 countries.

In spring 2015, The Joint Commission and the NQF presented the ACS NSQIP with the John M. Eisenberg Patient Safety and Quality Award in the category of Innovation in Patient Safety and Quality at the National Level. The Eisenberg Awards recognize major achievements of individuals and organizations in improving patient safety and health care quality, consistent with the aims of the National Quality Strategy—better care, healthy people and communities, and affordable care.

At present, 802 centers participate in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). A total of 647 centers are fully accredited and 99 are initial applicants. The remaining 56 centers are data collection sites, which were originally American Society for Metabolic and Bariatric Surgery provisional centers that chose to continue with data entry but did not complete the process to meet full accreditation status. From October 2014 to September 2015, 377 site visits were completed to determine compliance with MBSAQIP standards, and, as of October 2015, 86 more site visits were scheduled in 2015. Nine new surgeon surveyors were trained for the 2015 cycle, for a total of 71 surgeon surveyors.

The ACS continues to develop the Surgeon Specific Registry (SSR) as a tool for individual surgeon data capture. At the time of the meeting, the SSR contained reports from approximately 6,000 surgeons who had submitted at least 20 cases and nearly 6 million records. Surgeons continue to use the registry as a case log system in addition to the other program benefits.

The ACS Clinical Scholars in Residence program is a two-year on-site fellowship in applied surgical outcomes research, health services research, and health care policy. Second-year Clinical Scholars in Residence are Elizabeth Berger, MD; Julia Berian, MD; and Michael W. Wandling, MD. First-year scholars are Kristen A. Ban, MD, and Jason Liu, MD.

With respect to ACS Cancer Programs, 1,532 centers in the U.S. and Puerto Rico have received Commission on Cancer (CoC) accreditation. CoC accreditation encourages hospitals, treatment centers, and other facilities to improve their quality of care through various cancer-related programs and activities.

Furthermore, National Accreditation Program for Breast Centers Program accreditation has been awarded to 640 centers in the U.S. Another 31 programs were added as of the October B/R meeting; 32 additional centers were pending survey in late 2015/early 2016. Reaccreditation rates for 2015/2016 remain at 99 percent. Approximately 20 percent of breast centers ask to be surveyed.

Other ACS activities

As of September 2015, more than $3,261,540 had been raised toward the goal of $5 million for the ACS Foundation’s 1913 Legacy Campaign.

In addition to the nearly 400 Scientific Forum abstracts published in the October 2015 supplement of the Journal of the American College of Surgeons (JACS), a total of 374 additional abstracts from Clinical Congress 2015, including Scientific Papers and Scientific Poster Presentations, were published online in JACS and can be accessed via the ACS mobile app. As ACS members increasingly access JACS’ Continuing Medical Education program online, 2015 saw the journal’s highest number of users, with nearly 3,000 individual test takers through the first nine months of the year.

At Clinical Congress 2015, the ACS welcomed the following new Officers and Regents:

Officers-Elect, 2015−2016

  • President-Elect—Courtney Townsend, Jr., MD, FACS, Galveston, TX
  • First Vice-President-Elect—Hilary A. Sanfey, MB, BCh, BAO, MCh, MHPE, FACS, FRCSI, FRCS, Springfield, IL
  • Second Vice-President Elect—Mary C. McCarthy, MD, FACS, Dayton, OH

Board of Regents appointments

  • James C. Denneny, III, MD, FACS, Alexandria, VA
  • Timothy J. Eberlein, MD, FACS, St. Louis, MO
  • Linda G. Phillips, MD, FACS, Galveston, TX
  • Anton N. Sidawy, MD, FACS, Washington, DC

Board of Governors Executive Committee

At Clinical Congress 2015, the B/G reelected Fabrizio Michelassi, MD, FACS, New York, NY, to chair its Executive Committee. Diana L. Farmer, MD, FACS, Sacramento, CA, was elected Vice-Chair of the B/G; and Steven C. Stain, MD, FACS, Albany, NY, was elected Secretary.

In addition, the College acknowledges the contributions of the following retiring Regents and Officers:

  • Julie A. Freischlag, MD, FACS, Regent and Past-Chair, B/R
  • Jay L. Grosfeld, MD, FACS, First Vice-President
  • Kenneth L. Mattox, MD, FACS, Second Vice-President
  • Raymond F. Morgan, MD, FACS, Regent
  • Andrew L. Warshaw, MD, FACS, FRCSEd(Hon), President
  • Mark C. Weissler, MD, FACS, B/R Chair

We also recognize Carlos A. Pellegrini, MD, FACS, FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), Immediate Past-President, for his invaluable contributions in 2015.

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