Report on ACSPA/ACS activities, June 2017

The Board of Directors of the American College of Surgeons Professional Association (ACSPA) and the Board of Regents (B/R) of the American College of Surgeons (ACS) met June 9–10 at the College’s headquarters in Chicago, IL. The following is a summary of their discussions and actions.

ACSPA

The following is an update on activities from January 1, 2017, through May 18, 2017, for programs conducted by the ACSPA and its political action committee (PAC), the ACSPA-SurgeonsPAC. In addition to reporting $262,972 in donation receipts from more than 770 individual College members and staff, SurgeonsPAC disbursed more than $219,220 to 50 congressional candidates, leadership PACs, and political campaign committees. In line with congressional party ratios, 60 percent of the amount given was to Republicans and 40 percent to Democrats.

ACS

In addition to reviewing reports from the ACS division directors, the Board of Regents reviewed and approved the following policy statements:

  • Statement on the Rationale for Emergency Surgical Call (Revised)
  • Statement on the Development and Use of Proprietary Guidelines for Accountable Patient-Centered Care (Revised)
  • Statement on Gender Salary Equity
  • Statement on Injury Prevention
  • Statement on the Opioid Abuse Epidemic

Division of Education

Clinical Congress

The total number of physician attendees at the 2016 Clinical Congress was 8,781, of whom 1,792 were residents and 748 were guest physicians. Other attendees included 638 medical students, 201 allied health professionals, and 106 doctors of philosophy.

The 2017 Clinical Congress program, which was approved during Clinical Congress 2016, includes 24 Tracks, 118 Panel Sessions, 19 Didactic Courses, 12 Skills Courses, 45 Meet-the-Expert Sessions, and 21 Town Hall Meetings. In early 2017, 1,797 abstracts were submitted for the Clinical Congress—the highest number of abstract submissions in recent years and a 33 percent increase from the 1,347 abstracts submitted in 2016.

SESAP

The Surgical Education and Self-Assessment Program (SESAP®) remains the premier self-assessment and cognitive skills education program for practicing surgeons. The new edition, SESAP 16, was released in October 2016, marking the 45th year of SESAP. The latest edition includes more questions than were in the past editions and features an innovative Self-Assessment model. The 850 questions and critiques may be used to earn up to 90 Category 1 Continuing Medical Education (CME) Self-Assessment Credits. SESAP 16 can be applied to fulfill requirements for Part 2 of Maintenance of Certification (MOC) as defined by the American Board of Surgery (ABS) and is useful in preparing for the recertification examination to fulfill the requirements of Part 3 of MOC. SESAP is available in web, mobile-friendly, and print versions.

Comprehensive General Surgery Review Course

The annual ACS Comprehensive General Surgery Review Course is a 3.5-day intensive review of the essential content areas in general surgery. The course uses a robust educational design, with online pre- and posttests, and includes a unique, interactive educational model. A combination of didactic and case-based formats is used to create an efficient review while enhancing comprehension and retention. The course is designed to help practicing surgeons fulfill requirements for Part 2 of MOC and to help surgeons prepare for the ABS General Surgery MOC Exam to fulfill requirements of Part 3 of MOC. The course offers 30 Category 1 CME Self-Assessment Credits. The 2016 course had 192 participants.

Selected Readings in General Surgery

In January 2017, Selected Readings in General Surgery (SRGS®) entered its 10th year. It continues to publish evidence-based reviews of the medical literature with a cycle of topics that is designed to cover the field of general surgery in 48 months. The SRGS education and self-assessment model aims to promote expertise in surgery. SRGS offers the opportunity to earn 80 Self-Assessment Credits per year. SRGS has 2,350 subscribers, 500 of whom are surgery residents.

Evidence-Based Decisions in Surgery

Evidence-Based Decisions in Surgery includes concise, focused modules derived from practice guidelines. Modules are developed based on diagnoses that are relevant to the operations that general surgeons perform frequently. Each module includes information on the source of the guideline, an analysis of the strength of the evidence supporting the recommendations, a flow diagram of a typical patient (when appropriate), a page summarizing the resources necessary to implement the guideline in a surgeon’s practice, and a listing of the data necessary to determine whether the guideline is working in practice. A list of items to facilitate patient education is included. Each module concludes with a list of recommended articles that provide additional information. The modules are intended to be used at the point-of-care and may be accessed through handheld devices. In all, 60 modules are available.

Fundamentals of Surgery Curriculum

More than 1,500 residents from more than 230 programs are enrolled in the ACS Fundamentals of Surgery Curriculum®. Assessment models are in development for each of the 14 modules to provide program directors with information regarding resident performance, and pilot testing of these models is under way. The addition of advanced cases to address the needs of senior residents is in the planning stages.

MyCME

The number of ACS Members using the MyCME Program to request transfer of their CME Credits to the ABS has been steadily increasing. In 2016, a total of 3,974 members sent 5,885 records to the ABS. There are plans to explore similar opportunities with other surgical specialty boards.

Division of Member Services

The Board of Regents accepted resignations from 25 Fellows and changed the status from Active or Senior to Retired for 91 Fellows.

The Board of Regents approved the appointment of three new Governors representing the countries of Bangladesh, Kuwait, and Qatar. These Governors will begin their terms in October. The Regents also approved the formation of chapters in Bangladesh and Kuwait.

The Chairs of the Board of Governors, Young Fellows Association, and Resident and Associate Society provided updates on their activities.

Division of Research and Optimal Patient Care

The Division of Research and Optimal Patient Care (DROPC) encompasses the areas of Continuous Quality Improvement and ACS research and accreditation programs.

ACS NSQIP

A total of 782 hospitals participate in the College’s National Surgical Quality Improvement Program (ACS NSQIP®), 682 of which participate in the adult option. At present, 87 hospitals outside of the U.S. participate in ACS NSQIP—about 11 percent of all participating hospitals—and interest from international sites continues to build. Sites in Australia, Canada, Kuwait, and Vietnam have shown significant interest.

ACS NSQIP has 53 established collaboratives, with several more in development. ACS NSQIP is in the final stages of hospital enrollment for The Military Health Service Strategic Partnership American College of Surgeons (MHSSPACS), with 41 enrolled hospitals, one pending enrollment, and four awaiting applications. After full enrollment, the goal will be to ramp up the military’s systemwide collaborative with the assistance of the hospital commanders and ACS leadership.

The ACS Quality and Safety Conference (formerly the ACS NSQIP Conference) took place July 21–24 at the New York Hilton Midtown, NY. This year’s theme, Achieving Quality: Present and Future, reflected a more comprehensive approach to quality, with the perspectives of adult, pediatric, geriatric, and bariatric specialties, with surgeons, nurses, anesthesiologists, and hospital administrators all represented. The conference included specialty tracks and breakout sessions relevant to participants from multiple ACS quality programs including ACS NSQIP Adult and Pediatric, the Children’s Surgery Verification (CSV) Quality Improvement Program, the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), and the Surgeon Specific Registry (SSR).

MBSAQIP

A total of 828 facilities participate in MBSAQIP. From October 2014 through April 2017, 796 site visits were completed using the MBSAQIP standards. In 2016, the program performed 291 site visits with 67 surgeon surveyors.

CSV

In January 2017, the ACS CSV Quality Improvement Program officially released its verification program with the goal of ensuring that pediatric surgical patients have access to quality care. This new program defines the resources required to achieve optimal patient outcomes for children receiving surgical care at verified health care facilities. The program has garnered key endorsements from multiple specialty societies, including the American Academy of Pediatrics, American Pediatric Surgical Association, and Society of Pediatric Anesthesiology. Five sites have been verified and 11 have applied for verification. The Children’s Hospital Association, based on its own analysis, estimates that 200 hospitals will participate in the CSV Program.

The Coalition for Quality in Geriatric Surgery Project

The ACS is nearing completion of the second year of the Coalition for Quality in Geriatric Surgery Project. Funded by the John A. Hartford Foundation, this project aims to systematically improve surgical care of patients older than 65 years of age by establishing a verification program in older adult surgery.

SSR

The new platform for the ACS SSR launched this spring. More than 8,000 users of the former SSR were moved to the new SSR platform, hosted by QuintilesIMS, in mid‐April 2017. The new SSR is an online software application and database that allows surgeons to track their cases and outcomes in a convenient, streamlined, and easy‐to‐use manner from their computer or mobile devices. The SSR builds on the ACS Case Log system, enabling surgeons not only to log and track their cases, but also to participate in an increasing number of regulatory programs for the individual surgeon. The system supports Part 4 of MOC and provides electronic transmittal of cases to the ABS. The ACS has worked with the Centers for Medicare & Medicaid Services (CMS) to achieve and maintain recognition of the SSR as both a Qualified Registry and a Qualified Clinical Data Registry (QCDR) for the former Physician Quality Reporting System (PQRS) and, moving forward, under the Quality Payment Program (QPP). The SSR has been approved as a Merit‐Based Incentive Payment System (MIPS)‐qualified entity for 2017.

Cancer programs

The Commission on Cancer (CoC) has accredited a total of 1,508 programs, and 41 cancer programs surveyed in 2016 received the Outstanding Achievement Award.

The National Accreditation Program for Breast Centers (NAPBC) has accredited more than 600 U.S. centers and had received 60 new applications for 2017 as of June.

A soft launch of the Oncology Medical Home Accreditation Program took place during the Community Oncology Alliance conference in April. The program is in the process of recruiting medical oncologists who are familiar with the program’s standards to become surveyors.

National Accreditation Program for Rectal Cancer (NAPRC)

NAPRC standards have been finalized, and final work on the manual is being completed. Accreditation staff exhibited at the American Society of Colon and Rectal Surgeons Tripartite meeting June 10–14, where publication of the manual was announced. A preapplication will be released to interested programs in mid-summer.

American Joint Committee on Cancer (AJCC)

More than 400 individuals across 18 expert panels and several disease-specific groups have developed the content for the AJCC Cancer Staging Manual, Eighth Edition. The eighth edition was published October 15, 2016, and more than 18,000 copies of the book had been sold as of May 19. The Cancer Staging Manual protocols take effect January 1, 2018.

Trauma programs

Committee on Trauma (COT)

The ACS COT convened a two-day conference in Bethesda, MD, in April in response to the recent publication of the National Academies of Science, Engineering, and Medicine (NASEM) Report, A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths after Injury, released in June 2016. The meeting brought together a multidisciplinary group of approximately 170 professionals from the spectrum of the trauma care system with the goal of creating the framework for building a National Trauma Care System Action Plan.

TQIP

As of May 15, a total of 716 hospitals were participating in Trauma Quality Improvement Program (TQIP). As of May 2017, a total of 477 hospitals  were participating in the ACS trauma center verification program.

The 2017 TQIP Annual Scientific Meeting and Training will convene November 11–13 at the Hilton Chicago, IL. To accommodate the growth in meeting attendance, the number of breakout sessions was increased for all members of the TQIP team, pediatrics centers, Level III centers, and hospitals participating in all COT quality programs. Last year, 1,579 trauma professionals attended the TQIP, representing more than 500 hospitals and collaboratives—a 37 percent increase from the previous year.

Bleeding Control

The Bleeding Control program has experienced rapid growth in the short period since its inception. The number of instructors trained, as well as the number of classes held and locations, has indicated the trauma community’s commitment to this valuable effort. The Stop the Bleed® program is now located in all 50 states, with instructor requests from 30 countries.

Integral to this growth is the expansion of the website, bleedingcontrol.org, to become a larger portal for materials, marketing, and instructor/community resources. The website is now home for materials, instructor resources, listing of classes, and the purchase of bleeding control kits and training materials. The website, with more than 140,000 unique views since its inception, has become a trusted home for articles and information on bleeding control worldwide.

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