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 October 21, 2017, at the Manchester Grand Hyatt during the annual Clinical Congress in San Diego, CA. The following is a summary of their discussions and actions. Further details about all ACS activities in 2017 are provided in the “Executive Director’s annual report: 2016–2017: A year of transformational growth,” in the December 2017 Bulletin.
The following is an update on activities from January 1, 2017, through October 2, 2017, for programs conducted by the ACSPA and its political action committee (PAC), the ACSPA-SurgeonsPAC. In addition to reporting $374,000 in donation receipts from more than 1,000 individual College members and staff, SurgeonsPAC disbursed more than $325,000 to 80 congressional candidates, leadership PACs, and political campaign committees. In line with congressional party ratios, 59 percent of the amount given was to Republicans and 41 percent to Democrats.
In addition to reviewing reports from the ACS division directors, the Board of Regents reviewed and approved the following policy statements:
- Statement on Post-traumatic Stress Disorder
- Statement on Cannabis Regulation and Risk of Injury
- Statement on Social Media
- Statement on the Uniform Emergency Volunteer Health Practitioner Act (Revised)
- Statement on Diversity (Revised)
- Statement on Maintaining Surgical Access with Locum Tenens Surgeon
Division of Education
The Clinical Congress Program Committee has made transformational changes over the past several years. Recent changes include the development and use of taxonomies for clinical and nonclinical content, establishment of a new system to define evolving needs and propose a slate of timely Skills Courses to address a broad spectrum of domains, introduction of e-posters to replace traditional posters, simplification of the system for gap analyses, and webcasts of most panel presentations and didactic courses. Two additional changes are being explored, as follows: a plan to present cutting-edge science in the early part of the Clinical Congress, and a possible shift in the footprint of the Clinical Congress by starting the program over the weekend and concluding earlier than Thursday. The Program Committee will continue to work with the B/R to give further consideration to these possible changes.
The Committee on Ethics, which is based in the ACS Division of Education, released Ethical Issues in Surgical Care at Clinical Congress 2017. More than 30 authors contributed to 21 chapters that are organized by the predominant arenas in which ethical issues in surgical care arise, including the surgeon-patient relationship, the surgeon and the surgical profession, and the surgeon and society. Chapters feature case scenarios to ground discussions in the realities of clinical practice. Several related educational sessions were presented at Clinical Congress 2017.
Division of Member Services
A record number of Initiates—a total of 1,827, with 1,221 from the U.S. and its territories, 24 from Canada, and 582 from 68 other countries—were welcomed into the ACS in 2017. Also during the 2017 Convocation, the Initiate classes of 1967 and 1992 celebrated their respective 50 and 25 years of Fellowship.
The Board of Regents accepted resignations from 11 Fellows and changed the status from Active or Senior to Retired for 95 Fellows. The Regents also approved 1,099 fellowship terminations. At the end of October 2017, the College had more than 81,000 members.
The Division of Member Services engaged in efforts to retain Fellows who are in jeopardy of losing their Fellowship because their dues are in arrears. This included outreach from members of the Board of Regents, Advisory Councils, the Young Fellows Association, Board of Governors (international), and Women in Surgery Committee.
Fellowship recruitment efforts focused on outreach to non-member registrants of ACS meetings and courses, non-member purchasers of ACS products, as well as non-member registrants of Clinical Congress 2017, who received a waived application fee if they applied for membership on site. Additional recruitment efforts were conducted via outreach to specialty program directors for residents and to Surgery Interest Groups for medical students.
Two new Affinity Programs partners have been added to the College’s member offerings: the Collette Travel Program and AIG Insurance.
A member survey was conducted in July and was sent to all dues-paying Fellows and Associate Fellows. The survey had a 12 percent response rate, and the results were presented to the Regents, and will be published in a future issue of the Bulletin.
The Division of Member Services collaborated with Convention and Meetings to create a new ACS Central area, which debuted in the Exhibit Hall at Clinical Congress 2017. This reimagined space was designed to encourage meeting attendees to relax and recharge; meet with colleagues, staff, and ACS leaders; learn about the latest programs, products, and services from College; purchase merchandise; and attend ACS Theatre sessions.
Electronic newsletters have been developed for the 13 Advisory Councils to better communicate with specialty colleagues on ACS activities and specialty-specific issues and programming.
Chapter Services continues to provide guidance and assistance to the College’s 111 chapters, of which 67 are domestic and 44 are international. The Board of Regents approved the formation of a chapter in Qatar.
Other Chapter Services activities include the following:
- Conducting two surveys to gauge international member engagement and capture information from all chapters on member recruitment, chapter finances, chapter management, chapter events, and communications
- Convening the first Chapter Officer Leadership Program in May 2017
- Developing an online Chapter Guidebook and Meeting Toolkit
- Creating digital e-mail banners for all chapters and premiering quarterly e-newsletters for both domestic and international chapters
Serving as the historical memory of the College, the Archives accepted more than 60 new accessions this year, including additional papers from C. Rollins Hanlon, MD, FACS, Past-Director of the ACS, as well as a rare book donation of the 1645 Adrianus Spiegelius anatomy book.
2018 Leadership & Advocacy Summit
Following a successful 2017 Leadership & Advocacy Summit, which attracted more than 400 surgeons and residents, the 2018 Leadership & Advocacy Summit will be held May 19–22 at the Renaissance Hotel in Washington, D.C.
Division of Research and Optimal Patient Care
The Division of Research and Optimal Patient Care (DROPC) encompasses the areas of Continuous Quality Improvement (CQI) and ACS research and accreditation programs.
A total of 806 hospitals participate in the College’s National Surgical Quality Improvement Program (ACS NSQIP®)—698 in the adult option and 108 in the pediatric option. An additional 65 hospitals are in various stages of the onboarding process. At present, 89 hospitals outside of the U.S. participate in ACS NSQIP—approximately 11 percent of all ACS NSQIP participating hospitals. Interest from international sites continues to build, particularly in Pakistan, the Philippines, Portugal, and Vietnam.
ACS NSQIP has 53 established collaboratives, with several more in development, including a New Jersey Collaborative and an Ohio Collaborative. The ACS NSQIP Geriatric Pilot, which launched in 2014, is ongoing, with 23 sites collecting data on 19 geriatric-specific variables.
Launched in 2011, the Quality In-Training Initiative (QITI) has more than 120 participating ACS NSQIP sites collecting four resident-specific variables. In July 2017 the QITI Advisory Board released an updated version of the QITI Curriculum, Practical QI: The Basics of Quality Improvement Education.
A total of 848 facilities participate in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), and 68 surgeon surveyors performed 250 site visits during the 2017 calendar year.
Children’s Surgery Verification Program
In January 2017, the ACS Children’s Surgery Verification (CSV) Quality Improvement Program officially released its verification program with the goal of ensuring that pediatric surgical patients have access to quality care. Five sites have been verified (original pilot sites) and 16 non-pilot sites are involved in the verification process. The Children’s Surgery Verification Committee offered a Town Hall at Clinical Congress 2017, which provided an update on the program to attendees.
The Coalition for Quality in Geriatric Surgery Project
The ACS has completed its 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. In the last quarter, the team finalized and disseminated the beta pilot invitations and created materials, held a pre-conference session at the ACS Quality and Patient Safety Conference, and conducted the third and fourth patient family advisory council meetings.
The Agency for Healthcare Research and Quality Improving Surgical Care and Recovery (ISCR) Program, a collaborative effort between the ACS and the Johns Hopkins Armstrong Institute for Patient Safety and Quality, is under way. At present, 313 hospitals are actively engaged in the enrollment process, with 139 hospitals that have signed contracts to participate in the cohort.
The new platform for the ACS Surgeon Specific Registry (SSR) launched this spring. The SSR has been approved as a Merit‐based Incentive Payment System (MIPS)‐qualified entity for 2017. Continued enhancements are under way to improve functionality of the system.
Optimal Resources for Surgical Quality and Safety
The College officially released the Optimal Resources for Surgical Quality and Safety (previously referred to as the quality manual) in July 2017. The manual is intended to be a trusted resource for surgical leaders seeking to improve patient care in their institutions, departments, and practices.
The Commission on Cancer (CoC) has a total of 1,486 accredited programs, and 42 cancer programs surveyed in 2016 received the CoC Outstanding Achievement Award.
The National Accreditation Program for Breast Centers (NAPBC) has accredited more than 600 U.S. centers and as of the October board meeting had received 62 new applications for 2017.
National Accreditation Program for Rectal Cancer staff exhibited at the June 2017 American Society of Colon and Rectal Surgeons Tripartite meeting and disseminated a new brochure to track leads and communicate with programs that are interested in seeking accreditation. A session was developed for Clinical Congress 2017 to update members on the program’s progress.
More than 400 individuals across 18 expert panels and several disease-specific groups have developed the content for the AJCC (American Joint Committee on Cancer) Cancer Staging Manual, Eighth Edition. The eighth edition was released October 15, 2016, and more than 21,000 copies of the book had been sold as of August 29, 2017. The Cancer Staging Manual protocols take effect January 1, 2018.
Following the ACS Committee on Trauma’s (COT) April conference on Achieving Zero Preventable Deaths, COT leaders formed four core workgroups to write articles describing the status and challenges within each area and to offer potential solutions for implementation of the National Academies of Sciences, Engineering, and Medicine’s report recommendations. The articles will be submitted to the Journal of Trauma.
The Trauma Center Leadership Course, which provides training on developing and managing a trauma program, is expected to be conducted for the first time at the 2018 Trauma Quality Improvement Program (TQIP) conference.
As of September 18, a total of 736 hospitals were participating in TQIP. The 2017 TQIP Annual Scientific Meeting and Training took place November 11–13 at the Hilton Chicago, IL. The number of abstract submissions increased by 65 percent from the previous year, yielding a total of 172 submissions. Thirty abstracts were selected for oral presentation.
The 10th edition of the Advanced Trauma Life Support program, scheduled for release this spring, will include significant changes to the format and delivery of education. Alpha testing took place in 2017 and beta testing is under way at 36 course sites across all 17 regions.
The Bleeding Control program has experienced rapid growth in the short period since its inception. In August, a strategic planning session took place in Chicago. The Stop the Bleed® program is now located in all 50 states, with instructor requests from 32 countries.
Other ACS activities
The ACS continues to extend association management services to domestic chapters and is contracted with six chapters. An additional 18 clients are contracted for services.