Archive for June, 2013

Dr. Hoyt

Looking forward – June 2013

In his June column, Dr. Hoyt discusses a one-day strategic planning retreat for ACS Executive Staff. Attendees discussed the College’s two-year engagement with GE Healthcare and the launch of the Performance Improvement program, as well as future goals and objectives of each ACS Division to continue to move the organization forward.

Initial management of mass-casualty incidents due to firearms: Improving survival

Since 1996, more than 60 mass-casualty shootings have occurred in the U.S., and 18 have transpired in other countries. Analysis and policymaking are required to reduce the suffering and burdens that are a direct result of these events. This article discusses several aspects of mass- casualty firearm events, such as medical scene management and tactical emergency medical support.

Improving Survival from Active Shooter Events: The Hartford Consensus

The ACS brought together senior leaders from medical, law enforcement, fire/rescue, and the emergency medical services (EMS) communities at the recently held Hartford Consensus Conference to produce a document titled Improving Survival from Active Shooter Events, with the goal of promoting local, state, and national policies to improve survival in these uncommon but horrific events. This short statement describes methods to minimize loss of life in these terrible incidents.

Surgeons bring RRT to patients in Guyana

A network of U.S. kidney transplant surgeons and Guyanese health care professionals worked together to develop a program to deliver free renal replacement therapy to Guyanese patients. This article describes the 14 medical missions the authors made to Guyana, with an emphasis on logistics and outcomes of the team’s public-private partnership. This model is now being extended to the CARICOM (Caribbean community), a group of 15 countries in the Caribbean basin.

Figure 1. Adverse outcomes

Symptoms of normal recovery or complication: The risks of postoperative care

Although patients are exposed to many risks in the preoperative phase of care (diagnosis and treatment selection) and during a procedure, the authors of this article found that some of the most dangerous risks exist in the postoperative stage. This article focuses on claims against surgeons that arose from care provided in the postoperative period, explores the causes and effects of postoperative complications, and describes lessons learned from the study and offers recommendations on steps to take to avoid unnecessary litigation.

ACS scholarship recipients: Where are they now?

As the ACS celebrates its Centennial by reflecting on the achievements of the College’s founders and other surgeon leaders, it’s clear that the organization has a long history of providing opportunities for promising young physicians. In this article, several former ACS scholars describe how the ACS scholarship program had a notable effect on their career path and why these programs will continue to play an essential role as the College enters its next century.

Physician personalities and burnout

The Bulletin will be publishing excerpts from the Board of Governors’ Committee on Physician Competency and Health guidebook titled Being Well and Staying Competent: Challenges for the Surgeon, which is posted on the members-only Web portal. The following is the first article in that series.

Centennial reprint: ACS Fellow offers recommendations for avoiding “Death in a Ditch”

To help commemorate the American College of Surgeons’ (ACS) 100th anniversary, the Bulletin of the American College of Surgeons is reprinting articles centered on the issues and developments that have defined the character and integrity of the organization throughout its history.

This month, the Bulletin is reprinting “Death in a Ditch,” which was originally published in the May-June 1967 issue. The article, written by trauma surgeon J.D. Farrington, MD, FACS, presents the concepts he used to instruct rescue workers on the safe extrication, emergency care, and transport of patients involved in vehicular crashes.

The inpatient list

This column describes the Centers for Medicare & Medicaid Services’ (CMS) inpatient list and CMS’ policies for payment of services that are either included or not included on this listing. Although the inpatient list directly affects Medicare reimbursement to hospitals and other patient care centers, surgeons should be aware of the inpatient list, because the inclusion of services on the list could affect their interactions with their hospitals.

Effectively using E/M codes for trauma care

This column provides coding guidance and clinical scenarios on the appropriate use of E/M codes during the care of injured or critically ill patients, including the use of critical care codes, the coordination/counseling guide as a coding alternative to the tradition documentation guidelines (“bullets”), and modifiers for coding during the global surgical period.

Using Lean methodology to improve sterilization of surgical instruments

In a study undertaken at The Joint Commission-accredited Virginia Mason Medical Center in Seattle, WA, quality improvement interventions in the surgical instrument sterilization process were based on adoption of a specific set of Lean production improvement methods called the Virginia Mason Production System (VMPS). The article describes how the center used VMPS to improve surgical sterile instrument processing in its 24 operating rooms where approximately 18,000 operative procedures are performed annually.

Workers’ compensation

In order to examine the occurrence of occupational injuries in the National Trauma Data Bank® (NTDB®) research dataset for 2012, admissions medical records were searched using the field work-related (indication of whether the injury occurred during paid employment) with a field value of yes. This column highlights these findings takes a brief look at the history of compensation for bodily injury.

Letters to the Editor

The following comments were received regarding recent articles published in the Bulletin.

Replacing the SGR: The latest developments in the ACS Value-Based Update proposal

Updates on the College’s Value-Based Update (VBU) proposal are outlined, including efforts to develop additional structure for the plan and obtaining additional feedback from ACS Fellows.

ACS releases primer on bundled payment

The ACS recently released the Surgeons and Bundled Payment Models: A Primer for Understanding Alternative Physician Payment Approaches, which summarizes the concept of bundled payment and the effect bundled payment policies could have on surgical practices.

C. Everett Koop, MD, FACS, former U.S. Surgeon General, renowned pediatric surgeon, and public health advocate

On February 25, America and the world lost a great humanitarian, C. Everett Koop, MD, FACS, who died peacefully at age 96 in Hanover, NH.

Leading trauma surgeon Eric R. Frykberg, MD, FACS, dies at age 62

Eric R. Frykberg, MD, FACS, an ACS Governor and leading trauma surgeon, died March 25 at the age of 62.

More than 100 hospitals participate in ACS NSQIP CMS Hospital Compare

A total of 102 hospitals are now participating in a collaborative project between the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) and the Centers for Medicare & Medicaid Services (CMS), which allows ACS NSQIP hospitals to voluntarily report surgical performance measures on the CMS Hospital Compare website. On April 18, the results of the second reporting period were posted to the Hospital Compare website.

New book recounts lessons learned through Inspiring Quality forums

The ACS released a limited-edition book, ACS Inspiring Quality Tour: Lessons Learned in the Pursuit of Quality Surgical Health Care, on April 15, which summarizes the findings of an 18-month effort to expand a national dialogue about surgical quality and patient safety through a series of nationwide forums.

2013 COT Residents Trauma Papers Competition winners announced

The American College of Surgeons Committee on Trauma (ACS COT) announced the 15 winners of the 36th annual Residents Trauma Papers Competition at its March 21–23 meeting in San Diego, CA.


Bulletin of the American College of Surgeons
633 N. Saint Clair St.
Chicago, IL 60611


Download the Bulletin App

Apple Store
Get it on Google Play
Amazon store