Looking forward – November 2013

David B. Hoyt, MD, FACS

The pace of change in health care is staggering. Public demands that health care professionals and institutions improve quality, efficiency, and cost-effectiveness grow increasingly forceful. The surgical boards continue to move forward with implementation of Maintenance of Certification (MOC) requirements. Technological advances that may require mastery of a whole new skill set continue to enter the marketplace. Sometimes the pressure to keep up can feel overwhelming.

The American College of Surgeons’ (ACS) leadership is working hard to help surgeons cope with and influence many of these changes. We are looking ahead and conducting a strategic planning process centered on four pillars: quality, education, advocacy, and member services. As we move ahead with our strategic plan, the ACS leadership and staff are using as guideposts our five core values—
professionalism, excellence, innovation, introspection, and inclusion. We are approaching this endeavor with excellent communication, team spirit, and a sense of fun. This month, I provide a brief summary of the progress we are making.

The strategic view

As we have looked back at the College’s 100-year history these past months, the Fellowship was reminded that a key function of the ACS has been and remains ensuring that surgical patients receive quality care. We also learned that development of meaningful, reliable quality measures and best practices is a highly complex process with many variables, including convincing all members of the operating team that their compliance with evidence-based guidelines, checklists, and other instruments will help them to improve their outcomes. The ACS is seeking to increase surgeon involvement in quality improvement and awareness of techniques that are effective in providing high-quality care. Reimbursement and quality are likely to be linked in the future.

Another traditional area of focus for the College is surgical education, and the ACS is continually updating existing and developing new programs, courses, and processes to help surgeons engage in the educational opportunities they need to provide optimal patient care and to keep pace with MOC requirements. We also are developing programs aimed at providing residents with the experiences they need to confidently and competently enter active practice.

As key elements of the Affordable Care Act are progressively implemented and new regulations are established, surgeons need to advocate for changes that ensure that surgical patients have access to the care they need. Surgeons and the College need to advocate for policies and legislation that will allow us to train and sustain a strong surgical workforce. And surgeons need to advocate for sensible and equitable payment policies. The ACS is strategizing for the future and developing new programs to encourage grassroots advocacy.

We have reorganized many of the activities that fall under the purview of Member Services, including the structure and expectations of the Board of Governors, in an effort to be certain that the College’s leadership can more effectively take the pulse of the Fellowship and your evolving concerns. We are planning to revitalize the Advisory Councils and chapters in the near future as well.

Staying true to our values

As I write this column, the Fellows and staff of the ACS are getting ready to conclude our Centennial celebration at the 2013 Clinical Congress in Washington, DC. Meanwhile, the U.S. Congress was shut down due to disagreements over the nation’s health care system and, more specifically, implementation of the Affordable Care Act. In light of the confusing discourse, it is more important than ever that the ACS recommit to working on behalf of our patients.

These times represent an opportunity to provide unprecedented leadership, if we are willing to seize it. Think of what our predecessors were up against in establishing the first standards for hospitals and surgical education, which we now take for granted.

As we go through this strategic planning process and begin implementing the changes we need to make, remember our five values:

Professionalism is marked by accountability, honesty, responsibility, loyalty, and respect. These characteristics are inherent in all surgeons who are working to provide their patients with quality care, and in the ACS leadership’s and staff’s efforts on their behalf.

Excellence involves aspiring to and working to exceed internal and external standards. It means having a can-do attitude about work. Surgeons put their all into everything they do to care for their patients.

Innovation is marked by a willingness to take risks, creativity, and imagination. Surgeons are fearless problem solvers. They are remarkably curious and investigate everything, following clues as to what is causing a problem and developing new ideas about how to approach it. A surgeon with a goal will pursue it using every strategy possible until the objective is fulfilled.

Introspection involves being open to feedback on how one can improve and acknowledging personal limits. As a group, the ACS can act independently with confidence as we advocate for what the evidence shows is best for our patients and our profession.

Inclusion means working with our colleagues to do what is best for our patients—whether it means working with the other health care professionals on high-performance surgical teams to deliver quality care or working with other medical and surgical organizations to advocate for our patients.

We have a lot of work ahead of us as we seek to bring transformative changes to the ACS. But as long as we stay true to our values and focused on strengthening the four pillars of quality, education, advocacy, and member service, we will see the rewards.

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