Report from the Past-Chair of the Board of Regents: Fostering innovation at the ACS through strategic planning

It was my distinct honor to serve as Chair of the American College of Surgeons (ACS) Board of Regents from 2012 to 2014 with Mark C. Weissler, MD, FACS, as the Vice-Chair. The two Presidents who served during that time are A. Brent Eastman, MD, FACS, FRCSEd(Hon) (2012–2013), followed by Carlos A. Pellegrini, MD, FACS, FRCSI(Hon) (2013–2014). Together the Officers; Board of Regents; Board of Governors; ACS Executive Director David B. Hoyt, MD, FACS; and the staff and volunteers of the ACS accomplished a great deal of work.

Structural changes

At its quarterly meetings, the Board of Regents continued to follow the format changes that J. David Richardson, MD, FACS, had introduced as Chair of the Board of Regents (2011–2012). A key change that Dr. Richardson had implemented was to devote each meeting primarily to one or two key areas of the College, with brief updates from the other division directors and program chairs.

During my first term, six new Regents joined us (all MD, FACS): John L. D. Atkinson, a neurosurgeon from Rochester, MN; Henri R. Ford, a pediatric surgeon from Los Angeles, CA; Enrique Hernandez, a gynecological oncologist from Philadelphia, PA; L. Scott Levin, an orthopaedic surgeon from Philadelphia, PA; Beth H. Sutton, a general surgeon from Wichita Falls, TX; and Steven D. Wexler, a colorectal surgeon from Weston, FL. One new Regent joined us for the 2013–2014 term—James Gigantelli, MD, FACS, an ophthalmologist from Omaha, NE. The energy emanating from this new group of surgical leaders helped us realize that the Board was ready to move quickly in a direction marked by enhanced involvement with current and future members of the ACS.

Marching forward

To help the Board of Regents develop fresh approaches to working with the membership and to encourage other surgeons to join the College, we enlisted the services of Jeffrey DeGraff, PhD, professor of management and organizations, Ross School of Business, University of Michigan, Ann Arbor. Dr. DeGraff worked previously with Dr. Hoyt and the College’s Performance Improvement (PI) team to reenergize and refocus the ACS staff, assisting in the development of the ACS Values of Professionalism, Excellence, Inclusion, Innovation, and Introspection. His research focuses on leading innovation, and he has written several books on the topic, including Creativity at Work: Developing the Right Practices to Make Innovation Happen and Leading Innovation: How to Jumpstart Your Company’s Growth Engine.

The Regents agreed to participate in a strategic planning retreat led by Dr. DeGraff. While preparing for this program, I recalled a question my son once asked me when he was younger: “Mom—why would you ever retreat? You should never retreat; you should always march forward!” Keeping that admonition in mind, our “retreat” in July 2014 at the ACS headquarters in Chicago, IL, focused on moving the College forward. The leaders of the Board of Governors, Young Fellows Association, and the Resident and Associate Society attended, along with the ACS Executive Staff.

Innovation though introspection

Dr. DeGraff spoke about the new role of innovation and creativity in fostering change in health care and the need for us all to be creative as leaders to help solve the problems facing the profession. He explained that we use different approaches to solving problems. We can lead as collaborators and lead groups of stakeholders toward meaningful and lasting change. Collaborative activities are usually value-driven. We can lead entirely by being creative and doing new things to fulfill a vision. We can lead by being competitive, which encourages us to reach our goals in a timely way. Strategy, organizational culture, competencies, and leadership ability drive these activities. And we can be controlling, which ensures that we complete tasks through process-driven efforts that lead to efficiency and quality.

While leaders often use several or all of these strategies to achieve their goals, we typically use one or two most often. At the retreat, we engaged in exercises to discover how we make decisions and worked in small groups to learn how these different approaches can be used collaboratively. For example, I learned that my dominant behavioral trait is “collaborative” and my secondary is “creative.” It was fun for us to see where each of the Regents landed in their personal and community profile.

Next came some hard work as we looked at the Board of Regents—specifically, at how the board is organized and the processes involved in achieving our goals over the last several years. What needed to change? Could we change? Could we be innovative and creative? Did we need to be controlling and/or collaborative? We worked in groups and listed what we thought we needed to change, and we listened closely to one another.

We then began to brainstorm about how the Regents could be more involved in leading the ACS, and more effective as they serve the more than 80,000 members of the College. The important issues that we discussed included how the Regents are elected and how long they should serve, whether nonsurgeons should have a seat on the Board, how meetings could be conducted to better use the experience and knowledge of the Regents, and how the Regents can play a more active role with ACS committees, Advisory Councils, domestic and international chapters, and other groups.

Following the retreat, Dr. Hoyt and the PI team organized our numerous thoughts and ideas and developed four working groups to further discuss the issues. We continued our discussion at the Regents’ meeting at the 2014 Clinical Congress in San Francisco, CA. We have already had our first conference calls, and the group that I am in, which is led by ACS Regent Raymond F. Morgan, MD, FACS, has had a tremendously productive call about the involvement of the Regents with committees and chapters of the College. Initial reports from each of the four working groups were presented at the February Regents’ meeting. Final recommendations and proposed changes are scheduled to be submitted for approval at the June meeting.

Enthusiasm for these changes is strong among the leadership of the ACS, and the energy that the Regents have displayed has been exceptional. Following the retreat, we all agreed that it is the perfect time for changes on the Board of Regents, as we want to be able to lead the ACS in the best way possible. By redefining our responsibilities and involvement throughout the College, the Board of Regents will be ready to address the changes occurring in health care, medical education, residency training, Maintenance of Certification, or any other surgery-related matter. I am more excited about my ninth and final year as a Regent than I was even in my first.

As they move on to new places to practice or train, I advise young faculty and residents to always assess how they contributed to the place they are leaving. Will the other surgeons and staff have a party for you before you leave, or will they have a party because you’ve gone? If asked, would they welcome you back? Can you name one or two things that you did to make the place you are leaving a bit better than when you arrived? The members of the Board of Regents involved in this self-assessment process hope to leave it better.

I want to thank all the members of the ACS for the marvelous opportunity to serve as a Regent since 2006 and to serve as the Chair of the Board of Regents from 2012 to 2014—the first woman to do so. It was an amazing time to be in the position as the ACS celebrated its 100-year anniversary. Here’s to the next 100!

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