ACS Case Reviews in Surgery and AHRQ Safety Program for ERAS: New ACS programs enhance quality patient care

The American College of Surgeons (ACS) is introducing two new programs this spring to help surgeons improve their surgical skills and to enhance the provision of evidence-based perioperative care.

The ACS Case Reviews in Surgery is a new product that supports surgeons’ continuing medical education (CME) and Maintenance of Certification (MOC) needs. Specifically, ACS Case Reviews in Surgery allows surgeons to learn through the review of actual surgical cases.

ACS Case Reviews in Surgery

The ACS Division of Education has launched a new online journal, ACS Case Reviews in Surgery, which will cover an extensive array of specialties, including breast, colorectal, pediatric, transplant, acute care, trauma, general, and rural surgery. This journal will link to other College publications that cover similar topics, including the Journal of the American College of Surgeons, Selected Readings in General Surgery, and Evidence-Based Decisions in Surgery modules.

Gerald A. Isenberg, MD, FACS, is the Editor-in-Chief of ACS Case Reviews in Surgery, which will be published electronically six times per year. Each issue will be peer reviewed by leaders in academic U.S. surgery and will feature 10 case reports, along with a CME posttest.

Unlike many other current online case report journals, surgeons will not be charged to submit or publish their case reports. “It has become difficult to get case reports published in major journals,” Dr. Isenberg said. “Yet, there is a need from an educational standpoint to publish interesting cases while meeting strict publication guidelines.” Surgery residents and medical students also will have the opportunity to begin publishing early in their surgical careers by having select reports featured in ACS Case Reviews in Surgery.

Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education, added, “ACS Case Reviews in Surgery will publish and disseminate peer-reviewed information relating to interesting surgical cases. This practical resource should be of great interest to surgeons in practice and surgery residents.”

CME credit

ACS Case Reviews in Surgery is intended to be a convenient and effective source for attaining Self-Assessment CME Credit. Users may claim up to 36 Self-Assessment CME Credits per annual subscription.

For surgeons interested in earning CME (including Self-Assessment Credits), an annual subscription to ACS Case Reviews in Surgery can be purchased for $125. For surgery residents, medical students, and other members of the surgical community who do not have CME Credit needs, an annual subscription is available for $75.

Surgeons who are interested in submitting case reports for review are encouraged to send them to Contact Dr. Isenberg at, or Whitney Greer at with any questions or comments regarding ACS Case Reviews in Surgery.

ERAS program to lower costs, improve patient safety

The ACS, in collaboration with the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore, MD, has launched the Enhanced Recovery After Surgery (ERAS) program—a new surgical quality improvement initiative funded and guided by the Agency for Healthcare Research and Quality (AHRQ). The ACS announced plans in February to enroll at least 750 hospitals to participate in this program.* Hospitals in the U.S., Puerto Rico, and the District of Columbia are eligible to participate across five cohorts: colorectal, orthopaedic, bariatric, gynecology, and emergency general surgery.

Key elements of ERAS

ERAS aims to promote the delivery of evidence-based perioperative care and reduces variability. Key elements of the ERAS program include patient and family engagement, including counseling about expectations for surgery and recovery; state-of-the-art analgesia, which minimizes the use of narcotics and promotes multimodal analgesia; early mobility and restoration of functional status; avoidance of prolonged periods of fasting; and evidence-based best practices for surgical site infections (SSI), venous thromboembolism (VTE), and catheter-associated urinary tract infections (CAUTI) prevention.

ERAS within a CUSP framework

The goal of the AHRQ Safety Program for ERAS is to disseminate and support implementation of evidence-based ERAS protocols within the framework of the Comprehensive Unit-based Safety Program (CUSP) across hospitals in the U.S. CUSP is a proven strategy to engage in culture change in pursuit of patient safety. This quality improvement program has been used successfully to prevent central line-associated bloodstream infections and catheter-associated urinary tract infections, as well as other preventable conditions.

Hospitals that participate in the ERAS program will have access to the following:

  • Leading experts in ERAS, perioperative quality, and implementation science from the fields of surgery, anesthesiology, and nursing
  • Evidence-based, locally adaptable ERAS protocols
  • Tools, including coaching calls, to assist with ERAS protocols implementation
  • Ad hoc implementation support from a quality improvement nurse consultant
  • ACS-based ERAS data collection platform and access to an ACS ERAS clinical support team
  • Face-to-face training and site visits

For hospitals, the AHRQ Safety Program for ERAS program aligns with five of the 11 Hospital Improvement Innovation Networks (HIIN) core areas targeted for improvement by the Centers for Medicare & Medicaid Services (CMS), including reduction in opioid prescribing, prevention of SSIs, CAUTIs, and VTEs, as well as the creation of a culture of safety and teamwork.

For health care practitioners, the AHRQ Safety Program for ERAS aligns with the requirements under the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA) of 2015. More specifically, provider participation in ERAS may include certain clinical practice improvement activities established by CMS under the Quality Payment Program to ensure compliance with MACRA.

The AHRQ Safety Program for ERAS is especially useful to hospitals that meet the following criteria:

  • No prior ERAS implementation experience
  • Hospitals that have implemented ERAS in one area and are looking to expand ERAS to other units
  • Hospitals that have attempted to implement ERAS but did not experience significant improvements or were unable to sustain the program

Recruitment efforts will begin in spring 2017, with the first cohort beginning in June 2017. For more information, contact Stacey McSwine, Enrollment Project Manager, at

*American College of Surgeons. ACS will recruit 750 hospitals for new program to lower costs, improve safety, and shorten recovery times for surgical patients. Press release. February 6, 2017. Available at: Accessed February 22, 2017.

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