Report on ACSPA/ACS activities, October 2020

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 virtually September 29 and October 2, 2020. The following is a summary of key activities discussed. The information provided was current as of the dates of the meeting.

ACSPA

From January 1, 2019, through September 15, 2020, the ACSPA Political Action Committee (ACSPA-SurgeonsPAC) reported more than $665,000 in receipts from 1,330 College members and staff, and disbursed more than $625,000 to 140 congressional candidates, political campaigns, and other PACs. To remain balanced and bipartisan, 52 percent of SurgeonsPAC contributions went to Democrats and 48 percent to Republicans, including support for all ACS Fellows in Congress, several physician candidates and incumbents, key majority and minority leadership, and members serving on important U.S. House and Senate committees of jurisdictions that handle health care policies and procedures.

ACS

The B/R reviewed reports from the ACS division directors and approved the recommendations from the ACS Task Force on Racial Issues.

Division of Education

The Division of Education reported on the following key activities.

Academy of Master Surgeon Educators

Established in 2017, the Academy recognizes and assembles a cadre of Master Surgeon Educators to work closely with the Division of Education to advance the science and practice of surgical education and training. The Board of Regents approved a Membership Mark, MAMSE (Member, Academy of Master Surgeons Educators), that members of the Academy will be able to use after their names.

Clinical Congress 2021

The Division of Education presented the proposed program for Clinical Congress 2021 for comment and review.

Committee on Ethics

The Committee on Ethics, housed in the Division of Education, selected four recipients of the Fellowship in Surgical Ethics, which prepares surgeons for careers that combine clinical surgery with scholarly studies in surgical ethics.

Royal College of Physicians and Surgeons of Canada

The B/R approved a memorandum of understanding (MOU) between the ACS and the Royal College of Physicians and Surgeons of Canada (RCPSC), which will allow the organization to recognize the self-assessment credits the ACS offers to participants in educational programs that include self-assessment and feedback, and may involve simulation activities, to fulfill requirements for Section 3 of the RCPSC Maintenance of Certification Program.

Division of Member Services

The ACS welcomed a record number of Initiates in 2020, with a total of 2,120 surgeons from 75 countries. General surgery Initiates accounted for 60 percent of the class, and all other specialties accounted for 40 percent. Overall Initiate growth continues to trend upward. Applications for 2021 are on track to exceed 2020’s numbers. The B/R accepted resignations from nine Fellows and changed the status from Active or Senior to Retired for 91 Fellows. Together with the 2020 Initiate class, as of September 18, 2020, the College had 84,012 members: 64,507 Fellows, 2,820 Associate Fellows, 10,989 Resident Members, 3,085 Medical Student Members, and 491 Affiliate Members.

The Division of Member Services identified several recruitment opportunities via a selection of staff-directed recruitment and retention projects. One project targeted several specialties for a recruitment pilot program, which is aligned with the College’s strategic priority of hosting a series of in-person meetings with the leadership of surgical specialties to explore opportunities for strategic alignment and collaboration on key issues affecting surgeons.

Another recruitment project focused on increasing the relevance and prevalence of ACS Resident membership. This recruitment campaign targets eight specialty training programs, as well as general surgery programs. A cross-training initiative was created and executed to improve and accelerate the approval and renewal process for applicants in all membership categories. Another project targeted five countries that show the greatest potential for membership growth and developed a recruitment plan for those countries.

The College conducted a quantitative research study of domestic and international members in June and July 2020 to obtain fact-based information about how members value and use ACS services and benefits. The research will be used to develop and implement strategies for member acquisition and retention programs.

Advisory Councils

The ACS has 14 Advisory Councils, representing every specialty that the ACS recognizes. In the last year, the Advisory Councils assisted the Central Judiciary Committee with review of expert witness testimony, nominated members for boards and specialty review committees, recommended members to represent the ACS on panels that develop specialty guidelines, and provided input on specialty society guidelines.

The Advisory Councils submitted 134 proposals for Panel Sessions at Clinical Congress 2021 and distributed electronic communications to specialty colleagues highlighting Clinical Congress 2020 programming. Advisory Councils also contributed content to the weekly Bulletin Brief.

The Advisory Council for Rural Surgery is developing a verification program to address the specific needs of surgery programs at rural hospitals. This program is in development and has recently begun pilot site visits to test the standards and verification process. Archives The Archives responded to 98 research requests over the last year and has received 34 new accessions, including records from the B/R, Cancer Programs, Clinical Congress, Division of Integrated Communications, Surgical Forum, and various College committee records. The History and Archives Committee (HAC) published four Bulletin articles based on the Clinical Congress 2019 Panel Session, Women Pioneers in Surgery. Clinical Congress 2020 activities included the Surgical History Poster Session sponsored by the HAC and a virtual History of Surgery Community Breakfast. The History of Surgery Online Community remains active, with more than 800 members. Members of the HAC frequently post historical vignettes and have begun inviting previous poster presenters to submit their research to the Community.

Board of Governors

The members of the ACS Board of Governors (B/G) serve as an official, direct communications link between the B/R and ACS Fellows. The College has 294 Governors—157 Governors At-Large from each U.S. state and Canadian province and territory, 88 Specialty Society Governors, and 49 International Governors.

The B/G Executive Committee hosted three virtual strategic retreats to discuss key priorities this year. In June, the Governors Alumni Program (GAP) was launched to further maximize the knowledge and enthusiasm of former ACS Governors. The GAP was established to provide an opportunity for former Governors to remain actively involved with the College and further assist in activities such as membership recruitment and retention efforts, outreach to chapters and specialty societies, and mentoring new Governors. The program has more than 50 members, and additional activities are planned for the upcoming months.

Initiatives during the COVID-19 pandemic included the following:

    • Several Governors provided first-hand experiences in the Bulletin: ACS COVID-19 Updates, published twice weekly in March through May 2020, and in the ACS Communities.
    • The B/G Quality Pillar and the B/G Advocacy Pillar developed late-breaking sessions for Clinical Congress 2020.
    • The B/G Survey Workgroup included questions related to COVID-19 in the 2020 Annual Governors Survey.

Chapters

The chapters work with the College to provide members with additional benefits, such as the opportunity to network with surgical peers locally, to participate in advocacy activities at the state and federal levels, and to conveniently attend educational meetings with Continuing Medical Education. Chapter Services provides guidance and assistance in these areas to the College’s 115 chapters—65 in the U.S., 3 in Canada, and 47 overseas. The Ontario Chapter was chartered by the B/G in February 2020, joining the Alberta and Manitoba Chapters as the third chapter in Canada.

The 2019 Annual Report captured information about the efforts of chapters in the following areas: administration and management, membership recruitment and retention, communications, chapter finances, educational programming and events, and advocacy (domestic chapters only). Based on the data collected from the Annual Reports, Chapter Services continues to clarify chapter expectations and requirements, works with them to define their value proposition, and develops marketing tools and templates to enhance member communications. A new Member Recruitment Grant Program was established in 2020 to offer small grants to chapters to help with recruitment activities.

Committee on Diversity Issues

The Committee on Diversity Issues updated the ACS Statement on Diversity and hosted several sessions at Clinical Congress 2020, including Tools for Leadership Success, Recruiting, Incentivizing, and Promoting Different Generations and a Diverse Workforce. Work on the Profiles in Diversity project continues to spotlight Fellows who have overcome adversity or created or led diversity initiatives within their institutions.

International activities

An analysis of active, dues-paying Fellows examined geographic trends, including regional analysis, to understand areas of membership growth. Regionally, the ACS is realizing membership growth for active, dues-paying Fellows in all regions, with Africa, Asia-Pacific, and the Middle East regions experiencing double-digit percent growth. These data were used to understand growth opportunities and more effectively target recruitment and retention messaging and will be shared with international Chapter Leaders and Governors at Clinical Congress so they can promote the message of Fellowship as a lifelong commitment to ensure retention and to recruit new members.

International Relations Committee

The mission of the International Relations Committee (IRC) is “to spread the College’s mission globally and guide its international engagement.” It seeks to attract and involve international Fellows and surgeons in the activities of the College.

The Bangladesh Chapter and Bolivia Chapter were selected as the awardees for the 2020 International Chapter Opportunity Program, which provides financial support for chapters to host a local educational course. The IRC submitted a proposal to the Division of Education to collaborate on creating an equitable, tiered pricing structure based on World Bank Classifications for ACS educational materials. The Division of Education plans to implement this structure for Ultrasound for Surgeons: The Basic Course, webcasts, the video library, and Suggested Readings in General Surgery.

The IRC created a series of regular webinars for all Fellows, with an emphasis on international moderators and panelists to provide unique perspectives. The first webinar on COVID-19 and Global Surgery Management took place August 18, 2020. Because of the pandemic, all scholarships awarded to international surgeons to visit major meetings of the ACS for 2020 were deferred to 2021.

Intimate Partner Violence Task Force

Formed in 2018, the Intimate Partner Violence (IPV) Task Force raises awareness of the incidence of IPV in the surgical community, educates surgeons to recognize the signs and consequences of IPV in themselves and their colleagues, provides resources for survivors, including prevention and escape strategies, and creates resources and curricula in partnership with other national professional and educational organizations to instruct surgeons to recognize IPV in colleagues and trainees. Recent IPV Task Force accomplishments included three Bulletin articles to raise awareness, development of several educational sessions for Clinical Congress, the addition of institutional policy examples on the IPV resources page, and inclusion of IPV resources in several issues of the Bulletin Brief.

Military Health System Strategic Partnership ACS

The Military Health System Strategic Partnership ACS (MHSSPACS) was formalized in 2014 between the ACS and the U.S. Department of Defense (DoD) to share knowledge about surgical quality care, trauma systems, education and training of military surgeons, and military-relevant trauma research. The National Defense Authorization Act (NDAA) of 2017 requires all major Military Treatment Facilities (MTFs) to participate in their regional civilian trauma system or to partner with a civilian trauma center to provide military trauma surgeons and trauma teams with experience in trauma care, so they will always be prepared for deployment.

Participation in the local system will be driven by regional needs; however, the establishment of military-civilian partnerships (MCPs) addresses readiness needs while also expanding trauma care for thousands of civilians who have no access to a major trauma center. The MHSSPACS brought together military and civilian surgeons to create the Blue Book, outlining the criteria for selecting and evaluating MCPs that want to apply for the appropriated funds. During the COVID-19 pandemic, military tents were deployed to assist responses in New York, NY, and the Navy hospital ships USNS Comfort and USNS Mercy were sent to Los Angeles, CA, and to New York, providing an opportunity to use the Blue Book to assist in managing these new and temporary MCPs.

Operation Giving Back

The mission of Operation Giving Back (OGB) is to leverage the passion, skills, and humanitarian ethos of the surgical community to effectively meet the needs of the medically underserved. OGB provides the tools necessary to facilitate humanitarian outreach among surgeons of all specialties, at all stages of the profession, and an emphasis on both domestic and international service. During the pandemic, OGB developed a survey and registry to recruit volunteers for states and cities where the pandemic has created major health care professional shortages.

OGB and the IRC also hosted the Surgical Leadership during Crisis Situations Webinar on important aspects of crisis readiness for surgeons to consider in a pandemic.

Since 2019, 28 U.S. surgeons from the consortium surgical departments have dedicated more than $440,000 worth of hours volunteering at the ACS-COSECSA (College of Surgeons of East, Central and Southern Africa) Surgical Training Hub at Hawassa University, Ethiopia. As the work at Hawassa University continues, plans are under way to establish a second surgical training hub in the COSECSA region.

OGB also prepared two sessions for the 2020 ACS Quality and Safety Conference Virtual. OGB’s volunteer database continues to grow, with 83 registered partner organizations providing volunteerism opportunities to 890 registered volunteers.

Resident and Associate Society

The Resident and Associate Society (RAS-ACS) serves to familiarize Resident Members with ACS programs and provides an avenue for participation in College affairs, fosters development and use of leadership skills, and offers opportunities for young surgeons and trainees to voice their opinions and concerns. During the COVID-19 pandemic, the RAS designed, created, and implemented a 15-week virtual general surgery education curriculum that featured a collection of selected SCORE modules to guide topic content; faculty-created, topic-specific video lectures; and reviews of landmark journal articles from the field shared before a one-hour video-based call, during which an RAS leader presented a flipped classroom-style lecture.

In conjunction with the Behind the Knife podcast team, the RAS has assisted with the creation of an online Journal Club, also known as the Journal Cast. The Journal Cast comprises five-minute YouTube videos reviewing seminal papers in general surgery and related subspecialties to provide an overview of key papers and studies in a condensed yet critical review of the primary literature.

Quality improvement (QI) efforts focused on the development of three sessions for the virtual 2020 Quality and Safety Conference and a two-year Geriatric QI Fellowship. The Grand Rounds Webinar Series continues to focus on timely, career-focused topics for surgeons entering practice. More than 60 webinars are available on the ACS website.

Surgeon Well-Being

The College is addressing surgeon well-being by providing resources to address fatigue and burnout. The Ad Hoc Task Force on Surgeon Well-Being is composed of leaders involved in well-being initiatives at their institutions. The task force discusses systemic and individual policies, programs, and initiatives aimed at supporting surgeon well-being.

At present, the task force is developing the following resources: a statement on surgeon well-being and resilience; individual toolkits for surgeons at various career stages; regular webinars on topics related to well-being; education and resources for significant others and family; and incorporation of wellness opportunities at other ACS meetings and conferences. The task force also plans to address systemic and cultural factors that adversely affect well-being and work with governing bodies on these issues.

Young Fellows Association

The Young Fellows Association (YFA) represents the interests and concerns of young Fellows and promotes active participation and input from this demographic to support ACS activities. The work of the YFA is accomplished through the efforts of its workgroups and special project committees.

Key activities in 2020 included writing a primer for graduating residents on preparation for a career in private practice, conducting the YFA Annual Mentor Program, and collaborating with the Division of Research and Optimal Patient Care (DROP-C) to create a Future Quality Leaders program. During the COVID-19 pandemic, the YFA and RAS surveyed residents and young surgeons about their experiences personally, clinically, and educationally, and the YFA leadership increased its use of Twitter to share information with young surgeons.

Women in Surgery Committee

The Women in Surgery Committee (WiSC) conducts its work through the efforts of six subcommittees: Structure, Mission, and Communications; Awards; Program; Mentorship Program; Personal Empowerment; and International. Key activities carried out by these subcommittees included development of a plan to begin posting meeting minutes on the Women Surgeons Online Community to increase awareness; drafting statements on lactation and on bullying, harassment, and discrimination; and partnering with the IRC’s International Fellowship Subcommittee to host a webinar on the HeForShe Movement among surgeons.

Division of Integrated Communications

The Division of Integrated Communications (IC) has implemented many initiatives aimed at accelerating the College’s digital strategy, refreshing brand identity, and using data and insights to drive communications strategy. IC also partnered with the Division of Advocacy and Health Policy to galvanize the surgical community to fight the Medicare payment cuts scheduled to have taken place in January 2021, independently and as part of the ACS-led Surgical Care Coalition.

A major initiative during the past several months was the completion of the search for a new website/digital strategy partner. That process concluded this summer, and the firm Hugo & Cat was chosen. Efforts on a new website are under way.

Member publications

Rapid communications to Fellows continues via the Bulletin Brief newsletter, social media, and the communities. In partnership with the Division of Advocacy and Health Policy, the Advocacy Brief, a biweekly newsletter highlighting the activities the division is undertaking on Capitol Hill to support surgeons, was launched. The traditional Bulletin resumed quarterly publication with the July issue, and a second issue was published in October. The Bulletin’s online edition has an average of nearly 80,000 page views per month, and approximately 5,000 Fellows have requested that they receive the print edition each month of publication.

IC continues to use video to share information with key audiences. Since March, there have been nearly 1 million views of content from the Bulletin Brief and Surgeon Voices interviews, messages from leadership, the From the Frontlines series, and the Practice Protection Committee.

Public profile and visibility

The ACS public profile and visibility team has focused its media outreach efforts on promoting ACS clinical guidance documents and studies published in the Journal of the American College of Surgeons (JACS). The team continues to support research publications with press releases alerting journalists to the findings, as well as with infographics and author videos. This multimedia approach has led to increased exposure for the College and the studies, including a placement in U.S. News & World Report in early September on the costs of gun violence on the U.S. health care system.

ACS Communities

The Communities continue to be a popular benefit of membership. Since its launch in 2014, the platform has received more than 5 million page views, and 40,052 members of the College have agreed to the site’s terms of use. A total of 6,121 unique contributors have posted 117,353 discussion group posts, created 19,284 threads, and viewed library items 232,472 times. The five most active communities are General Surgery, Breast Surgery, Colon and Rectal Surgery, Rural Surgery, and Women Surgeons. Popular discussion topics in 2020 included COVID-19, race and racism, open appendectomies, personal protective equipment, and resuming elective surgery.

Marketing

IC has developed tools and communication vehicles that accommodate digital and more sophisticated means of communication. The scope of projects ranges from developing and executing comprehensive marketing plans to creating programmatic branding, advertising, social media graphics and ads, targeted digital promotion, and collateral. Conference marketing, particularly for the Quality and Safety Conference and Clinical Congress, has shifted to largely digital applications to support the move to virtual meetings and programming, as well the College’s stronger emphasis on digital communication.

Division of Research and Optimal Patient Care

DROP-C encompasses the areas of Continuous Quality Improvement (CQI), including ACS research and the accreditation programs.

ACS COVID-19 Registry

The ACS COVID-19 Registry launched in April 2020 to respond to the requests of National Surgical Quality Improvement Program (ACS NSQIP®) participating sites to track COVID-19 patients. Hospitals participating in the ACS COVID-19 Registry enter data variables covering demographics, severity predictors, admission information, hospitalization information, therapies used, and discharge information. Participating hospitals capture data on all patients ages 18 and older and are tracked from hospital admission through discharge.

Approximately 70 hospitals participate in the new registry, and more than 10,000 cases had been entered as of September 2020. Registry data are being evaluated on an ongoing basis to determine the reports and research datasets that can be made available.

Quality and Safety Conference

The 2020 ACS Quality and Safety Conference (QSC) originally was scheduled for July 24–27 in Minneapolis, MN. Because of the COVID-19 pandemic’s impact on travel restrictions and social distancing, the in-person conference was canceled. The conference transitioned to a virtual format that took place August 21–24. Registration was free of charge to broaden the conference’s reach. Presentations were offered in three engaging formats: panel sessions, fireside chats, and abstract presentations. The 2021 ACS QSC is scheduled for July 10–13 in Denver, CO, and is expected to become a hybrid meeting, with both in-person and virtual content.

Optimal Resources for Surgical Quality and Safety

The development of adjunctive and integrated resources/standards based on Optimal Resources for Surgical Quality and Safety is near completion. These standards will be used to launch a Surgical Quality Verification Program. Pilot visits began with a group of targeted hospitals in 2018 and continued into 2020 as the verification elements of the program were further refined. The goal is to refine and revise the standards based on findings from the pilot phase and launch the program either through on-site or virtual site visits in the first quarter of 2021. During the COVID-19 pandemic, several pilot hospitals indicated that the core principles behind the standards were critical to their ability to effectively respond. The experiences of these hospitals were highlighted in multiple presentations and fireside chats during the 2020 QSC VIRTUAL.

ACS NSQIP

A total of 833 hospitals participate in ACS NSQIP—685 in the adult option. The pediatric option represents 18 percent of overall participation. Another 34 hospitals are in various stages of the onboarding process. At present, 137 hospitals outside of the U.S. participate in ACS NSQIP—approximately 16 percent of all participating facilities. MBSAQIPA total of 959 facilities participate in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). From October 2014 through August 2020, 1,600 site visits have been completed using the MBSAQIP standards. Because of COVID-19 restrictions, a total of 64 surgeon surveyors are expected to perform approximately 150 site visits in 2020, which is far fewer than previous years.

CSV Quality Improvement Program

The Children’s Surgery Verification (CSV) Quality Improvement Program launched in 2017 with the goal of ensuring that pediatric surgical patients have access to quality care. A total of 148 centers participate in CSV. These centers also participate in ACS NSQIP Pediatric—10 more sites than participated in January 2019. Approximately 45 of these centers are in the various stages of verification, and 27 sites are fully verified as Level I children’s surgery centers—a 35 percent increase from the same time in 2019.

GSV Quality Improvement Program

The Geriatric Surgery Verification (GSV) Quality Improvement Program launched in 2019 to ensure that older surgical patients have access to high-quality care. The program defines the resources required to achieve optimal patient outcomes in older adults undergoing inpatient surgery and offers institutional verification to sites that meet the prescribed standards. Less than a year into accepting applications for participation, and despite the COVID-19 crisis, 17 hospitals have applied.

The GSV Program also developed an Implementation Course for U.S. hospitals to preparing for verification. The web-based curriculum consists of 10 self-paced modules.

ISCR Program

The Agency for Healthcare Research and Quality (AHRQ) Improving Surgical Care and Recovery (ISCR) Program, a collaborative effort between the ACS and the Johns Hopkins Armstrong Institute for Patient Safety and Quality, Baltimore, MD, continues to attract hospitals interested in implementing enhanced recovery practices. Hospitals participating in ISCR receive a ready-to-use pathway, access to education materials on implementing the pathway, access to experts in performance improvement and education who will help with troubleshooting, and inclusion in a community of professionals rolling out the same pathway. Approximately 60 percent of enrolled hospitals also participate in ACS NSQIP. The fourth cohort, which is focused on Emergency General Surgery and with a concentration in appendectomy, cholecystectomy, and laparotomy surgeries, was delayed until September 2020 because of the COVID-19 pandemic.

Strong for Surgery

Strong for Surgery (S4S), a joint program of the ACS and the University of Washington, Seattle, is a quality initiative aimed at identifying and evaluating evidence-based practices to optimize the health of patients before surgery. The program empowers hospitals and clinics to integrate checklists into the preoperative phase of clinical practice for elective operations. Since its release in 2017, S4S has more than 700 participating sites. The goal is to eventually move the patient-facing version to an online platform for patients to complete before meeting with their surgeon.

SSR

The Surgeon Specific Registry (SSR) allows surgeons to track their cases, measure outcomes, and comply with changing regulatory requirements. The SSR can be used to meet the requirements of the Centers for Medicare & Medicaid Services’ Quality Payment Program Merit-based Incentive Payment System, as well as the American Board of Surgery’s Continuous Certification Program requirements. The SSR has an active user base of approximately 6,000 surgeons, and more than 11.6 million case records have been entered in the SSR system since its release in 2017.

Cancer Programs

Because of the COVID-19 pandemic, the Commission on Cancer (CoC), National Accreditation Program for Breast Centers (NAPBC), and National Accreditation Program for Rectal Cancer (NAPRC) canceled in-person workshops and converted them to a series of webinars. Virtual site visits were developed for all three accreditation programs, and pilot site visits are under way. The CoC released new standards in 2019 and the NAPRC followed suit in July. A complete review and revision of the NAPBC standards is under way.

In response to the pandemic, triage criteria documents were developed and disseminated that outlined prioritization for 10 common solid malignancies for which surgery plays a vital curative role. Acute and recovery phases of the pandemic were defined, providing context for the urgency and importance of cancer surgery prioritization. The content from the triage criteria documents was presented in six webinars.

The Cancer Surgery Standards Program (CSSP) launched in July 2020. The CSSP evolved as an outgrowth of the Cancer Research Program efforts to codify evidence-based operative standards for cancer care. CSSP’s mission is to improve the quality of surgical care for cancer patients and is supported by three goals and three functioning committees that focus on development of the content, implementation of the digital tool, and education about the tool and content. CSSP is focused on designing, building, piloting, and disseminating products that support the new CoC surgery standards, including electronic health record (EHR)-based synoptic operative reports (SORs) and web-based protocols. It is expected that EHR-based SORs and the web-based protocols will be delivered in 2021 for melanoma, colon, and breast cancer.

In 2020 the American Joint Committee on Cancer (AJCC) developed the necessary processes and procedures to transition AJCC material from a seven-year publication cycle to an annual update and annual release of cancer staging standards. A new version of cervix staging has been released, and breast and colon cancer updates are expected in 2021. The National Cancer Database (NCDB), in collaboration with IQVIA, is pilot testing the Rapid Cancer Reporting System (RCRS), with the expectation of broad dissemination to CoC-accredited programs. The value of RCRS will be the ability of CoC-accredited programs to enter data in near real-time or at least concurrent with cancer care to support quality measures and QI initiatives.

Trauma Programs

In response to lessons learned early in the COVID-19 pandemic on the importance of regional coordination of health care, the Committee on Trauma (COT) is encouraging the development of Regional Medical Operations Centers (RMOCs) to support situational awareness and the ability to distribute patients among hospitals based on available resources. A guide for trauma medical directors on establishing an RMOC has been published. The COT also has worked with the Office of the Assistant Secretary for Preparedness and Response and the Federal Emergency Management Agency Healthcare Resilience Task Force on a webinar and online toolkit.

Gun violence

The National Collaborative for Gun Violence Research has awarded a $711,218 grant to the COT for a multicenter, prospective study to improve understanding of the individual and community-level risk factors for nonlethal firearm injuries in the U.S. The study is among $7.5 million in grants awarded for 15 research projects that will produce evidence for improving gun policy.

The inaugural ACS COT Firearm Injury Prevention Clinical Scholar in Residence, Arielle Thomas, MD, began her two-year fellowship in July 2020. This opportunity was made possible through collaboration with the American Foundation for Firearm Injury Reduction in Medicine, the American Association for the Surgery of Trauma, the Eastern Association for the Surgery of Trauma, and the Western Trauma Association.

Field Triage Guidelines revision

The National Highway Transportation Safety Administration awarded a two-year cooperative agreement for the College to lead the revision of the 2011 Field Triage Guidelines. A multidisciplinary expert panel will use prehospital end-user feedback on the present guidelines, along with a comprehensive literature review being conducted by an AHRQ Center of Excellence to guide the revision by a multidisciplinary expert panel.

Resources for Optimal Care of the Injured Patient

The COT continues to revise Resources for Optimal Care of the Injured Patient. All standards have been updated and transitioned into the nine ACS Standards Categories. The next phase of the process will focus on creating the content for the next edition.

Future Trauma Leaders

Launched at Clinical Congress 2019, the FTL100 Fundraising Campaign was established to generate financial support for 100 Future Trauma Leaders (FTL) to coincide with the 100th anniversary of the COT in 2022. The FTL’s mission is to foster the advancement of future leaders in trauma. The FTL aims to recruit, mentor, provide program support, and reimburse travel to various trauma meetings for eight participants annually. Because of the COVID-19 pandemic, fundraising efforts are paused temporarily but remain a strategic priority.

TQIP

TQIP celebrated its 10th anniversary in 2020 at the virtual TQIP Annual Scientific Meeting and Training December 7–10, 2020. The meeting included informative sessions for all trauma team members including medical directors, nurse program managers, trauma registrars, and performance improvement coordinators. The TQIP Best Practice Guidelines on Acute Pain Management debuted at the meeting, which included a keynote address by Mike Barger, MD, co-founder of JetBlue Airways.

STOP THE BLEED®

STOP THE BLEED® (STB) faced programmatic challenges because of COVID-19 and expanded its resources to include a video-based educational component. In accordance with the U.S. Department of Defense guidelines, STB courses have resumed adhering to local regulations for gatherings. Instructors have been given instructions on social distancing, the use of masks, and equipment sanitization. All future STB kits will include two face masks, providing a measure of protection for the immediate responder and the victim.

In 2020, the STB program partnered with the 9/11 Day of Service organization to bring awareness to first responders and their commitment to STB. This collaboration will be ongoing with increased involvement for the 20th anniversary of 9/11 in 2021. The STB program also will partner with the Martin Luther King Day of Service in 2021.

ACS Foundation

The ACS Foundation remains focused on securing and growing financial support for the College’s charitable, educational, and patient-focused initiatives. Fiscal year (FY) 2020 ended with $3,277,989 in donations and grant support, exceeding FY 2019 support of $2,052,753. Individual donations totaling $304,730 supported Greatest Needs with $200,000 of those monies being directed toward scholarships. Programs, projects, and initiatives received $2,582,711 to support international education opportunities. The number of individual contributors to the Foundation remained steady at 1,248. The average individual gift of $927 is a substantial increase over the average FY 2019 individual gift of $500. The annual Fall Appeal generated $157,737, a 6.9 percent increase from FY 2019.The Foundation continues to build its portfolio of projects and initiatives to create a broader menu of giving opportunities.

OGB, STB training in rural communities, international scholarship travel awards, fellowship research awards, and the ACS Greatest Needs Fund continue to be supported by generous philanthropic gifts from Fellows.

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