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 June 12, 2021. The following is a summary of key activities discussed. The information provided was current as of the dates of the meeting.
During the 2022 election cycle ( January 1–May 20, 2021), the ACSPA Political Action Committee (ACSPA-SurgeonsPAC) raised more than $143,400 from more than 300 College members and staff and disbursed $109,500 to more than 25 congressional candidates, political campaigns, multi-candidate, and other PACs. SurgeonsPAC continues to prioritize a balanced, nonpartisan disbursement strategy, including support for Democrats and Republicans, particularly health professionals, key leadership, and members who serve on important U.S. House and Senate committees with jurisdiction over various health care policies and procedures, including ACS-supported legislative priorities.
The Board of Regents reviewed reports from the ACS division directors and approved the following policy statements:
- Resident Access to Personal Protective Equipment (PPE)
- Restrictive Covenants
- The Importance of Workplace Accommodations for Pregnancy, Parental Leave, and Lactation Support for Practicing Surgeons
The Board of Regents also accepted resignations from 11 Fellows and changed the status from Active or Senior to Retired for 294 Fellows.
Division of Advocacy and Health Policy
The Division of Advocacy and Health Policy reported on the following key activities.
Virtual Leadership & Advocacy Summit
The 2021 Virtual Leadership & Advocacy Summit took place May 15–17 with a record number of attendees, representing more than 43 states and participating in 289 meetings with their legislators.
The primary advocacy goals for 2021 are focused on preventing a 9 percent Medicare payment cut scheduled for January 1, 2022, as well as developing a plan to stop consideration of yearly cuts.
Surgical Care Coalition
The Surgical Care Coalition is composed of 13 surgical professional associations representing more than 150,000 surgeons working across the country with a common goal of improving the quality of care, and quality of life, for all patients. Surgical Care Coalition members have met informally since the 1980s. In the spring of 2020, the founding surgical professional associations formalized this existing network. A new campaign will be introduced later this year.
The Biden Administration and Congress are interested in a public option for health care, pursuing goals of universal coverage and lower costs. The ACS will be contributing feedback in response to a request for information received from congressional leaders. The ACS also will be communicating with decision-makers about the unique, indispensable nature of the work of surgeons. This effort will require strategic advocacy, as it is essential to convey stories relating the importance of surgeons within the health care system.
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 of national and international renown to work closely with the Division of Education to advance the science and practice of surgical education and training. Current membership includes 93 Members, 123 Associate Members, and five Affiliate Members. Twelve surgical specialties are represented in the membership.
ACS Course on the Fundamentals of Ergonomics
The ACS Course on the Fundamentals of Ergonomics is being developed with significant contributions from a multidisciplinary panel of experts. The course will target the needs of practicing surgeons, surgical trainees, and medical students with specific online modules aimed at individuals at various levels in their professional development.
ACS Surgeons as Leaders Course: From Operating Room to Boardroom
The ACS Surgeons as Leaders Course provides surgeons with the core knowledge relating to effective organizational leadership at all levels and helps them in acquiring essential skills for effective leadership. Because the ACS Surgeons as Leaders Course relies heavily on interactive, in-person modules based on the principles of experiential, situated, and social learning, the course could not be held in 2020 and 2021 during the coronavirus 2019 (COVID-19) pandemic. The next course is being planned for Spring 2022.
ACS Surgeons as Educators Course
The ACS Surgeons as Educators Course aims to provide a unique and immersive experience based on interactive sessions, small group exercises, role play and simulations, and extensive situated and social learning to surgeons interested in acquiring the essential knowledge and skills in the field of surgical education. Because of the highly interactive and experiential nature of the course involving in-person modules, the course could not be offered in 2020 and 2021 during the COVID-19 pandemic. The next course is being planned for 2022.
ACS Fundamentals of Surgery Curriculum®
Launched in 2005, the ACS Fundamentals of Surgery Curriculum® (ACS FSC) is a simulation-based curriculum for surgery residents that has established a new standard for cognitive simulation-based education and addresses diagnostic and patient management skills in surgery. The ACS FSC includes a total of 108 case scenarios spanning 14 essential content areas. In the 2020–2021 curriculum year, 1,314 residents from 194 residency programs were enrolled in the ACS FSC.
Clinical Congress 2021 will be held virtually. In addition to the various types of sessions offered during the virtual Clinical Congress 2020, selected Didactic Courses and the didactic components of certain Surgical Skills Courses will be offered this year. The tracks will be identified with sessions of interest for the surgical specialties within the House of Surgery.
Optimal Resources for Surgery Resident Training
A new resource under development, Optimal Resources for Surgery Resident Training (the “Gold Book ”), will serve as the authoritative reference for surgical education leaders to ensure educational excellence in the training of general surgery residents. A total of 14 chapters currently are being written by renowned leaders in surgical resident training. The resource will include special emphasis on new technologies, animations, simulations, and virtual environments in training and assessing surgery residents. The Gold Book is scheduled for release by the end of 2021.
Resources in Surgical Education
The Resources in Surgical Education (RISE) online journal includes timely and informative peer-reviewed articles written by surgical educators that address a spectrum of topics in surgical education. An article is posted on the site every six to eight weeks. A total of 36 articles have been posted since its launch and have received 21,676 hits.
The Surgical Education and Self-Assessment Program (SESAP®), now in its 49th year, remains the premier self-assessment and guided cognitive skills education program for practicing surgeons. SESAP 17 features a redesigned educational model that further reinforces learning and supports mastery of the content. SESAP 17 Advanced was released in 2020 to address in-depth content relating to complex and evolving topics. SESAP 17 Advanced includes rigorously peer-reviewed content similar to SESAP 17. SESAP 17 Advanced modules examine topics more deeply and focus on issues that may have been beyond the scope of the core content in traditional SESAP by exploring specialized or controversial problems in more depth, emphasizing nuances in care, and providing additional references. SESAP 17 Advanced offers a total of 243 questions in five modules.
Summit on Surgical Training across the Surgical Specialties
The Sixth Annual ACS Summit on Surgical Training across the Surgical Specialties was held virtually on May 26–27. The summit focused on the selection of surgery residents. Leaders from the various certifying boards, academies/professional organizations, review committees, and program director organizations participated in the summit. A leader from each specialty presented information on successful strategies for resident selection from their respective specialty. Recommendations from the summit will form the basis of a well-coordinated effort to address the surgery resident selection across the House of Surgery.
Division of Research and Optimal Patient Care
The Division of Research and Optimal Patient Care (DROPC) encompasses the areas of Continuous Quality Improvement (CQI), including ACS research and the accreditation programs.
Quality and Safety Conference
The 2021 ACS Quality and Safety Conference (QSC) convened virtually July 12–16. Attendees participated in a combination of on-demand content and live sessions. Nearly 450 abstracts were submitted and approved. Attendees could vote on their favorite abstract and category winners were highlighted throughout the platform. The keynote speaker, Eduardo Garcia, shared his story of becoming a patient after being shocked by a 2,400-volt power line while elk hunting in Montana’s backcountry. Mr. Garcia endured months of intensive care, the amputation of half of his left arm, removal of several ribs, and a cancer diagnosis. Viewers were able to submit questions to be answered by Mr. Garcia during a live interview.
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. Work is under way to develop a communication plan and launch strategy to provide an on-ramp for hospitals that may have established quality infrastructure in some specialties through their participation in the College’s National Surgical Quality Improvement Program (ACS NSQIP®) and other ACS verification programs. Applications are expected to be formally accepted by January 2022. More than 10,000 manuals have been distributed since its release.
A total of 842 hospitals participate in ACS NSQIP—692 in the adult option. The pediatric option represents 18 percent of overall participation. At present, 142 hospitals outside of the U.S. participate in ACS NSQIP—approximately 17 percent of all participating facilities.
A total of 981 facilities participate in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). From October 2014 through March 2021, 1,656 site visits were completed using the MBSAQIP standards. Because of COVID-19 restrictions, a total of 58 surgeon surveyors are expected to perform approximately 250 site visits in 2021, which is a considerable reduction compared with previous years.
Children’s Surgery Verification 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 150 centers participate in CSV. Approximately 35 of these centers are in the various stages of verification. In all, 32 of the active sites are fully verified as Level I children’s surgery centers. All 150 centers participate in ACS NSQIP Pediatric.
Geriatric Surgery Verification 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 standards. At present, 32 hospitals have applied to one of the three levels of participation: Level 1 Verification—Comprehensive Excellence; Level 2 Verification—Focused Excellence; and Commitment Level. The GSV Program launched a webinar series in early 2021 on topics related to improving surgical care and outcomes for the aging adult population.
The Agency for Healthcare Research and Quality 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 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. More than 350 hospitals have participated in the program. Enrollment in ISCR is now closed to new sites, but the program will continue until December 2022.
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 now has more than 700 participating sites. The goal is to move the patient-facing version to an online platform for patients to complete before meeting with their surgeon.
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 6,900 surgeons, and more than 12.1 million case records have been entered in the SSR system since its release in 2017.
ACS COVID-19 Registry
The ACS COVID-19 Registry launched in April 2020 to respond to the requests of ACS NSQIP participating sites to track COVID-19 surgical and nonsurgical patients. The ACS COVID-19 Registry is free for any hospital and was created in Research Electronic Data Capture. 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. At present, approximately 70 hospitals are participating and have submitted more than 11,000 cases. Registry data are being evaluated on an ongoing basis to determine what reports and research data sets can be made available.
Launched at Clinical Congress 2019, the Future Trauma Leaders fundraising campaign (FTL100) was established to generate financial support for an initiative to coincide with the 100th anniversary of the Committee on Trauma (COT) in 2022. 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. The COT has begun its Centennial Push to achieve a fundraising goal of $1 million by the next annual meeting.
The COT Equity, Diversity, and Inclusion (EDI) Workgroup continues to function as a resource to help amplify the importance of using EDI principles in committee and program work. Four new focus groups were announced in March to continue the work of addressing EDI within the COT in the following ways:
- Engagement of current members
- Recruitment of underrepresented groups
- Content review
A new initiative launched earlier this year to include solicitation for membership from underrepresented groups for regional and central committee membership, as well as participation in the FTL program. The COT responded to the rise in violence against the Asian community by releasing a Statement against Recent Anti-Asian American Violence.
The 2021 TQIP Annual Meeting will be held virtually November 15–17. The meeting will focus on change management and keynote speaker, Chip Heath, will address how to successfully make changes within an organization to the betterment of both providers and patients.
The Spine Injury Guidelines are expected to be published this fall and released at the 2021 Trauma Quality Improvement Program Annual Meeting. Revisions are under way for the Geriatric Trauma Management Guidelines to better align with the Geriatric Surgery Verification Standards. A guidelines effort on Screening for Mental Health Disorder and Substance Abuse currently is in development.
STOP THE BLEED® (STB) faced programmatic challenges because of COVID-19 and expanded its resources to include a video-based educational component. To foster the continued growth of the program, a virtual STB Course launched in April. The virtual training provides a mechanism for STB instructors to educate through various virtual platforms, allowing for multiple participants to obtain the didactic and skills portion of the training. The month of May was designated National STOP THE BLEED® Month and May 20, 2021, was National STOP THE BLEED® Day. The STB program is partnering with the 9/11 Day of Service organization to bring awareness to first responders and their commitment to STB. At present, 104,072 classes and 1,698,384 attendees are captured in the portal. The number of registered instructors has increased to 89,240.
The ACS Foundation remains focused on securing and growing financial support for the College’s charitable, educational, and patient-focused initiatives. Through May 15, 2021, the ACS Foundation had raised $1,738,755 in donations and grant support. Individual donations totaling $1,248,889 were secured, a six-year high, with $327,789 supporting Greatest Needs; those monies are directed toward scholarships.
Programs, projects, and initiatives received $1,410,966 with a generous Fellow providing a gift of $500,000 to support the FTL100 campaign, which will provide leadership training to young trauma surgeons. The number of individual contributors to the The ACS Foundation grew to 1,263. The fall appeal generated $217,094, the highest amount ever.
Operation Giving Back, 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.
Charles E. Lucas, MD, FACS, was selected as the 2021 Philanthropist of the Year and will be formally recognized at the virtual Donor Luncheon this October.