Report on ACSPA/ACS Activities, October 2021

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 October 30, 2021. The following is a summary of key activities discussed. The information provided was current as of the date of the meeting.

ACSPA

During the 2022 election cycle ( January 1–December 31, 2021), the ACSPA Political Action Committee (ACSPA-SurgeonsPAC) raised nearly $200,000 from more than 380 College members and staff and disbursed $171,000 to more than 60 congressional candidates, political campaigns, and other PACs. SurgeonsPAC continues to prioritize a balanced, nonpartisan disbursement strategy, including support for Democrats and Republicans, particularly health professionals, key congressional leaders, and members who serve on important US House and Senate committees with jurisdiction over various healthcare policies and procedures, including ACS-supported legislative priorities.

ACS

The B/R reviewed reports from the ACS division directors, approved a policy Statement on Surgeon Well-Being, and authorized the formation of the Costa Rica Chapter and the United Kingdom Chapter.

Department of Diversity, Equity, and Inclusion

Leaders from surgical organizations attended the virtual ACS Promoting DEI & Anti-Racism: Professional Surgical Society Retreat June 23, 2021. This retreat convened the House of Surgery and included an address from Ibram X. Kendi, PhD, director, Boston University Center for Antiracist Research, MA, and best-selling author of Stamped from the Beginning and How to Be an Antiracist, and a discussion with Wayne A. I. Frederick, MD, MBA, FACS, president, Howard University, Washington, DC. Following the address, attendees transitioned to breakout sessions to discuss diversity, equity, and inclusion (DEI) and anti-racism initiatives across all organizations, share best practices, and determine initiatives that can have the greatest impact.

The ACS Regents Anti-Racism Committee instituted a matching grant mechanism to solicit and engage organizations and departments throughout the House of Surgery. The B/R approved seven applications to receive $25,000 and three $50,000 awards for the 2021 Innovative Grants for Diversity, Equity, Inclusion, and Anti-Racism. In August 2021, C. Cie Armstead, MPA, DBA, was onboarded as the ACS Director, Diversity, Equity, and Inclusion.

Division of Education

The Division of Education reported on the following key activities.

Clinical Congress 2022

The Division of Education presented the proposed program for Clinical Congress 2022 for the Regents’ comment and review.

Committee on Ethics

The Committee on Ethics, housed in the Division of Education, sponsored several sessions at the 2021 Clinical Congress, including the John J. Conley Ethics and Philosophy Lecture given by Michele Harper, MD, the author of The Beauty in Breaking. Dr. Harper’s lecture was titled Call It by Its True Name: Forms, Textures, and Implications of Anti-Black Racism in Medicine. A special session, Should COVID-19 Vaccination Be Mandatory?, was added to address the ethics of vaccines and mandates. The Ethics Colloquium was Rage Against the Machine: When Institutional or Group Practices Conflict with Individual Surgeons’ Obligations. Plans are under way for sessions at upcoming Clinical Congresses.

Information Technology

ACS Information Technology (IT) continues to support improving the membership’s experience via better applications and the management, analysis, and security associated with these applications.

In collaboration with the Division of Integrated Communications (IC), IT is working with external vendors and internal stakeholders to relaunch the ACS website, ensuring information can be quickly found in an intuitive, forward-looking design. IT’s role is to ensure the website is seamlessly and securely integrated with the College’s membership data and third-party vendors to advance usability. A new e-commerce solution also will be launching to provide a smooth and predictive experience. The e-commerce solution will allow members and guests to maintain credit cards securely on file to purchase products, conduct registration, and obtain online learning without reentering card information.

Division of Integrated Communications (IC)

IC has been focused on transformational efforts to reimagine the College’s brand, develop and implement a user-centric digital strategy, and launch a landmark public campaign, To Heal All with Skill and Trust. The overall goal is to provide seamless experiences tailored to a diverse set of audiences with unique needs while consistently presenting the ACS’s image and values across channels. IC also continues to support programs and initiatives across the College, optimizing ways of working with partners to assist in promoting the College’s efforts in public health, continuing medical education, and quality improvement.

New Visual Identity

The first comprehensive redesign of the College’s brand identity—comprising a new logo, color palette, and design style—launched at Clinical Congress 2021. This effort provides a fresh, contemporary look for the ACS, while referencing the College’s traditional brand attributes. IC will continue to develop materials and guidelines to better integrate all divisions and programs into a unified ACS design system on an ongoing basis. This modern, cohesive, and compelling evolution of the visual identity will support the College in representing the past, present, and future of surgery.

COVID-19 Public Health Promotion

IC continues to seek opportunities to communicate critical COVID-19 information to the surgical community and the public. Rapid digital communications via the weekly Bulletin Brief, social media, and the ACS COVID-19 microsite are ongoing. In August 2021, the College launched #TalkItUp, a public service announcement encouraging surgeons to talk to their patients about COVID-19 vaccination. In its first month, the campaign garnered 5 million impressions on Twitter, with more than 400 tweets and 320 retweets.

Website Update

The College is working closely with its digital agency partner, Hugo & Cat, to develop a new facs.org website using a user-centered design approach. As of October 2021, the discovery process, visual design, and content strategy phases have been completed. In progress is the content development of several sections and the migration phase. A content strategy also was developed to serve as a cornerstone for College communications across media channels, including the facs.org taxonomy.

Social Media Engagement

The College’s social media presence significantly improved with the development of a comprehensive social media strategy. Key advancements include launching ACS’s Instagram account in July 2021 to help engage the College’s younger members. Successful content series have highlighted iconic contemporary and historical surgeons, ACS and surgical history, and College programs and campaigns.

Policy Communications/Surgical Care Coalition

IC continues to work in close partnership with the Division of Advocacy and Health Policy and other member organizations of the Surgical Care Coalition to implement a national public relations campaign to fight Medicare payment cuts to surgeons. A multifaceted communications campaign, supported by the Brunswick Group, focused on persuading Congress to stop these cuts before January 1, 2022. Intensive efforts will continue throughout 2022.

Bulletin Brief

IC continues to refine the Bulletin Brief—the most widely distributed, widely read weekly news source from the ACS, covering the affairs of the College and issues of concern to the House of Surgery, including health equity and the COVID-19 pandemic. Each section of the Bulletin Brief has evolved to meet to the demands and expectations of its readers.

ACS Communities

ACS Communities hosted lively discussions among members about vital topics in surgery, including health equity and anti-racism, clinical best practices ranging from inferior vena cava injury treatment to operating room humidity, and COVID-19 vaccination and misinformation. The Communities host an average of 1.3K total discussions, has 297 unique contributors, and publishes 213 new threads per month.

Bulletin

The Bulletin has remained a popular member benefit. Approximately 5,000 ACS members and staff continue to receive the print edition, and an average of more than 65,000 individuals visit the Bulletin website each month. The Bulletin provides important perspectives on relevant social and scientific topics, including social determinants of health and surgery, global volunteerism in surgery, and climate change and surgery.

Journal of the American College of Surgeons (JACS)

From data available through the first three quarters of 2021, JACS full-text articles were downloaded approximately 500,000 times across journalacs.org and the Science Direct and Clinical Key platforms, an increase from 375,000 during the same period last year. As part of the College’s strategy to increase brand recognition, the JACS Twitter handle has been changed to @ACSJACS. The JACS Twitter account has gained 10,474 new followers this year, for a total of 27,474. Total JACS media mentions in the lay press increased by 39% in 2021, with articles covered by The New York Times, U.S. News & World Report, CBS News, People magazine, and Yahoo with a total potential reach of 1.1 billion—a 14% increase from 2020.

Optimal Resources for Surgical Education and Training

Optimal Resources for Surgical Education and Training, also known as the Gold Book, was published in late 2021. With expert guidance from 72 contributing authors, the Gold Book serves as a manual for training surgical residents. The volume defines all aspects of surgical training with a focus on general surgery training, recognizing that most of the features apply to all surgical training regardless of specialty, and seeks to outline the best way to evaluate and think about surgical training going forward. Many of the chapters give examples of how a curriculum should be implemented and how specific procedures should be taught. Similarly, the broad domain of responsibility of a modern surgeon is covered in terms of professionalism, advocacy, financial health, diversity, and well-being.

Division of Member Services

The ACS welcomed a record number of Initiates in 2021, with a total of 2,350 surgeons from 84 countries. General surgeons accounted for 62% of the class, and 26.5% were women. Overall Initiate growth continues to trend upward, consistent with the last several years.

The B/R accepted resignations from 26 Fellows and changed the status from Active or Senior to Retired for 99 Fellows. As of October 1, 2021, the College had 85,580 members: 66,504 Fellows, 3,850 Associate Fellows, 11,207 Resident Members, 3,558 Medical Student Members, and 461 Affiliate Members.

In the ongoing effort to bolster resident enrollment, Member Services launched an aggressive email and social media campaign. The campaign highlighted the range of benefits available to residents, including surgeon well-being, the Surgical Education and Self-Assessment Program, the Committee on Trauma, ACS Quality Programs, and other College programs. The division also launched a marketing campaign to increase group enrollment by targeting specialty residency programs using postal mail, email, and social media. Targeted specialties included colon-rectal, otolaryngology, plastic surgery, and urology.

The division identified several recruitment opportunities via a selection of staff-directed recruitment and retention projects focused on:

  • Identifying new communications technologies
  • Recruiting specialty surgeons and engaging with specialty societies• Increasing awareness of the ACS within specialty residency programs
  • Targeting countries with a disproportionately low ratio of Fellows

For Clinical Congress 2021, in collaboration with the Clinical Congress Organizing Committee and the Convention and Meetings, Member Services developed several virtual engagement opportunities, including a walking/running wellness challenge, Pilates and yoga sessions, an exploration challenge, Morning Brew with ACS Leaders, a mixology class, hobby breakout rooms, multiple social media engagement opportunities, a virtual Convocation Ceremony, and a virtual Board of Governors Awards Ceremony.

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 Council Engagement Plan was developed to maximize Advisory Council involvement in recruitment, retention, and engagement efforts and serve as a road map for current and future endeavors. The primary goals of the Engagement Plan are to:

  • Create an organized member recruitment campaign for the Advisory Councils
  • Enhance Advisory Council involvement in the retention of specialty members
  • Use the next Advisory Council Chairs meeting to review the state of the Advisory Councils and create a road map for strategic and operational improvements.

Archives

In 2021, the ACS Archives responded to 160 research requests. The Archives has received nine new accessions that included records from the Committee on Trauma, Clinical Congress, Excelsior Surgical Society, Margaret Hanlon, Society of Surgical Chairs, and the Division of Member Services. An upgrade of the collection management system, ArchivEra, has been completed and is accessible through the ACS Archives website. The new software features multi-word search, more advanced search capabilities, facets, and direct reference request through the catalog.

In July 2021, the Archives contracted with Archive-It, a web-archiving software that crawls and captures web content. A snapshot of the entire ACS website has been completed in preparation for the site’s redesign. The Archives has set up crawls for vital public-facing content that should be preserved in the Archives, such as press releases, College statements, newsletters, the Bulletin Brief, COVID-19 updates, and more.

Board of Governors

The ACS Board of Governors (B/G) members serve as an official, direct communications link between the B/R and the Fellows. The College has 293 Governors: 154 Governors At-Large representing each US state and Canadian province and territory, 88 specialty society Governors, and 51 international Governors.

The B/G is structured around six Pillars and 18 Workgroups and governed by an eight-member Executive Committee. In the last year, the Executive Committee met monthly and focused on the following activities:

  • Establishing the B/G Diversity Pillar and three workgroups focused on DEI
  • Creating a B/G Telehealth Workgroup
  • Revising the scope/purpose for the B/G Grassroots Advocacy Engagement Workgroup and B/G Health Policy and Advocacy Workgroup to better align with the Division of Advocacy and Health Policy
  • Enhancing communication efforts via Bulletin Brief submissions from Governors
  • Encouraging Governor participation in the ACS Foundation and ACSPA-SurgeonsPAC
  • Increased collaboration with Advisory Councils
  • Conducting succession planning for B/G Pillars
  • Selecting new members for the B/G Nominating Committee

Chapters

Membership at the ACS chapter level provides additional benefits, such as the opportunity to network with surgical peers locally, participate in advocacy activities, and earn continuing medical education credits.

Chapter Services provides guidance and assistance to the College’s 116 chapters; 65 in the US, three in Canada, and 48 in countries outside the US and Canada. Because of the COVID-19 pandemic, many of the chapters’ activities, plans, and strategies were altered, postponed, or canceled. Nonetheless, chapters adapted and, in many cases, thrived by including virtual learning and social opportunities for their members. In 2021, the B/R approved the formation of a chapter in Paraguay.

International Relations Committee

In 2021, the International Relations Committee (IRC) submitted 13 panel proposals to the Clinical Congress Program Committee, collaborating with ACS international chapters, international Governors, and other committees to create inclusive proposals with a global perspective. The IRC also worked on two online textbooks for international surgeons: Gastrointestinal Surgical Emergencies and A Practical Guide to Managing Breast Cancer in Low-Middle Income Countries.

In addition, the IRC partnered with the Women in Surgery Committee (WiSC) to create resources and host two webinars supporting the HeForShe initiative promoting gender equity at institutions and programs domestically and internationally, as well as providing practical ways to support women surgeons throughout their careers and in leadership roles within the ACS.

Intimate Partner Violence Task Force

Formed in 2018, the Intimate Partner Violence (IPV) Task Force raises awareness about 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 accomplishments include publishing several articles in the ACS Bulletin to raise awareness during Domestic Violence Awareness month, presenting panel sessions at Clinical Congress 2020 and 2021, and developing several program session submissions for Clinical Congress 2022.

Military Health System Strategic Partnership

The Military Health System Strategic Partnership ACS (MHSSPACS) over the last several years has led a combined effort involving military and civilian surgeons to develop a blueprint of knowledge points and skill sets essential for the expeditionary surgeon deploying to a forward military base. The blueprint was based primarily on the Joint Trauma System ( JTS) Clinical Practice Guidelines and Department of Defense Trauma Registry data of actual cases performed during Operation Iraqi Freedom and Operation Enduring Freedom in Iraq and Afghanistan, respectively. The resulting knowledge test has been delivered electronically to 123 military general surgeons over the last year and is valid using psychometric measures.

2021 was a critical year for the US Military JTS. The evacuation of troops from Iraq and Afghanistan resulted in little exposure to trauma care for combat casualty care teams. These teams must now maintain trauma skills through assignments at Military Treatment Facilities that participate in their regional trauma system or military-civilian partnerships. The MHSSPACS is working with the JTS to maintain and develop both strategies.

Operation Giving Back

Operation Giving Back’s (OGB’s) International Subcommittee has been pivotal in creating the inaugural ACS-COSECSA (College of Surgeons of East, Central and Southern Africa) Surgical Training Hub at Hawassa University, Ethiopia. In total, 28 US surgeons from the consortium surgical departments have dedicated more than $440,000 worth of hours volunteering onsite.

As the work at Hawassa University continues, OGB has established a second surgical training hub in the COSECSA region. Five workgroups of surgeons from both the ACS and Zambia have been created to work remotely in the areas of research, education, trauma, clinical care, and quality. OGB also has committed to coordinating the buildout of subspecialties in Rwanda in response to the country’s 10-year National Strategy for Health Professions Development 2020–2030. Based on current capacity in Rwanda, the subspecialties in most need are cardiothoracic/vascular surgery, plastic/maxillofacial surgery, and trauma surgery. OGB aims to strategize for recruiting surgeons to travel onsite after the acute phase of the COVID-19 pandemic and explore opportunities for potential training during the design of the resident curriculum. King Faisal Hospital, Riyadh, Saudi Arabia, will serve as the primary institution involved in the project.

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. Current projects include a Financial Literacy series highlighting the effect of the COVID-19 pandemic on young surgeons, and expansion of the “So You Think You Can Operate” toolkit.

In the August 2021 ACS Bulletin, six RAS articles discussed the surgeon’s role in healthcare policy. The RAS-sponsored symposium at Clinical Congress 2021 was Competency-based Training: A Gateway to Efficiency or a Sprint to the Finish Line? Future opportunities include increased involvement of RAS members in ACS Chapters and the development of resident-led activities by the RAS Education Committee.

Surgeon Well-Being

The ACS addresses surgeon well-being by gathering existing resources and creating new content and programs to manage fatigue and burnout. The Well-Being 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 to address 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. Key activities in 2021 focused on diversity and inclusion, such as the development of a transparent process to select YFA leaders and liaisons. Additional projects included the development of the ACS restrictive covenant policy, Clinical Congress submissions, the YFA mentorship program, and a white paper on best practices to ensure inclusivity at meetings. Continued efforts to assist young surgeons include the development of educational activities in creating high-performance teams, virtual networking opportunities, and promotion of ACS benefits.

Women in Surgery Committee

The WiSC comprises six subcommittees: Structure, Mission, and Communications; Awards; Program; Mentorship Program; Personal Empowerment; and International. Key activities carried out by these subcommittees included identifying the annual Olga M. Jonasson Lecturer at the Clinical Congress. The 2021 lecturer, Andrea Hayes, MD, FACS, FAAP, spoke on Grit in Spite of Adversity in the Pursuit of Excellence. The Awards Subcommittee selected and awarded the 2021 Dr. Mary Edwards Walker Inspiring Women in Surgery Award to M. Margaret Knudson, MD, FACS. The Structure, Mission, and Communications Subcommittee developed a Letters of Recommendation Guide and Resource Bank.

Division of Research and Optimal Patient Care

The Division of Research and Optimal Patient Care encompasses the areas of Continuous Quality Improvement, 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 90 on-demand content and live sessions. Nearly 450 abstracts were submitted and approved. 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. Garcia endured months of intensive care, the amputation of half of his left arm, removal of several ribs, and a cancer diagnosis.

A preview of the ACS Quality Improvement (QI): The Basics course featured six on-demand modules guiding the learner through basic key principles. QI course attendees also learned how to conduct a QI project from start to finish. The 2022 ACS Quality and Safety Conference will take place in Chicago, IL.

ACS Quality Improvement Course

The ACS Quality Improvement Course: The Basics is intended for the surgeons and other QI staff interested in improving quality at their hospitals. After completing the course, participants will understand the basic principles of surgical quality and safety. Attendees also will be able to apply a collection of tools and strategies to ensure the success of their QI initiatives. The self-paced online version of the course launched in November. Additional formats, including a nine-month instructor-led version, are being considered for future development.

Optimal Resources for Surgical Quality and Safety

In 2017, the College released the Optimal Resources for Surgical Quality and Safety manual, also called the Red Book. More than 10,000 manuals have been distributed since its release. Additional marketing efforts are under way to broaden the current reach and to better inform the national audience of its instructional and educational content. The manual also served as source material to develop new standards and an adjunctive verification program, the ACS Quality Verification Program (ACS QVP). The ACS QVP formally launched in July 2021, and multiple participation options are now available to interested hospitals, with additional participation options for hospital systems and National Surgical Quality Improvement Program (ACS NSQIP®) participants available in the future.

ACS NSQIP

A total of 851 hospitals participate in ACS NSQIP—701 in the adult option. The pediatric option represents 18% of overall participation. At present, 152 hospitals outside of the US participate in ACS NSQIP—approximately 18% of all participating facilities. MBSAQIPA total of 992 facilities participate in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). From October 2014 through August 2021, 1,759 site visits have been completed using the MBSAQIP Standards. A total of 58 Site Reviewers were expected to perform approximately 250 site visits during the 2021 calendar year—less than typical because of COVID-19 restrictions.

Children’s Surgery Verification Program

The Children’s Surgery Verification (CSV) Quality Improvement Program launched in 2017 with the goal of ensuring that pediatric surgery patients have access to quality care. A total of 151 centers participate in CSV. Approximately 35 of these centers are in various stages of verification; 32 of the active sites are fully verified as Level I children’s surgery centers. All 151 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. At present, 38 hospitals have applied for 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.

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 to help with troubleshooting, and inclusion in a community of professionals rolling out the same pathway. Approximately 60% of enrolled hospitals 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 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.

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 CMS’s 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 7,000 surgeons, and more than 12.3 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 patients. The ACS COVID-19 Registry is free for any hospital and was created in Research Electronic Data Capture (REDCap). 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 and have submitted more than 11,000 cases. Participating sites can download their data at any time to look for trends or areas for quality improvement.

Cancer Programs

The College’s Cancer Programs continue to meet their 2021 strategic goals to innovate and deliver new products and services, adapt to challenges associated with the pandemic, and prepare for the centennial of the Commission on Cancer (CoC). The accreditation programs of the CoC, National Accreditation Program for Breast Centers (NAPBC), and National Accreditation Program for Rectal Cancer (NAPRC) quickly adopted virtual site visits and virtual site visit training. Approximately 500 virtual site visits were completed by 120 site visitors. In-person site visits will resume when COVID-19 surges abate.

The COVID-19 pandemic disrupted cancer care, most likely leading to thousands of deaths because of the estimated 9 million missed screenings in 2020. The CoC, NAPBC, and American Cancer Society responded by providing a Return-to-Screening Plan/Do/Study/Act Quality Improvement protocol and clinical study, complete with guidelines, COVID-19 messaging, and interventions. 749 cancer programs enrolled in the national Return-to-Screening study, resulting in 814 QI projects.

The CoC Accreditation Committee explored how best to integrate DEI efforts into the existing standards and address cancer care disparities. Similarly, participants in the American Cancer Society and National Cancer Database have examined disparities in estimated performance rates. These efforts now are folded into a DEI Accreditation Task Force to initially identify areas of opportunity within CoC standards and quality measures and develop mitigation strategies.

The American Joint Committee on Cancer (AJCC) made progress in transitioning away from the printing of a comprehensive staging book every 7 years to the annual release of individual, digital staging protocols. The cervix protocol was published in 2020 as an e-book and print-on-demand. Protocols for anus, appendix, and vulvar were published in 2021.

The four committees of the Cancer Research Program (CRP) continue to advance the CoC operative standards and develop several new operative standards for publication in the third and fourth volumes of the manuals. Promotion of the CoC operative standards is supported by JACS videos series and Society of Surgical Oncology podcasts.

The Cancer Surgery Standards Program (CSSP) recently celebrated its 1-year anniversary. Progress has been made to commercialize three synoptic operative reports supporting the 2020 CoC operative standards. Team efforts are focused on supporting the broad implementation of synoptic operative reports, which is expected to be a multi-year endeavor. In addition, third-party vendors have licensed the ACS synoptic reports and are completing builds and implementations through dominant electronic health record vendors. The CSSP is focused on training surgeons and accredited cancer program staff, site visitors, and others through diverse educational and promotional efforts.

Trauma Programs

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 is nearing its fundraising goal of $1 million.

The 2021 TQIP Annual Meeting took place virtually, November 15–17. The meeting focused on change management, and Keynote Speaker Chip Heath addressed how to successfully make changes within an organization to the betterment of both providers and patients. Heather Martin spoke about her experience as a trauma survivor of the Columbine school shooting. The TQIP Best Practice Guidelines for Spine Injury also were released.

The COT Leadership Opportunity and COT Participation Opportunity Boards launched in 2021 to provide greater opportunity for engagement among members and increased transparency in the appointment process for leadership positions. The primary goal is to ensure that all qualified candidates are considered for leadership positions in the COT.

The STOP THE BLEED® (STB®) program continues to focus on empowering, educating, and informing individuals in bleeding control techniques. The STB program provides training, both virtually and in person, on the importance of learning the lifesaving skills to deploy in a bleeding emergency. The STB program continues to promulgate the initiative globally, creating awareness throughout communities worldwide. The STB program’s Virtual-Interactive Course premiered in September 2021 and provides unlimited access to an animated interactive course. Upon completing the course, the participant is required to pass a quiz. Participants also are directed to seek out the skills portion of the training to receive a certificate of completion. The STB program partnered with the 9/11 Day of Service organization to bring awareness to first responders and their commitment to STOP THE BLEED®. As of September 30, 2021, the STB program has trained 1,788,776 individuals with 95,638 global instructors.

ACS Foundation

The ACS Foundation remains focused on securing and growing financial support for the College’s charitable, educational, and patient-focused initiatives. Through June 30, 2021, the Foundation had raised $2,618,553 in donations and grant support. Individual donations of $356,918 supported the Greatest Needs Fund, with $200,000 of those monies being directed toward scholarships. Programs, projects, and initiatives received $2,185,617, with a generous Fellow providing a gift of $500,000 to support the FTL100 Campaign. The number of individual contributors totals 1,325. The Fall Appeal generated $217,094, the highest amount ever.

National Doctors’ Day secured $101,956 in donations, continuing a four-year period of substantial growth. Corporate grants secured by the ACS Foundation provided support for the Resident Surgical Skills Competition, virtual Skills Courses at Clinical Congress, and Patient Education resources.

Charles E. Lucas, MD, FACS, was selected as the 2021 Philanthropist of the Year and was formally recognized at the virtual Donor Luncheon in October.

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