One of the primary goals of the American College of Surgeons (ACS) is to provide surgeons with knowledge and skills to deliver the highest quality of patient care. The guidelines and statements developed by the ACS are intended to inform and guide Fellows in the care of their patients and to educate their patients and their institutions on best practices in those situations that may warrant specific guidance and direction.
Over the last decade, the College has participated in the development of guidelines and “point of care” modules that address those diagnoses most relevant to general surgeons. The Evidence-Based Decisions in Surgery (EBDS) are clinical guideline summaries that provide recommendations based on the latest practice guidelines in an easy-to-use, widely accessible format, including mobile devices and tablets. Module development involves a rigorous multi-step process, including contributions from experts on the ACS Board of Governors and the ACS Advisory Council for General Surgery. It is important to note that EBDS is not intended to reflect standards of care as defined by the ACS, but rather to serve as educational resources that practicing surgeons can use within the context of their respective practices. These guidelines should be used when appropriate based on the surgical condition and the surgeon’s experience, as well as the patient’s needs and preferences.
EBDS now comprises more than 70 point of care modules covering the following categories—bariatric surgery, biliary tract and pancreas, breast disease, colon, rectum and anus, critical care, endocrine, gastrointestinal surgery, geriatrics and palliative care, miscellaneous surgical conditions, perioperative care, surgical oncology, and vascular.
The complete list of guidelines is available at ebds.facs.org/topics, and new modules are released regularly. To access individual guidelines, members are required to log in. Contact firstname.lastname@example.org for member log-in information, and go to facs.org/ebds for more information about the program.
The Trauma Quality Improvement Program (TQIP®) generates the ACS TQIP Best Practice Guidelines to provide recommendations for managing patient populations or injury types. The TQIP Best Practices Project Team and a panel of guest experts from appropriate specialties work together over the course of the year to create each guideline. The guidelines are created from evidence-based literature when available and the consensus of the group when evidence is lacking. To date, the following guidelines have been created for use by trauma centers and are available for download at facs.org/quality-programs/trauma/tqip/best-practice:
• Geriatric Trauma Management
• Massive Transfusion in Trauma
• Management of Traumatic Brain Injury
• Management of Orthopaedic Trauma
• Palliative Care
The College’s National Surgical Quality Improvement Program (ACS NSQIP®) and the American Geriatrics Society’s Geriatrics for Specialists Initiative have developed two best practice guidelines that address management of older patients: Optimal Preoperative Assessment of the Geriatric Surgical Patient and Optimal Perioperative Management of the Geriatric Patient. These consensus-based recommendations were developed with support from the John A. Hartford Foundation and are available for download at facs.org/quality-programs/acs-nsqip/geriatric-periop-guideline.
Founded to provide opportunities for the continuing education of surgeons, the ACS has had a deep concern for the improvement of patient care and for the ethical practice of medicine. These values are reflected in the ACS Statements on Principles, which serve as the guidepost resource for all ACS Fellows. In addition to the Fellowship Pledge and Code of Professional Conduct, the Statements on Principles address the qualifications of the responsible surgeon, the surgeon-patient relationship, interprofessional relations, medical education, and surgeons and society. Fellows are encouraged to familiarize themselves with the contents of the Statements on Principles, which can be accessed at facs.org/about-acs/statements/stonprin.
In addition to the Statements on Principles, the ACS has issued more than 90 statements that have been adopted by the Board of Regents and address topics of importance to surgeons and the surgical profession. These statements have been developed by a range of volunteer committees and workgroups within the College, including the ACS Board of Governors, the ACS Advisory Councils, and various ACS standing committees. Statements are reviewed and updated annually, and new statements are created as appropriate. Statements are generally communicated to the membership via the Bulletin and are posted to the ACS website. Thus far in 2018, the Board of Regents has approved seven new statements and two revised statements. To review the complete list of ACS statements, go to facs.org/about-acs/statements and share those of interest with your colleagues and your institution.
Ms. Bura is Associate Director, ACS Division of Member Services, Chicago, IL.