As we commemorate the American College of Surgeons’ Centennial, the leadership and staff continue to develop and engage in initiatives designed to ensure that members of the College are best positioned to continuing providing quality surgical care for the next 100 years.

With respect to advocacy and health policy, the College remains at the forefront of efforts to repeal and replace the flawed sustainable growth rate formula used to calculate Medicare physician payment. Importantly, the College has been working on a proposal to replace the SGR with a value-based update, which emphasizes that value = quality/cost.

The ACS is also looking at alternative methods of resolving medical liability claims. We hosted a Medical Liability Summit in October, and articles based on the presentations given at the meeting will be published in a special issue of the Bulletin this March.

Advocacy

In addition, the College has successfully nominated Fellows to serve on panels that are advising the government on quality of care issues. Last year, ACS nominee Stephen B. Edge, MD, FACS, was appointed co-chair of the National Quality Forum’s Cancer Maintenance Endorsement Project, and Frank Opelka, MD, FACS, Associate Medical Director of the Division of Advocacy and Health Policy, was appointed chair of the Physician Consortium for Performance Improvement.

Quality improvement

The College’s National Surgical Quality Improvement Program (ACS NSQIP^®) continues to grow in size and stature. More than 500 hospitals now participate in ACS NSQIP, and data promulgated through this outcome measurement system were key in the completion of a project that the College conducted last year with the Joint Commission Center for Transforming Healthcare aimed at reducing colorectal surgical site infections. A total of 135 SSIs were averted at seven health care institutions that participated in the demonstration project, saving those facilities more $3.7 million. The Centers for Disease Control and ACS NSQIP also have entered into a formal agreement to study SSI. Additionally, approximately 30% of ACS NSQIP hospitals are participating in the Centers for Medicare & Medicaid Services public reporting pilot program, Hospital Compare.

The Rapid Quality Reporting System has enabled Commission on Cancer–accredited programs to better adhere to five NQF-endorsed quality performance measures. Recognizing the potential value of this program, CMS recently contracted with the ACS to implement RQRS at 11 cancer centers that support public reporting through Hospital Compare.

At press time, ACS leaders had completed visits to 12 cities to discuss how quality-improvement efforts enhance surgical patient safety and reduce costs as part of the College’s Inspiring Quality initiative. With the assistance of Weber Shandwick, we also released the video Driven, which explores how surgical leaders and other innovators over the past 100 years have inspired quality by advancing surgical care.

Education

The College continues to establish benchmarks and standards in surgical education. This past year, new emphasis was placed on helping surgeons and residents to navigate transitions in their careers. Perhaps the most significant example of our efforts to assist residents as they transition into practice is the development of fellowships for young surgeons who are leaving training and entering into general surgery practice. The College will begin pilot testing the ACS Transition to Practice Fellowship in General Surgery on July 1 at five institutions in regions of the United States that currently are underserved by general surgeons. Furthermore, the ACS is collaborating with the Association of Program Directors in Surgery and the Association for Surgical Education to develop a new Entering Surgery Resident Prep Curriculum.

Workforce issues

Rural areas feel the effects of general surgeon shortage most acutely. To ensure that the College is better able to address the challenges that rural surgical practice poses, the College established a new Advisory Council for Rural Surgery.

And, to help surgeons make smart decisions as the trend toward hospital employment for physicians continues to grow, the ACS developed a new resource titled Surgeons as Institutional Employees: A Strategic Look at the Dimensions of Surgeons as Employees of Hospitals. This document mailed with the February 2013 Bulletin.

Communications

The College continues to modernize its communications vehicles. In September 2012, the College released the first issue of the newly redesigned Bulletin and is now in the process of working with consultants to reconstruct the public website (www.facs.org) and to integrate the members’ portal into the main site. To increase the visibility of the College’s advocacy efforts, the ACS last summer launched a monthly e-newsletter, The ACS Advocate.

Looking forward

The ACS is continuing to develop proactive solutions to the challenges facing surgeons. Your continued input on how we can address your concerns is always welcome.

Dr. Hoyt is Executive Director of the American College of Surgeons.

ACS takes steps to lead the profession through the next 100 years