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Official Newspaper of the American College of Surgeons
Commentary: Preemptive planning is key to palliative care
For decades, surgeons have been at the forefront of the palliative care movement. From the historic utilization of palliative operations to relieve suffering to creation of the American College of Surgeons Palliative Care Task Force, surgeons are often first-line palliative care providers in the management of patients with advanced malignancy.
Palliative care involves paying attention to symptom distress, communicating with patients and families about goals of care in relation to prognosis and patient preferences, planning transitions, and engaging family support. Yet, despite a clear and established role, many surgeons are not prepared to effectively provide palliative care, and they are often resistant to the use of specialty palliative care services.
In my own training, I have witnessed apprehension and failure to use palliative care services. In one instance, I was managing an older patient after a complicated sarcoma resection. The patient suffered complications, which kept him hospitalized and returning to the hospital after short periods at a long-term acute care facility. I suggested that we call palliative care for assistance in management of the patient. He had pain, nausea, and poor oral intake, and he was depressed and anxious about his future. I was told "we don’t want the patient believing we were giving up on him."
After 3 weeks of minimal change, my attending relented. In a short time, the patient’s pain and nausea were better controlled, and we were able to have discussions with the patient and his family to clarify goals of care. Some of the symptom management techniques used methods that I had not yet encountered in my training and that seemed foreign and curious. But seeing the response left no question as to their utility. The patient was able to leave the hospital 2 weeks later with the palliative care service coordinating his management with the primary care provider and surgical team. This was a positive resolution to a significant problem. But what really hindered palliative care use?
Roadblocks include the term palliative having a negative connotation, being equated with "failure." Increased use of quality metrics may deincentivize palliative operations. Also, there is poor training and support for surgeons to provide primary palliative care services themselves. Yet, despite these barriers, there are opportunities for surgeons to improve care of patients with advanced malignancy by improving surgeon-patient communication and giving greater emphasis to advanced care planning prior to operative interventions.
As front-line providers for these patients, surgeons are an ideal conduit for delivery and improved use of early palliative care. My practice includes a discussion of advanced care planning with all of my cancer patients. I introduce this as a normal part of every discussion and refer the patient to the primary care provider or our Quality of Life service to facilitate further conversations and documentation. By destigmatizing the discussion for patients and families, a door is opened to an important part of comprehensive quality care. We must understand that diseases progress and complications occur. Failing to provide preemptive support to patients and families is true failure. With a preemptive approach, patients, families, and caregivers have a better understanding of the medical situation, and the latter can more effectively support the patient.
To standardize the role that surgeons routinely play in management of patients with advanced malignancy, efforts must focus on education and research. The role of education is twofold. First, surgical trainees need adequate tools to perform routine palliative care and an understanding of the appropriate timing to refer for specialized services. There have been multiple national efforts focused on teaching palliative care to varied practitioners. But given the aging population and the paucity of specialist palliative care providers, a renewed effort is needed. Second, surgeons must understand the role that palliative care plays and the benefits their patients can derive from it. Surgeons are routinely involved throughout the course of care of patients with malignancy from diagnosis to the end of life. Recognition of palliative care as a skill along the continuum of care already provided will improve outcomes.
Finally, research must focus on both models of use of palliative care and the quality of current practice. Palliative care as it pertains to surgeons is understudied: What teaching formats are most likely to affect clinical practice? What components of palliative care have an impact in surgical practice? What is the optimal timing and venue for providing palliative care in surgical practice? What health care system changes are needed to support surgeons to provide primary palliative care services?
We are uniquely aware of the complexities of care needed for management of patients with advanced malignancies. We are routinely called on to aid in the management of these patients. Surgical educators and researchers should focus their efforts on what is needed to fully integrate palliative care into patient-centered care already provided by trainees and surgeons.
Dr. Johnston is an assistant professor of surgery in the division of surgical oncology at the Medical College of Wisconsin, Milwaukee. He disclosed no conflicts.
For decades, surgeons have been at the forefront of the palliative care movement. From the historic utilization of palliative operations to relieve suffering to creation of the American College of Surgeons Palliative Care Task Force, surgeons are often first-line palliative care providers in the management of patients with advanced malignancy.
Palliative care involves paying attention to symptom distress, communicating with patients and families about goals of care in relation to prognosis and patient preferences, planning transitions, and engaging family support. Yet, despite a clear and established role, many surgeons are not prepared to effectively provide palliative care, and they are often resistant to the use of specialty palliative care services.
In my own training, I have witnessed apprehension and failure to use palliative care services. In one instance, I was managing an older patient after a complicated sarcoma resection. The patient suffered complications, which kept him hospitalized and returning to the hospital after short periods at a long-term acute care facility. I suggested that we call palliative care for assistance in management of the patient. He had pain, nausea, and poor oral intake, and he was depressed and anxious about his future. I was told "we don’t want the patient believing we were giving up on him."
After 3 weeks of minimal change, my attending relented. In a short time, the patient’s pain and nausea were better controlled, and we were able to have discussions with the patient and his family to clarify goals of care. Some of the symptom management techniques used methods that I had not yet encountered in my training and that seemed foreign and curious. But seeing the response left no question as to their utility. The patient was able to leave the hospital 2 weeks later with the palliative care service coordinating his management with the primary care provider and surgical team. This was a positive resolution to a significant problem. But what really hindered palliative care use?
Roadblocks include the term palliative having a negative connotation, being equated with "failure." Increased use of quality metrics may deincentivize palliative operations. Also, there is poor training and support for surgeons to provide primary palliative care services themselves. Yet, despite these barriers, there are opportunities for surgeons to improve care of patients with advanced malignancy by improving surgeon-patient communication and giving greater emphasis to advanced care planning prior to operative interventions.
As front-line providers for these patients, surgeons are an ideal conduit for delivery and improved use of early palliative care. My practice includes a discussion of advanced care planning with all of my cancer patients. I introduce this as a normal part of every discussion and refer the patient to the primary care provider or our Quality of Life service to facilitate further conversations and documentation. By destigmatizing the discussion for patients and families, a door is opened to an important part of comprehensive quality care. We must understand that diseases progress and complications occur. Failing to provide preemptive support to patients and families is true failure. With a preemptive approach, patients, families, and caregivers have a better understanding of the medical situation, and the latter can more effectively support the patient.
To standardize the role that surgeons routinely play in management of patients with advanced malignancy, efforts must focus on education and research. The role of education is twofold. First, surgical trainees need adequate tools to perform routine palliative care and an understanding of the appropriate timing to refer for specialized services. There have been multiple national efforts focused on teaching palliative care to varied practitioners. But given the aging population and the paucity of specialist palliative care providers, a renewed effort is needed. Second, surgeons must understand the role that palliative care plays and the benefits their patients can derive from it. Surgeons are routinely involved throughout the course of care of patients with malignancy from diagnosis to the end of life. Recognition of palliative care as a skill along the continuum of care already provided will improve outcomes.
Finally, research must focus on both models of use of palliative care and the quality of current practice. Palliative care as it pertains to surgeons is understudied: What teaching formats are most likely to affect clinical practice? What components of palliative care have an impact in surgical practice? What is the optimal timing and venue for providing palliative care in surgical practice? What health care system changes are needed to support surgeons to provide primary palliative care services?
We are uniquely aware of the complexities of care needed for management of patients with advanced malignancies. We are routinely called on to aid in the management of these patients. Surgical educators and researchers should focus their efforts on what is needed to fully integrate palliative care into patient-centered care already provided by trainees and surgeons.
Dr. Johnston is an assistant professor of surgery in the division of surgical oncology at the Medical College of Wisconsin, Milwaukee. He disclosed no conflicts.
For decades, surgeons have been at the forefront of the palliative care movement. From the historic utilization of palliative operations to relieve suffering to creation of the American College of Surgeons Palliative Care Task Force, surgeons are often first-line palliative care providers in the management of patients with advanced malignancy.
Palliative care involves paying attention to symptom distress, communicating with patients and families about goals of care in relation to prognosis and patient preferences, planning transitions, and engaging family support. Yet, despite a clear and established role, many surgeons are not prepared to effectively provide palliative care, and they are often resistant to the use of specialty palliative care services.
In my own training, I have witnessed apprehension and failure to use palliative care services. In one instance, I was managing an older patient after a complicated sarcoma resection. The patient suffered complications, which kept him hospitalized and returning to the hospital after short periods at a long-term acute care facility. I suggested that we call palliative care for assistance in management of the patient. He had pain, nausea, and poor oral intake, and he was depressed and anxious about his future. I was told "we don’t want the patient believing we were giving up on him."
After 3 weeks of minimal change, my attending relented. In a short time, the patient’s pain and nausea were better controlled, and we were able to have discussions with the patient and his family to clarify goals of care. Some of the symptom management techniques used methods that I had not yet encountered in my training and that seemed foreign and curious. But seeing the response left no question as to their utility. The patient was able to leave the hospital 2 weeks later with the palliative care service coordinating his management with the primary care provider and surgical team. This was a positive resolution to a significant problem. But what really hindered palliative care use?
Roadblocks include the term palliative having a negative connotation, being equated with "failure." Increased use of quality metrics may deincentivize palliative operations. Also, there is poor training and support for surgeons to provide primary palliative care services themselves. Yet, despite these barriers, there are opportunities for surgeons to improve care of patients with advanced malignancy by improving surgeon-patient communication and giving greater emphasis to advanced care planning prior to operative interventions.
As front-line providers for these patients, surgeons are an ideal conduit for delivery and improved use of early palliative care. My practice includes a discussion of advanced care planning with all of my cancer patients. I introduce this as a normal part of every discussion and refer the patient to the primary care provider or our Quality of Life service to facilitate further conversations and documentation. By destigmatizing the discussion for patients and families, a door is opened to an important part of comprehensive quality care. We must understand that diseases progress and complications occur. Failing to provide preemptive support to patients and families is true failure. With a preemptive approach, patients, families, and caregivers have a better understanding of the medical situation, and the latter can more effectively support the patient.
To standardize the role that surgeons routinely play in management of patients with advanced malignancy, efforts must focus on education and research. The role of education is twofold. First, surgical trainees need adequate tools to perform routine palliative care and an understanding of the appropriate timing to refer for specialized services. There have been multiple national efforts focused on teaching palliative care to varied practitioners. But given the aging population and the paucity of specialist palliative care providers, a renewed effort is needed. Second, surgeons must understand the role that palliative care plays and the benefits their patients can derive from it. Surgeons are routinely involved throughout the course of care of patients with malignancy from diagnosis to the end of life. Recognition of palliative care as a skill along the continuum of care already provided will improve outcomes.
Finally, research must focus on both models of use of palliative care and the quality of current practice. Palliative care as it pertains to surgeons is understudied: What teaching formats are most likely to affect clinical practice? What components of palliative care have an impact in surgical practice? What is the optimal timing and venue for providing palliative care in surgical practice? What health care system changes are needed to support surgeons to provide primary palliative care services?
We are uniquely aware of the complexities of care needed for management of patients with advanced malignancies. We are routinely called on to aid in the management of these patients. Surgical educators and researchers should focus their efforts on what is needed to fully integrate palliative care into patient-centered care already provided by trainees and surgeons.
Dr. Johnston is an assistant professor of surgery in the division of surgical oncology at the Medical College of Wisconsin, Milwaukee. He disclosed no conflicts.
Commentary: ACS Advisory Council tackles rural surgery crisis
The Advisory Council for Rural Surgery will be 2 years old in June 2014. Its creation resulted from the realization of ACS Leaders such as J. David Richardson, Brent Eastman, Patricia Numann, and the Board of Regents that a crisis was in process regarding surgical access in rural America.
The recognized crises in rural surgery are of interest to all surgeons. The core of therural surgical crisis is not just the access to surgical care for the estimated 60 million people of North America living in rural environs, but the role and sustainability of general surgery as a specialty in itself. General surgery, the parent of almost every specialty, has suffered a gradual attrition of its field through abdication or specialization.
While not universal, the shift from surgical training to creating specialist surgeons who take care of limited areas of anatomy leaves the American public facing a fragmented surgical world and, in those places where there cannot be multiple surgical "superspecialists," patients’ lives and well-being will depend on well-trained general surgeons in small communities and rural areas.
The Rural Council is wrestling with these large and fundamental questions. How do we train and support surgeons who must work in geographically or temporally isolated areas? Of the 1,200 residents graduating from ACGME-accredited general surgical residencies, only 30% seek broad-based practice, which amounts to 360 surgeons per year. Of those 360, about 10% –-– 36 surgeons – will practice in rural areas. More than 500 hospitals are deemed Critical Access and do general surgery. On the ACS rural listserv, there are 1,000 rural-based surgeons; 52% of rural surgeons are within 10 years of retirement (not to mention attrition from other sources such as health or burnout). A simple calculation proves that not enough surgeons will be there for those rural patients. A helicopter or runway does not equal surgical access. It takes the cognitive skills of a general surgeon to know who truly requires surgical care and what type.
Given these facts, new approaches to retaining surgical access in rural areas are coming either through proactive planning by surgeons or as a result of other parties with other interests "solving" the crisis.
Centralization is attractive to policy makers, but not to the rural patient 50-100 miles away on a snowy night. In the Affordable Care Act legislation, the ACS was able to procure a 10% increase in reimbursement for surgeons in underserved rural areas, which is appreciated. However, the motivation to practice in rural locales is not and will not be driven solely by money, for the joy of rural practice lies in the fulfillment of doing a difficult job well for an entire community in which one becomes an integral part. Finding ways to make that sort of surgical life possible to young men and women is the best answer.
The Advisory Council for Rural Surgery therefore is touching many areas of surgery and the ACS. Like the rest of the College, we function in five pillars – Education, Optimal Care/Quality, Membership Services, Communications, and Advocacy. Each pillar is actively engaged. Education, under Karen Deveney, is working on templates for rural tracks in general surgery residency programs in alignment with ABS and RRC requirements as well as medical student and postresidency surgeon education. Optimal Care, under Don Nakayama, is developing infrastructure standards for rural hospitals as well as research mechanisms for rural surgeons to develop their data. Membership Service, under Mike Sarap, works on recruitment and retention of rural surgeons, call relief strategies, and community-based services on oncology issues. Advocacy is well guided by Mark Savaris, who in particular is working on repeal of the infamous 96-hour rule that threatens surgical access in some of our most-remote hospitals. The Communication pillar, under Phil Caropreso, has made enormous strides through the development of a rural listserv, which allows rural surgeons to communicate in real time on subjects ranging from case review to practice management. Through Dr. Caropreso’s tireless efforts, 1,000 surgeons communicate approximately 20-100 times a day. In total, more than 5 million e-mails have been distributed in 18 months. Soon, this will morph into the Rural Surgical Community, with much-improved software, which also will be used by the rest of the College Fellows in their respective fields of interest.
Rural surgeons, like most surgeons, pride themselves on being individualists who can solve problems with limited resources. The Advisory Council for Rural Surgery is helping these individuals find a common place for education, advocacy, quality care, communication, and fellowship. Rural surgery is transforming from disparate surgeons in isolated areas to a common group of Fellows dedicated to the highest principles of the American College of Surgeons.
Dr. Hughes, an ACS Fellow, is a general surgeon practicing in McPherson, Kan., and chair of the ACS Advisory Council for Rural Surgery.
The Advisory Council for Rural Surgery will be 2 years old in June 2014. Its creation resulted from the realization of ACS Leaders such as J. David Richardson, Brent Eastman, Patricia Numann, and the Board of Regents that a crisis was in process regarding surgical access in rural America.
The recognized crises in rural surgery are of interest to all surgeons. The core of therural surgical crisis is not just the access to surgical care for the estimated 60 million people of North America living in rural environs, but the role and sustainability of general surgery as a specialty in itself. General surgery, the parent of almost every specialty, has suffered a gradual attrition of its field through abdication or specialization.
While not universal, the shift from surgical training to creating specialist surgeons who take care of limited areas of anatomy leaves the American public facing a fragmented surgical world and, in those places where there cannot be multiple surgical "superspecialists," patients’ lives and well-being will depend on well-trained general surgeons in small communities and rural areas.
The Rural Council is wrestling with these large and fundamental questions. How do we train and support surgeons who must work in geographically or temporally isolated areas? Of the 1,200 residents graduating from ACGME-accredited general surgical residencies, only 30% seek broad-based practice, which amounts to 360 surgeons per year. Of those 360, about 10% –-– 36 surgeons – will practice in rural areas. More than 500 hospitals are deemed Critical Access and do general surgery. On the ACS rural listserv, there are 1,000 rural-based surgeons; 52% of rural surgeons are within 10 years of retirement (not to mention attrition from other sources such as health or burnout). A simple calculation proves that not enough surgeons will be there for those rural patients. A helicopter or runway does not equal surgical access. It takes the cognitive skills of a general surgeon to know who truly requires surgical care and what type.
Given these facts, new approaches to retaining surgical access in rural areas are coming either through proactive planning by surgeons or as a result of other parties with other interests "solving" the crisis.
Centralization is attractive to policy makers, but not to the rural patient 50-100 miles away on a snowy night. In the Affordable Care Act legislation, the ACS was able to procure a 10% increase in reimbursement for surgeons in underserved rural areas, which is appreciated. However, the motivation to practice in rural locales is not and will not be driven solely by money, for the joy of rural practice lies in the fulfillment of doing a difficult job well for an entire community in which one becomes an integral part. Finding ways to make that sort of surgical life possible to young men and women is the best answer.
The Advisory Council for Rural Surgery therefore is touching many areas of surgery and the ACS. Like the rest of the College, we function in five pillars – Education, Optimal Care/Quality, Membership Services, Communications, and Advocacy. Each pillar is actively engaged. Education, under Karen Deveney, is working on templates for rural tracks in general surgery residency programs in alignment with ABS and RRC requirements as well as medical student and postresidency surgeon education. Optimal Care, under Don Nakayama, is developing infrastructure standards for rural hospitals as well as research mechanisms for rural surgeons to develop their data. Membership Service, under Mike Sarap, works on recruitment and retention of rural surgeons, call relief strategies, and community-based services on oncology issues. Advocacy is well guided by Mark Savaris, who in particular is working on repeal of the infamous 96-hour rule that threatens surgical access in some of our most-remote hospitals. The Communication pillar, under Phil Caropreso, has made enormous strides through the development of a rural listserv, which allows rural surgeons to communicate in real time on subjects ranging from case review to practice management. Through Dr. Caropreso’s tireless efforts, 1,000 surgeons communicate approximately 20-100 times a day. In total, more than 5 million e-mails have been distributed in 18 months. Soon, this will morph into the Rural Surgical Community, with much-improved software, which also will be used by the rest of the College Fellows in their respective fields of interest.
Rural surgeons, like most surgeons, pride themselves on being individualists who can solve problems with limited resources. The Advisory Council for Rural Surgery is helping these individuals find a common place for education, advocacy, quality care, communication, and fellowship. Rural surgery is transforming from disparate surgeons in isolated areas to a common group of Fellows dedicated to the highest principles of the American College of Surgeons.
Dr. Hughes, an ACS Fellow, is a general surgeon practicing in McPherson, Kan., and chair of the ACS Advisory Council for Rural Surgery.
The Advisory Council for Rural Surgery will be 2 years old in June 2014. Its creation resulted from the realization of ACS Leaders such as J. David Richardson, Brent Eastman, Patricia Numann, and the Board of Regents that a crisis was in process regarding surgical access in rural America.
The recognized crises in rural surgery are of interest to all surgeons. The core of therural surgical crisis is not just the access to surgical care for the estimated 60 million people of North America living in rural environs, but the role and sustainability of general surgery as a specialty in itself. General surgery, the parent of almost every specialty, has suffered a gradual attrition of its field through abdication or specialization.
While not universal, the shift from surgical training to creating specialist surgeons who take care of limited areas of anatomy leaves the American public facing a fragmented surgical world and, in those places where there cannot be multiple surgical "superspecialists," patients’ lives and well-being will depend on well-trained general surgeons in small communities and rural areas.
The Rural Council is wrestling with these large and fundamental questions. How do we train and support surgeons who must work in geographically or temporally isolated areas? Of the 1,200 residents graduating from ACGME-accredited general surgical residencies, only 30% seek broad-based practice, which amounts to 360 surgeons per year. Of those 360, about 10% –-– 36 surgeons – will practice in rural areas. More than 500 hospitals are deemed Critical Access and do general surgery. On the ACS rural listserv, there are 1,000 rural-based surgeons; 52% of rural surgeons are within 10 years of retirement (not to mention attrition from other sources such as health or burnout). A simple calculation proves that not enough surgeons will be there for those rural patients. A helicopter or runway does not equal surgical access. It takes the cognitive skills of a general surgeon to know who truly requires surgical care and what type.
Given these facts, new approaches to retaining surgical access in rural areas are coming either through proactive planning by surgeons or as a result of other parties with other interests "solving" the crisis.
Centralization is attractive to policy makers, but not to the rural patient 50-100 miles away on a snowy night. In the Affordable Care Act legislation, the ACS was able to procure a 10% increase in reimbursement for surgeons in underserved rural areas, which is appreciated. However, the motivation to practice in rural locales is not and will not be driven solely by money, for the joy of rural practice lies in the fulfillment of doing a difficult job well for an entire community in which one becomes an integral part. Finding ways to make that sort of surgical life possible to young men and women is the best answer.
The Advisory Council for Rural Surgery therefore is touching many areas of surgery and the ACS. Like the rest of the College, we function in five pillars – Education, Optimal Care/Quality, Membership Services, Communications, and Advocacy. Each pillar is actively engaged. Education, under Karen Deveney, is working on templates for rural tracks in general surgery residency programs in alignment with ABS and RRC requirements as well as medical student and postresidency surgeon education. Optimal Care, under Don Nakayama, is developing infrastructure standards for rural hospitals as well as research mechanisms for rural surgeons to develop their data. Membership Service, under Mike Sarap, works on recruitment and retention of rural surgeons, call relief strategies, and community-based services on oncology issues. Advocacy is well guided by Mark Savaris, who in particular is working on repeal of the infamous 96-hour rule that threatens surgical access in some of our most-remote hospitals. The Communication pillar, under Phil Caropreso, has made enormous strides through the development of a rural listserv, which allows rural surgeons to communicate in real time on subjects ranging from case review to practice management. Through Dr. Caropreso’s tireless efforts, 1,000 surgeons communicate approximately 20-100 times a day. In total, more than 5 million e-mails have been distributed in 18 months. Soon, this will morph into the Rural Surgical Community, with much-improved software, which also will be used by the rest of the College Fellows in their respective fields of interest.
Rural surgeons, like most surgeons, pride themselves on being individualists who can solve problems with limited resources. The Advisory Council for Rural Surgery is helping these individuals find a common place for education, advocacy, quality care, communication, and fellowship. Rural surgery is transforming from disparate surgeons in isolated areas to a common group of Fellows dedicated to the highest principles of the American College of Surgeons.
Dr. Hughes, an ACS Fellow, is a general surgeon practicing in McPherson, Kan., and chair of the ACS Advisory Council for Rural Surgery.
ACS hosts IQ Forums in Ohio and South Carolina
The American College of Surgeons (ACS) recently hosted two Surgical Health Care Quality Forums, one March 28 at The Ohio State University (OSU), Columbus, and the other, April 1 in Columbia, SC. The two events were part of a series of Inspiring Quality programs aimed at infusing community participation into the national discussion on quality improvement. Presentations at the Ohio Forum focused on improving the quality of surgical care and reducing complications and costs. Participants at the South Carolina forum, which was presented in partnership with Safe Surgery 2015 and the South Carolina Hospital Association, examined the successes of the Surgical Safety Checklist and best practices now used in all of the state’s operating rooms (ORs).
In his keynote address at the Ohio forum, Greg Moody, Director, Office of Health Transformation, State of Ohio, focused on the need for payment and delivery system reform and the state’s comprehensive approach to health care reform. E. Christopher Ellison, MD, FACS, and Susan D. Moffatt-Bruce, MD, PhD, FACS, cohosted the program. Dr. Ellison is distinguished professor and Robert M. Zollinger Professor of Surgery; chief executive officer, faculty group practice; vice-dean, clinical affairs; and general surgeon, OSU College of Medicine. Dr. Moffat-Bruce is chief quality and patient safety officer; associate dean for clinical affairs, quality and patient safety; cardiothoracic surgeon; and associate professor of surgery, division of thoracic surgery, department of surgery, OSU Wexner Medical Center.
Chad A. Rubin, MD, FACS, ACS Governor; Chair, ACS General Surgery Coding and Reimbursement Committee; and staff surgeon, Providence Hospitals, Columbia, hosted the South Carolina forum. Atul Gawande, MD, MPH, FACS, delivered the keynote address. Dr. Gawande is director, Ariadne Labs, Harvard School of Public Health (HSPH), Boston, MA; executive director, Safe Surgery 2015; general and endocrine surgeon, Brigham and Women’s Hospital, Boston; professor of surgery, Harvard Medical School; and professor, department of health policy and management, HSPH. Dr. Gawande discussed the development of the World Health Organization’s OR checklist, implementation of Safe Surgery 2015’s approach to checklists, and the impact on quality of engaging all members of the surgical team.
View a complete list of Ohio Forum participants, a video archive, and photos from the event on the ACS Inspiring Quality website at http://inspiringquality.facs.org/national-tour/ohio/. View a complete list of South Carolina Forum participants and a video on the ACS IQ website at http://inspiringquality.facs.org/national-tour/south-carolina/. For more information, e-mail [email protected].
The American College of Surgeons (ACS) recently hosted two Surgical Health Care Quality Forums, one March 28 at The Ohio State University (OSU), Columbus, and the other, April 1 in Columbia, SC. The two events were part of a series of Inspiring Quality programs aimed at infusing community participation into the national discussion on quality improvement. Presentations at the Ohio Forum focused on improving the quality of surgical care and reducing complications and costs. Participants at the South Carolina forum, which was presented in partnership with Safe Surgery 2015 and the South Carolina Hospital Association, examined the successes of the Surgical Safety Checklist and best practices now used in all of the state’s operating rooms (ORs).
In his keynote address at the Ohio forum, Greg Moody, Director, Office of Health Transformation, State of Ohio, focused on the need for payment and delivery system reform and the state’s comprehensive approach to health care reform. E. Christopher Ellison, MD, FACS, and Susan D. Moffatt-Bruce, MD, PhD, FACS, cohosted the program. Dr. Ellison is distinguished professor and Robert M. Zollinger Professor of Surgery; chief executive officer, faculty group practice; vice-dean, clinical affairs; and general surgeon, OSU College of Medicine. Dr. Moffat-Bruce is chief quality and patient safety officer; associate dean for clinical affairs, quality and patient safety; cardiothoracic surgeon; and associate professor of surgery, division of thoracic surgery, department of surgery, OSU Wexner Medical Center.
Chad A. Rubin, MD, FACS, ACS Governor; Chair, ACS General Surgery Coding and Reimbursement Committee; and staff surgeon, Providence Hospitals, Columbia, hosted the South Carolina forum. Atul Gawande, MD, MPH, FACS, delivered the keynote address. Dr. Gawande is director, Ariadne Labs, Harvard School of Public Health (HSPH), Boston, MA; executive director, Safe Surgery 2015; general and endocrine surgeon, Brigham and Women’s Hospital, Boston; professor of surgery, Harvard Medical School; and professor, department of health policy and management, HSPH. Dr. Gawande discussed the development of the World Health Organization’s OR checklist, implementation of Safe Surgery 2015’s approach to checklists, and the impact on quality of engaging all members of the surgical team.
View a complete list of Ohio Forum participants, a video archive, and photos from the event on the ACS Inspiring Quality website at http://inspiringquality.facs.org/national-tour/ohio/. View a complete list of South Carolina Forum participants and a video on the ACS IQ website at http://inspiringquality.facs.org/national-tour/south-carolina/. For more information, e-mail [email protected].
The American College of Surgeons (ACS) recently hosted two Surgical Health Care Quality Forums, one March 28 at The Ohio State University (OSU), Columbus, and the other, April 1 in Columbia, SC. The two events were part of a series of Inspiring Quality programs aimed at infusing community participation into the national discussion on quality improvement. Presentations at the Ohio Forum focused on improving the quality of surgical care and reducing complications and costs. Participants at the South Carolina forum, which was presented in partnership with Safe Surgery 2015 and the South Carolina Hospital Association, examined the successes of the Surgical Safety Checklist and best practices now used in all of the state’s operating rooms (ORs).
In his keynote address at the Ohio forum, Greg Moody, Director, Office of Health Transformation, State of Ohio, focused on the need for payment and delivery system reform and the state’s comprehensive approach to health care reform. E. Christopher Ellison, MD, FACS, and Susan D. Moffatt-Bruce, MD, PhD, FACS, cohosted the program. Dr. Ellison is distinguished professor and Robert M. Zollinger Professor of Surgery; chief executive officer, faculty group practice; vice-dean, clinical affairs; and general surgeon, OSU College of Medicine. Dr. Moffat-Bruce is chief quality and patient safety officer; associate dean for clinical affairs, quality and patient safety; cardiothoracic surgeon; and associate professor of surgery, division of thoracic surgery, department of surgery, OSU Wexner Medical Center.
Chad A. Rubin, MD, FACS, ACS Governor; Chair, ACS General Surgery Coding and Reimbursement Committee; and staff surgeon, Providence Hospitals, Columbia, hosted the South Carolina forum. Atul Gawande, MD, MPH, FACS, delivered the keynote address. Dr. Gawande is director, Ariadne Labs, Harvard School of Public Health (HSPH), Boston, MA; executive director, Safe Surgery 2015; general and endocrine surgeon, Brigham and Women’s Hospital, Boston; professor of surgery, Harvard Medical School; and professor, department of health policy and management, HSPH. Dr. Gawande discussed the development of the World Health Organization’s OR checklist, implementation of Safe Surgery 2015’s approach to checklists, and the impact on quality of engaging all members of the surgical team.
View a complete list of Ohio Forum participants, a video archive, and photos from the event on the ACS Inspiring Quality website at http://inspiringquality.facs.org/national-tour/ohio/. View a complete list of South Carolina Forum participants and a video on the ACS IQ website at http://inspiringquality.facs.org/national-tour/south-carolina/. For more information, e-mail [email protected].
Dr. Hall appointed co-chair of NQF Admissions and Readmissions Committee
American College of Surgeons’ (ACS) nominee Bruce Lee Hall, MD, PhD, MBA, FACS, was recently appointed co-chair of the National Quality Forum’s (NQF) Admissions and Readmissions Standing Committee. The NQF is a multi-stakeholder, not-for-profit organization that builds consensus on national priorities and goals for performance improvement.
The expert panel will review measures addressing length of stay and all-cause admissions and hospital readmissions from applicable settings and will conduct an ad hoc review of the hospital-wide, all-cause, unplanned readmissions measure.
Dr. Hall is professor of surgery at Washington University School of Medicine; professor of health care administration at Washington University’s Olin Business School; vice-president of patient-centered outcomes for BJC Healthcare in St. Louis, MO; and associate director of the ACS National Surgical Quality Improvement Program. He also has served on other NQF committees, including the Hospital-wide Readmission Measure Steering Committee and the Planned Readmissions Measures Technical Expert Review Committee.
For details about the appointment, go to http://www. qualityforum.org/Project_Pages/All-Cause_Admissions_and_Readmissions_Measures.aspx#t=1&s=&p.
American College of Surgeons’ (ACS) nominee Bruce Lee Hall, MD, PhD, MBA, FACS, was recently appointed co-chair of the National Quality Forum’s (NQF) Admissions and Readmissions Standing Committee. The NQF is a multi-stakeholder, not-for-profit organization that builds consensus on national priorities and goals for performance improvement.
The expert panel will review measures addressing length of stay and all-cause admissions and hospital readmissions from applicable settings and will conduct an ad hoc review of the hospital-wide, all-cause, unplanned readmissions measure.
Dr. Hall is professor of surgery at Washington University School of Medicine; professor of health care administration at Washington University’s Olin Business School; vice-president of patient-centered outcomes for BJC Healthcare in St. Louis, MO; and associate director of the ACS National Surgical Quality Improvement Program. He also has served on other NQF committees, including the Hospital-wide Readmission Measure Steering Committee and the Planned Readmissions Measures Technical Expert Review Committee.
For details about the appointment, go to http://www. qualityforum.org/Project_Pages/All-Cause_Admissions_and_Readmissions_Measures.aspx#t=1&s=&p.
American College of Surgeons’ (ACS) nominee Bruce Lee Hall, MD, PhD, MBA, FACS, was recently appointed co-chair of the National Quality Forum’s (NQF) Admissions and Readmissions Standing Committee. The NQF is a multi-stakeholder, not-for-profit organization that builds consensus on national priorities and goals for performance improvement.
The expert panel will review measures addressing length of stay and all-cause admissions and hospital readmissions from applicable settings and will conduct an ad hoc review of the hospital-wide, all-cause, unplanned readmissions measure.
Dr. Hall is professor of surgery at Washington University School of Medicine; professor of health care administration at Washington University’s Olin Business School; vice-president of patient-centered outcomes for BJC Healthcare in St. Louis, MO; and associate director of the ACS National Surgical Quality Improvement Program. He also has served on other NQF committees, including the Hospital-wide Readmission Measure Steering Committee and the Planned Readmissions Measures Technical Expert Review Committee.
For details about the appointment, go to http://www. qualityforum.org/Project_Pages/All-Cause_Admissions_and_Readmissions_Measures.aspx#t=1&s=&p.
Physicians found to overuse ‘low-value’ Medicare services
Clinicians seem to be overusing "low-value" medical services that provide little or no benefit to Medicare beneficiaries, according to a report published online May 12 in JAMA Internal Medicine.
In the study, Harvard researchers developed 26 claims-based measures drawn from evidence-based lists of services providing minimal clinical benefit. Categories included low-value cancer screening, diagnostic and preventive testing, imaging, and surgical procedures. In all, the study tracked more than 1.3 million Medicare beneficiaries’ claims from 2009, analyzing the proportion of them receiving such services, mean-per-beneficiary service use, and the proportion of total spending devoted to the services.
Among the study’s 26 designated measures of low-value services: cervical cancer screening for women 65 years and older, computed tomography scanning of the sinuses for uncomplicated acute rhinosinusitis, head imaging for uncomplicated headache, preoperative cardiac stress testing, and back imaging for patients with nonspecific low back pain. Researchers tweaked measures by age, symptoms, and site of care, creating different levels of sensitivity for each measure (i.e., a more sensitive, less specific baseline definition, along with a less sensitive, more specific definition with additional restrictions).
Nationwide, between 25% and 42% of beneficiaries received low-value services, accounting for as much as $8.4 billion, or 2.7% of annual spending for services covered by Medicare Parts A and B, the researchers estimated (JAMA Intern. Med. 2014 [doi: 10.1001/jamainternmed.2014.1541]).
"Now that we have this measurement tool, we can use it to try to better understand when overuse is happening and what can be done to reduce it," Aaron Schwartz, the study’s lead author, who is in the MD-PhD program at Harvard Medical School, Boston, said in an interview.
Researchers sought to "cast a broad net" in creating a low-value medical services index that could be tracked over time and used to evaluate various reform efforts, Mr. Schwartz said. "For the vast majority of services, whether it’s ‘low value’ or ‘high value’ really depends on the patient and the clinical setting," he said. Analyzing the use of different services within various geographic areas, researchers found that even geographic areas spending less on low-value Medicare services "still spent a lot on them," he said.
Payment reforms, such as global – or bundled – payment models, could afford greater discretion to clinicians in identifying low-value services and in finding incentives to eliminate them, according to Mr. Schwartz. "Our team generally favors proposals that retain provider discretion at point of care," he said.
The study’s results are "consistent with extensive overuse in the system ... even with just 26 measures," Mr. Schwartz noted. But many claims-based measures of overuse may not be accurate enough to support targeted coverage or payment policies without resulting in unintended consequences, he cautioned.
Arkansas Medicaid Director Dr. William Golden said the Harvard study’s findings are not surprising, with physicians’ overuse of "low-value" services extending beyond Medicare. But new payment strategies and financial incentives, such as those employed by his state Medicaid program, seem to be helping to change such practice patterns and manage total cost of care, he said.
"Low-value activities are embedded throughout the routine orders of health care," Dr. Golden said in an interview. "Since Arkansas Medicaid has made health providers accountable for total cost of care and included shared savings and cost sharing, the health care community has invested the time and energy to retrain clinical reflexive behavior. Delineation of effective strategies coupled with financial incentives has promise to be a promising strategy in our state."
Mr. Schwartz reported having no conflicts of interest.
Clinicians seem to be overusing "low-value" medical services that provide little or no benefit to Medicare beneficiaries, according to a report published online May 12 in JAMA Internal Medicine.
In the study, Harvard researchers developed 26 claims-based measures drawn from evidence-based lists of services providing minimal clinical benefit. Categories included low-value cancer screening, diagnostic and preventive testing, imaging, and surgical procedures. In all, the study tracked more than 1.3 million Medicare beneficiaries’ claims from 2009, analyzing the proportion of them receiving such services, mean-per-beneficiary service use, and the proportion of total spending devoted to the services.
Among the study’s 26 designated measures of low-value services: cervical cancer screening for women 65 years and older, computed tomography scanning of the sinuses for uncomplicated acute rhinosinusitis, head imaging for uncomplicated headache, preoperative cardiac stress testing, and back imaging for patients with nonspecific low back pain. Researchers tweaked measures by age, symptoms, and site of care, creating different levels of sensitivity for each measure (i.e., a more sensitive, less specific baseline definition, along with a less sensitive, more specific definition with additional restrictions).
Nationwide, between 25% and 42% of beneficiaries received low-value services, accounting for as much as $8.4 billion, or 2.7% of annual spending for services covered by Medicare Parts A and B, the researchers estimated (JAMA Intern. Med. 2014 [doi: 10.1001/jamainternmed.2014.1541]).
"Now that we have this measurement tool, we can use it to try to better understand when overuse is happening and what can be done to reduce it," Aaron Schwartz, the study’s lead author, who is in the MD-PhD program at Harvard Medical School, Boston, said in an interview.
Researchers sought to "cast a broad net" in creating a low-value medical services index that could be tracked over time and used to evaluate various reform efforts, Mr. Schwartz said. "For the vast majority of services, whether it’s ‘low value’ or ‘high value’ really depends on the patient and the clinical setting," he said. Analyzing the use of different services within various geographic areas, researchers found that even geographic areas spending less on low-value Medicare services "still spent a lot on them," he said.
Payment reforms, such as global – or bundled – payment models, could afford greater discretion to clinicians in identifying low-value services and in finding incentives to eliminate them, according to Mr. Schwartz. "Our team generally favors proposals that retain provider discretion at point of care," he said.
The study’s results are "consistent with extensive overuse in the system ... even with just 26 measures," Mr. Schwartz noted. But many claims-based measures of overuse may not be accurate enough to support targeted coverage or payment policies without resulting in unintended consequences, he cautioned.
Arkansas Medicaid Director Dr. William Golden said the Harvard study’s findings are not surprising, with physicians’ overuse of "low-value" services extending beyond Medicare. But new payment strategies and financial incentives, such as those employed by his state Medicaid program, seem to be helping to change such practice patterns and manage total cost of care, he said.
"Low-value activities are embedded throughout the routine orders of health care," Dr. Golden said in an interview. "Since Arkansas Medicaid has made health providers accountable for total cost of care and included shared savings and cost sharing, the health care community has invested the time and energy to retrain clinical reflexive behavior. Delineation of effective strategies coupled with financial incentives has promise to be a promising strategy in our state."
Mr. Schwartz reported having no conflicts of interest.
Clinicians seem to be overusing "low-value" medical services that provide little or no benefit to Medicare beneficiaries, according to a report published online May 12 in JAMA Internal Medicine.
In the study, Harvard researchers developed 26 claims-based measures drawn from evidence-based lists of services providing minimal clinical benefit. Categories included low-value cancer screening, diagnostic and preventive testing, imaging, and surgical procedures. In all, the study tracked more than 1.3 million Medicare beneficiaries’ claims from 2009, analyzing the proportion of them receiving such services, mean-per-beneficiary service use, and the proportion of total spending devoted to the services.
Among the study’s 26 designated measures of low-value services: cervical cancer screening for women 65 years and older, computed tomography scanning of the sinuses for uncomplicated acute rhinosinusitis, head imaging for uncomplicated headache, preoperative cardiac stress testing, and back imaging for patients with nonspecific low back pain. Researchers tweaked measures by age, symptoms, and site of care, creating different levels of sensitivity for each measure (i.e., a more sensitive, less specific baseline definition, along with a less sensitive, more specific definition with additional restrictions).
Nationwide, between 25% and 42% of beneficiaries received low-value services, accounting for as much as $8.4 billion, or 2.7% of annual spending for services covered by Medicare Parts A and B, the researchers estimated (JAMA Intern. Med. 2014 [doi: 10.1001/jamainternmed.2014.1541]).
"Now that we have this measurement tool, we can use it to try to better understand when overuse is happening and what can be done to reduce it," Aaron Schwartz, the study’s lead author, who is in the MD-PhD program at Harvard Medical School, Boston, said in an interview.
Researchers sought to "cast a broad net" in creating a low-value medical services index that could be tracked over time and used to evaluate various reform efforts, Mr. Schwartz said. "For the vast majority of services, whether it’s ‘low value’ or ‘high value’ really depends on the patient and the clinical setting," he said. Analyzing the use of different services within various geographic areas, researchers found that even geographic areas spending less on low-value Medicare services "still spent a lot on them," he said.
Payment reforms, such as global – or bundled – payment models, could afford greater discretion to clinicians in identifying low-value services and in finding incentives to eliminate them, according to Mr. Schwartz. "Our team generally favors proposals that retain provider discretion at point of care," he said.
The study’s results are "consistent with extensive overuse in the system ... even with just 26 measures," Mr. Schwartz noted. But many claims-based measures of overuse may not be accurate enough to support targeted coverage or payment policies without resulting in unintended consequences, he cautioned.
Arkansas Medicaid Director Dr. William Golden said the Harvard study’s findings are not surprising, with physicians’ overuse of "low-value" services extending beyond Medicare. But new payment strategies and financial incentives, such as those employed by his state Medicaid program, seem to be helping to change such practice patterns and manage total cost of care, he said.
"Low-value activities are embedded throughout the routine orders of health care," Dr. Golden said in an interview. "Since Arkansas Medicaid has made health providers accountable for total cost of care and included shared savings and cost sharing, the health care community has invested the time and energy to retrain clinical reflexive behavior. Delineation of effective strategies coupled with financial incentives has promise to be a promising strategy in our state."
Mr. Schwartz reported having no conflicts of interest.
OGB Medical Director Sought
The American College of Surgeons (ACS) is conducting a search for a full-time Medical Director of Operation Giving Back (OGB), Division of Member Services. The individual selected for this position will be based in the ACS headquarters, Chicago, IL, and will work with staff throughout the organization.
The OGB Medical Director is responsible for the strategy, design, development, and implementation of the College’s humanitarian programs. OGB programs include voluntary clinical care, education and training, and disaster response. The Medical Director will facilitate and integrate ACS members into the humanitarian efforts of the College, publicize the contributions made by ACS members, and underscore the essential role of surgery in global health care. Frequent contributions to the medical literature are required, as are oral presentations to a broad range of audiences. The Medical Director also will maintain an OGB website informing ACS Members of opportunities for humanitarian outreach.
OGB strives to leverage the surgical community’s passion, skill, and humanitarian calling to meet the needs of medically underserved populations. The program provides the tools necessary to facilitate humanitarian outreach among surgeons of all specialties at all stages of their career and promotes both domestic and international service.
Interested applicants should send a curriculum vitae and a statement of interest to [email protected]. Applications will be accepted through May 30. View the full job description online at https://www.linkedin.com/jobs2/view/13064306.
The American College of Surgeons is an Equal Opportunity/Affirmative Action Employer, AA/EEO/M/F/D/V.)
The American College of Surgeons (ACS) is conducting a search for a full-time Medical Director of Operation Giving Back (OGB), Division of Member Services. The individual selected for this position will be based in the ACS headquarters, Chicago, IL, and will work with staff throughout the organization.
The OGB Medical Director is responsible for the strategy, design, development, and implementation of the College’s humanitarian programs. OGB programs include voluntary clinical care, education and training, and disaster response. The Medical Director will facilitate and integrate ACS members into the humanitarian efforts of the College, publicize the contributions made by ACS members, and underscore the essential role of surgery in global health care. Frequent contributions to the medical literature are required, as are oral presentations to a broad range of audiences. The Medical Director also will maintain an OGB website informing ACS Members of opportunities for humanitarian outreach.
OGB strives to leverage the surgical community’s passion, skill, and humanitarian calling to meet the needs of medically underserved populations. The program provides the tools necessary to facilitate humanitarian outreach among surgeons of all specialties at all stages of their career and promotes both domestic and international service.
Interested applicants should send a curriculum vitae and a statement of interest to [email protected]. Applications will be accepted through May 30. View the full job description online at https://www.linkedin.com/jobs2/view/13064306.
The American College of Surgeons is an Equal Opportunity/Affirmative Action Employer, AA/EEO/M/F/D/V.)
The American College of Surgeons (ACS) is conducting a search for a full-time Medical Director of Operation Giving Back (OGB), Division of Member Services. The individual selected for this position will be based in the ACS headquarters, Chicago, IL, and will work with staff throughout the organization.
The OGB Medical Director is responsible for the strategy, design, development, and implementation of the College’s humanitarian programs. OGB programs include voluntary clinical care, education and training, and disaster response. The Medical Director will facilitate and integrate ACS members into the humanitarian efforts of the College, publicize the contributions made by ACS members, and underscore the essential role of surgery in global health care. Frequent contributions to the medical literature are required, as are oral presentations to a broad range of audiences. The Medical Director also will maintain an OGB website informing ACS Members of opportunities for humanitarian outreach.
OGB strives to leverage the surgical community’s passion, skill, and humanitarian calling to meet the needs of medically underserved populations. The program provides the tools necessary to facilitate humanitarian outreach among surgeons of all specialties at all stages of their career and promotes both domestic and international service.
Interested applicants should send a curriculum vitae and a statement of interest to [email protected]. Applications will be accepted through May 30. View the full job description online at https://www.linkedin.com/jobs2/view/13064306.
The American College of Surgeons is an Equal Opportunity/Affirmative Action Employer, AA/EEO/M/F/D/V.)
Register for ACS Comprehensive General Surgery Review Course
The American College of Surgeons (ACS) Comprehensive General Surgery Review Course, June 19-22 in Chicago, IL, is an intensive three-and-a-half-day review course covering essential content areas in general surgery, including abdomen, alimentary tract, endocrine, oncology, perioperative care, skin and breast, surgical critical care, trauma, and vascular operations. Course Chair John A. Weigelt, MD, DVM, FACS, and a distinguished faculty will use didactic and case-based formats for a comprehensive and practical review. Dr. Weigelt is Medical Director of the ACS Surgical Education and Self-Assessment Program (SESAP®), professor of surgery, chief of the division of trauma and critical care, and associate dean of clinical quality at the Medical College of Wisconsin, Milwaukee. The course will feature a variety of self-assessment materials as well as five monthly online modules following the course. Organized by the ACS Division of Education, this course will help fulfill the requirements for Maintenance of Certification, Part 2, and should be helpful to surgeons preparing for recertification examinations. Self-assessment credit will be available. Space is limited and registration will be accepted on a first-come, first-served basis. For more information and to register for the course, view the ACS website at http://www.facs.org/education/reviewcourse.html, e-mail [email protected], or call 312-202-5018.
The American College of Surgeons (ACS) Comprehensive General Surgery Review Course, June 19-22 in Chicago, IL, is an intensive three-and-a-half-day review course covering essential content areas in general surgery, including abdomen, alimentary tract, endocrine, oncology, perioperative care, skin and breast, surgical critical care, trauma, and vascular operations. Course Chair John A. Weigelt, MD, DVM, FACS, and a distinguished faculty will use didactic and case-based formats for a comprehensive and practical review. Dr. Weigelt is Medical Director of the ACS Surgical Education and Self-Assessment Program (SESAP®), professor of surgery, chief of the division of trauma and critical care, and associate dean of clinical quality at the Medical College of Wisconsin, Milwaukee. The course will feature a variety of self-assessment materials as well as five monthly online modules following the course. Organized by the ACS Division of Education, this course will help fulfill the requirements for Maintenance of Certification, Part 2, and should be helpful to surgeons preparing for recertification examinations. Self-assessment credit will be available. Space is limited and registration will be accepted on a first-come, first-served basis. For more information and to register for the course, view the ACS website at http://www.facs.org/education/reviewcourse.html, e-mail [email protected], or call 312-202-5018.
The American College of Surgeons (ACS) Comprehensive General Surgery Review Course, June 19-22 in Chicago, IL, is an intensive three-and-a-half-day review course covering essential content areas in general surgery, including abdomen, alimentary tract, endocrine, oncology, perioperative care, skin and breast, surgical critical care, trauma, and vascular operations. Course Chair John A. Weigelt, MD, DVM, FACS, and a distinguished faculty will use didactic and case-based formats for a comprehensive and practical review. Dr. Weigelt is Medical Director of the ACS Surgical Education and Self-Assessment Program (SESAP®), professor of surgery, chief of the division of trauma and critical care, and associate dean of clinical quality at the Medical College of Wisconsin, Milwaukee. The course will feature a variety of self-assessment materials as well as five monthly online modules following the course. Organized by the ACS Division of Education, this course will help fulfill the requirements for Maintenance of Certification, Part 2, and should be helpful to surgeons preparing for recertification examinations. Self-assessment credit will be available. Space is limited and registration will be accepted on a first-come, first-served basis. For more information and to register for the course, view the ACS website at http://www.facs.org/education/reviewcourse.html, e-mail [email protected], or call 312-202-5018.
AMT contributes to 1913 Legacy Leadership Gift
The Board of Directors of the American College of Surgeons (ACS) Foundation recently announced that Applied Medical Technology, Inc. (AMT) has committed to contributing a 1913 Legacy Campaign Leadership Gift ($100,000 and up), bringing the total raised to date for the campaign to $1.8 million. The goal of the campaign is to raise a total of $5 million. AMT joins more than 170 Fellows and organizations that have contributed to the program to support College priorities such as professional development, patient education, optimal patient care, rural surgery initiatives, and surgical volunteerism.
AMT’s donation will support the ACS Surgical Patient Education Program, specifically for the development and distribution of 2,500 skills kits on enteral feeding tubes to educate patients and their families about self-care following hospital discharge.
Read about the ACS Surgical Patient Education Program at http://www.facs.org/news//2014/home-skills0414.html. For more information about the 1913 Legacy Campaign, go to http://www.facs.org/1913campaign.
The Board of Directors of the American College of Surgeons (ACS) Foundation recently announced that Applied Medical Technology, Inc. (AMT) has committed to contributing a 1913 Legacy Campaign Leadership Gift ($100,000 and up), bringing the total raised to date for the campaign to $1.8 million. The goal of the campaign is to raise a total of $5 million. AMT joins more than 170 Fellows and organizations that have contributed to the program to support College priorities such as professional development, patient education, optimal patient care, rural surgery initiatives, and surgical volunteerism.
AMT’s donation will support the ACS Surgical Patient Education Program, specifically for the development and distribution of 2,500 skills kits on enteral feeding tubes to educate patients and their families about self-care following hospital discharge.
Read about the ACS Surgical Patient Education Program at http://www.facs.org/news//2014/home-skills0414.html. For more information about the 1913 Legacy Campaign, go to http://www.facs.org/1913campaign.
The Board of Directors of the American College of Surgeons (ACS) Foundation recently announced that Applied Medical Technology, Inc. (AMT) has committed to contributing a 1913 Legacy Campaign Leadership Gift ($100,000 and up), bringing the total raised to date for the campaign to $1.8 million. The goal of the campaign is to raise a total of $5 million. AMT joins more than 170 Fellows and organizations that have contributed to the program to support College priorities such as professional development, patient education, optimal patient care, rural surgery initiatives, and surgical volunteerism.
AMT’s donation will support the ACS Surgical Patient Education Program, specifically for the development and distribution of 2,500 skills kits on enteral feeding tubes to educate patients and their families about self-care following hospital discharge.
Read about the ACS Surgical Patient Education Program at http://www.facs.org/news//2014/home-skills0414.html. For more information about the 1913 Legacy Campaign, go to http://www.facs.org/1913campaign.
Register for Diadactic and Skills Courses
The American College of Surgeons (ACS) will offer several new Didactic Courses (DC) and Skills Courses (SC) at the 2014 Clinical Congress, October 26-30, in San Francisco, CA, including the following:
• SC08 Social Media for Surgeons will focus on surgeons’ daily use of health care social media to enhance patient care and outcomes, medical student and resident education, career development and personal networking.
• DC20 How to Use ACS National Surgical Quality Improvement Program, Trauma Quality Improvement Program, Cancer Quality Improvement Program, and the Surgeon Specific Registry in Your Institution will review the available programs and how surgeons may harness the information to drive quality improvement in their institutions that ultimately improves patient care.
• DC23 Reorganizing Care to Optimize Outcomes: How to Start an Enhanced Recover-after-Surgery Program at Your Hospital will provide a practical review of the components for creating enhanced recovery pathway (ERP) programs in digestive surgery. Course participants will discuss strategies for reorganization of care.
Several DC and SC Courses are back by popular demand. Reserve your space early for these courses:
• SC04 Measurement and Analysis for Health Care Delivery Transformation
• SC05 Ultrasound for Pediatric Surgeons
• SC06 Telemedicine: The Rapidly Expanding Field of Video-Based Telemedicine Health Care
• DC14 Emergency General Surgery Update
• DC19 MOC Review: Essentials for Surgical Specialties
• DC22 Employing an Allied Health Professional in Your Surgical Practice
Check the ACS website in early June when online registration opens for these and other courses at the 2014 Annual Clinical Congress. A Clinical Congress preview is now posted at http://www.facs.org/clincon2014/index.html.
The American College of Surgeons (ACS) will offer several new Didactic Courses (DC) and Skills Courses (SC) at the 2014 Clinical Congress, October 26-30, in San Francisco, CA, including the following:
• SC08 Social Media for Surgeons will focus on surgeons’ daily use of health care social media to enhance patient care and outcomes, medical student and resident education, career development and personal networking.
• DC20 How to Use ACS National Surgical Quality Improvement Program, Trauma Quality Improvement Program, Cancer Quality Improvement Program, and the Surgeon Specific Registry in Your Institution will review the available programs and how surgeons may harness the information to drive quality improvement in their institutions that ultimately improves patient care.
• DC23 Reorganizing Care to Optimize Outcomes: How to Start an Enhanced Recover-after-Surgery Program at Your Hospital will provide a practical review of the components for creating enhanced recovery pathway (ERP) programs in digestive surgery. Course participants will discuss strategies for reorganization of care.
Several DC and SC Courses are back by popular demand. Reserve your space early for these courses:
• SC04 Measurement and Analysis for Health Care Delivery Transformation
• SC05 Ultrasound for Pediatric Surgeons
• SC06 Telemedicine: The Rapidly Expanding Field of Video-Based Telemedicine Health Care
• DC14 Emergency General Surgery Update
• DC19 MOC Review: Essentials for Surgical Specialties
• DC22 Employing an Allied Health Professional in Your Surgical Practice
Check the ACS website in early June when online registration opens for these and other courses at the 2014 Annual Clinical Congress. A Clinical Congress preview is now posted at http://www.facs.org/clincon2014/index.html.
The American College of Surgeons (ACS) will offer several new Didactic Courses (DC) and Skills Courses (SC) at the 2014 Clinical Congress, October 26-30, in San Francisco, CA, including the following:
• SC08 Social Media for Surgeons will focus on surgeons’ daily use of health care social media to enhance patient care and outcomes, medical student and resident education, career development and personal networking.
• DC20 How to Use ACS National Surgical Quality Improvement Program, Trauma Quality Improvement Program, Cancer Quality Improvement Program, and the Surgeon Specific Registry in Your Institution will review the available programs and how surgeons may harness the information to drive quality improvement in their institutions that ultimately improves patient care.
• DC23 Reorganizing Care to Optimize Outcomes: How to Start an Enhanced Recover-after-Surgery Program at Your Hospital will provide a practical review of the components for creating enhanced recovery pathway (ERP) programs in digestive surgery. Course participants will discuss strategies for reorganization of care.
Several DC and SC Courses are back by popular demand. Reserve your space early for these courses:
• SC04 Measurement and Analysis for Health Care Delivery Transformation
• SC05 Ultrasound for Pediatric Surgeons
• SC06 Telemedicine: The Rapidly Expanding Field of Video-Based Telemedicine Health Care
• DC14 Emergency General Surgery Update
• DC19 MOC Review: Essentials for Surgical Specialties
• DC22 Employing an Allied Health Professional in Your Surgical Practice
Check the ACS website in early June when online registration opens for these and other courses at the 2014 Annual Clinical Congress. A Clinical Congress preview is now posted at http://www.facs.org/clincon2014/index.html.
ACS Committee on Diversity Issues seeks new members
The American College of Surgeons (ACS) Committee on Diversity Issues, chaired by Anthony G. Charles, MB, BS, FACS, University of North Carolina Medical Center, Chapel Hill, studies the educational and professional needs of underrepresented surgeons and surgical trainees and the impact that its work may have on eliminating of health disparities among diverse population groups in the U.S. and globally.
The committee currently seeks candidates to serve an initial three-year term, which would begin in October 2014. Surgeons interested in advancing cultural competency in surgical care and in developing efforts to expand diversity among the ACS membership are encouraged to apply. The committee seeks representation by individuals of diverse cultural, racial, and ethnic backgrounds. Applicants should submit their curriculum vitae and a letter of interest highlighting their skills and expertise along with contributions they could make to the committee to Connie Bura at [email protected] by June 30. The committee will select eligible candidates and notify them in July and August. Those selected will be invited to attend the committee meeting that will take place during the 2014 Clinical Congress October 26-30 in San Francisco, CA.
The American College of Surgeons (ACS) Committee on Diversity Issues, chaired by Anthony G. Charles, MB, BS, FACS, University of North Carolina Medical Center, Chapel Hill, studies the educational and professional needs of underrepresented surgeons and surgical trainees and the impact that its work may have on eliminating of health disparities among diverse population groups in the U.S. and globally.
The committee currently seeks candidates to serve an initial three-year term, which would begin in October 2014. Surgeons interested in advancing cultural competency in surgical care and in developing efforts to expand diversity among the ACS membership are encouraged to apply. The committee seeks representation by individuals of diverse cultural, racial, and ethnic backgrounds. Applicants should submit their curriculum vitae and a letter of interest highlighting their skills and expertise along with contributions they could make to the committee to Connie Bura at [email protected] by June 30. The committee will select eligible candidates and notify them in July and August. Those selected will be invited to attend the committee meeting that will take place during the 2014 Clinical Congress October 26-30 in San Francisco, CA.
The American College of Surgeons (ACS) Committee on Diversity Issues, chaired by Anthony G. Charles, MB, BS, FACS, University of North Carolina Medical Center, Chapel Hill, studies the educational and professional needs of underrepresented surgeons and surgical trainees and the impact that its work may have on eliminating of health disparities among diverse population groups in the U.S. and globally.
The committee currently seeks candidates to serve an initial three-year term, which would begin in October 2014. Surgeons interested in advancing cultural competency in surgical care and in developing efforts to expand diversity among the ACS membership are encouraged to apply. The committee seeks representation by individuals of diverse cultural, racial, and ethnic backgrounds. Applicants should submit their curriculum vitae and a letter of interest highlighting their skills and expertise along with contributions they could make to the committee to Connie Bura at [email protected] by June 30. The committee will select eligible candidates and notify them in July and August. Those selected will be invited to attend the committee meeting that will take place during the 2014 Clinical Congress October 26-30 in San Francisco, CA.