News From the College

As required under the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services (CMS) established the Physician Compare website in January 2011. This site currently features information on Medicare physicians and other eligible professionals (EPs) who participate in the Physician Quality Reporting System (PQRS).

In the 2013 Medicare Physician fee schedule (MPFS) final rule, CMS lays out a framework for expanding the website by collecting information on physician quality, efficiency, patient experience of care, and how such information will be made available on Physician Compare. This column details how CMS’ plan may impact surgeons. For additional information on the Physician Compare website, visit the Medicare website at http://www.medicare.gov/find-a-doctor/provider-search.aspx?AspxAutoDetectCookieSupport=1.

CMS lists basic provider information as well as information on whether a provider has successfully participated in the PQRS program and/or Electronic Prescribing (eRx) Incentive Program. CMS collects basic provider information through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS), making it imperative that the information a provider has on file in the PECOS system is up to date and accurate.

Using Physician Compare, EPs may obtain definitive information about physicians and other health care professionals by selecting a location and specialty. The results provide information on specialty, practice locations, group practice and hospital affiliations, Medicare assignment status, education, languages spoken, gender, and so on.

The ACA also mandates that CMS use the most recent incentive program information to indicate whether a professional has satisfactorily participated in the PQRS program and/or is a successful electronic prescriber under the eRx Incentive Program.

CMS is planning to include updated administrative information on an EP’s page as well as information regarding physician performance. CMS plans to enhance the administrative data by adding information on whether a physician or other health care professional is accepting new Medicare patients, board certification information, improved foreign language, and hospital affiliation data. CMS also intends to include the names of EPs who are successfully participating in the PQRS, the PQRS Maintenance of Certification bonus program, and the eRx Incentive Program. When feasible, CMS will post the names of EPs who are successfully participating in the Electronic Health Record (EHR) Incentive Program. As noted in the 2013 MPFS final rule, CMS will display an indicator on the profile Web page of an EP to acknowledge satisfactory participation in the incentive programs.

Under the ACA, CMS is required to implement a plan no later than January 1, 2013, and make publicly available on the Physician Compare website information on physician performance that provides comparable quality and patient experience measures. The 2013 fee schedule finalized CMS’ plan to use data from the existing PQRS program as a first step toward making physician measure performance information public on Physician Compare. CMS has finalized the decision to make public on Physician Compare, beginning later in 2013 or early 2014, the performance rates on the quality measures that group practices submit under the 2012 PQRS group practice reporting option Web-interface and the Medicare Shared Savings Program, as well as patient experience of care data.

Moreover, CMS will only post quality measure information on groups of 100 or more EPs and must meet a sample size of 20 patients who prove to be statistically valid and reliable. To ensure that the data are statistically valid, CMS will not report on a measure if a measure meeting the minimum threshold is invalid or unreliable for any reason. Additionally, CMS plans to post on the Physician Compare website in 2014 several composite measures that reflect group performance across related measures. CMS also intends to work with specialty societies in the future to include specialty society data that are already collected for other purposes and go through appropriate testing. Lastly, CMS plans to post information on individual-level data beginning in 2015 but will address the details of doing so in future rulemaking.

Although CMS will start posting physician performance and patient experience of care data in 2014, they will begin by only posting information on groups of 100 or more EPs. Before posting the patient experience of care data, CMS will provide group practices and accountable care organizations with a 30-day period to preview their quality data and how it will appear on the Physician Compare website. Eventually, CMS will include individual-level data on Physician Compare, and specific details on how this information will be presented will be decided in future rulemaking. EPs are encouraged to regularly check their profiles to ensure the accuracy of the information being provided.

Should there be any errors, providers are encouraged to log into their PECOS account, which is available at https://pecos.cms.hhs.gov/pecos/login.do. For more information on PECOS accounts, visit http://www.medicare.gov/find-a-doctor/staticpages/provider-resources/overview.aspx. By providing consumers with quality-of-care information, CMS’ goal is to help consumers make informed decisions about their health care and also encourage clinicians to improve the quality of care that they provide to their patients. 

Ms. Golak is the Quality Associate in the ACS Division of Advocacy and Health Policy in Washington DC.

As required under the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services (CMS) established the Physician Compare website in January 2011. This site currently features information on Medicare physicians and other eligible professionals (EPs) who participate in the Physician Quality Reporting System (PQRS).

In the 2013 Medicare Physician fee schedule (MPFS) final rule, CMS lays out a framework for expanding the website by collecting information on physician quality, efficiency, patient experience of care, and how such information will be made available on Physician Compare. This column details how CMS’ plan may impact surgeons. For additional information on the Physician Compare website, visit the Medicare website at http://www.medicare.gov/find-a-doctor/provider-search.aspx?AspxAutoDetectCookieSupport=1.

CMS lists basic provider information as well as information on whether a provider has successfully participated in the PQRS program and/or Electronic Prescribing (eRx) Incentive Program. CMS collects basic provider information through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS), making it imperative that the information a provider has on file in the PECOS system is up to date and accurate.

Using Physician Compare, EPs may obtain definitive information about physicians and other health care professionals by selecting a location and specialty. The results provide information on specialty, practice locations, group practice and hospital affiliations, Medicare assignment status, education, languages spoken, gender, and so on.

The ACA also mandates that CMS use the most recent incentive program information to indicate whether a professional has satisfactorily participated in the PQRS program and/or is a successful electronic prescriber under the eRx Incentive Program.

CMS is planning to include updated administrative information on an EP’s page as well as information regarding physician performance. CMS plans to enhance the administrative data by adding information on whether a physician or other health care professional is accepting new Medicare patients, board certification information, improved foreign language, and hospital affiliation data. CMS also intends to include the names of EPs who are successfully participating in the PQRS, the PQRS Maintenance of Certification bonus program, and the eRx Incentive Program. When feasible, CMS will post the names of EPs who are successfully participating in the Electronic Health Record (EHR) Incentive Program. As noted in the 2013 MPFS final rule, CMS will display an indicator on the profile Web page of an EP to acknowledge satisfactory participation in the incentive programs.

Under the ACA, CMS is required to implement a plan no later than January 1, 2013, and make publicly available on the Physician Compare website information on physician performance that provides comparable quality and patient experience measures. The 2013 fee schedule finalized CMS’ plan to use data from the existing PQRS program as a first step toward making physician measure performance information public on Physician Compare. CMS has finalized the decision to make public on Physician Compare, beginning later in 2013 or early 2014, the performance rates on the quality measures that group practices submit under the 2012 PQRS group practice reporting option Web-interface and the Medicare Shared Savings Program, as well as patient experience of care data.

Moreover, CMS will only post quality measure information on groups of 100 or more EPs and must meet a sample size of 20 patients who prove to be statistically valid and reliable. To ensure that the data are statistically valid, CMS will not report on a measure if a measure meeting the minimum threshold is invalid or unreliable for any reason. Additionally, CMS plans to post on the Physician Compare website in 2014 several composite measures that reflect group performance across related measures. CMS also intends to work with specialty societies in the future to include specialty society data that are already collected for other purposes and go through appropriate testing. Lastly, CMS plans to post information on individual-level data beginning in 2015 but will address the details of doing so in future rulemaking.

Although CMS will start posting physician performance and patient experience of care data in 2014, they will begin by only posting information on groups of 100 or more EPs. Before posting the patient experience of care data, CMS will provide group practices and accountable care organizations with a 30-day period to preview their quality data and how it will appear on the Physician Compare website. Eventually, CMS will include individual-level data on Physician Compare, and specific details on how this information will be presented will be decided in future rulemaking. EPs are encouraged to regularly check their profiles to ensure the accuracy of the information being provided.

Should there be any errors, providers are encouraged to log into their PECOS account, which is available at https://pecos.cms.hhs.gov/pecos/login.do. For more information on PECOS accounts, visit http://www.medicare.gov/find-a-doctor/staticpages/provider-resources/overview.aspx. By providing consumers with quality-of-care information, CMS’ goal is to help consumers make informed decisions about their health care and also encourage clinicians to improve the quality of care that they provide to their patients. 

Ms. Golak is the Quality Associate in the ACS Division of Advocacy and Health Policy in Washington DC.

As required under the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services (CMS) established the Physician Compare website in January 2011. This site currently features information on Medicare physicians and other eligible professionals (EPs) who participate in the Physician Quality Reporting System (PQRS).

In the 2013 Medicare Physician fee schedule (MPFS) final rule, CMS lays out a framework for expanding the website by collecting information on physician quality, efficiency, patient experience of care, and how such information will be made available on Physician Compare. This column details how CMS’ plan may impact surgeons. For additional information on the Physician Compare website, visit the Medicare website at http://www.medicare.gov/find-a-doctor/provider-search.aspx?AspxAutoDetectCookieSupport=1.

CMS lists basic provider information as well as information on whether a provider has successfully participated in the PQRS program and/or Electronic Prescribing (eRx) Incentive Program. CMS collects basic provider information through the Medicare Provider Enrollment, Chain, and Ownership System (PECOS), making it imperative that the information a provider has on file in the PECOS system is up to date and accurate.

Using Physician Compare, EPs may obtain definitive information about physicians and other health care professionals by selecting a location and specialty. The results provide information on specialty, practice locations, group practice and hospital affiliations, Medicare assignment status, education, languages spoken, gender, and so on.

The ACA also mandates that CMS use the most recent incentive program information to indicate whether a professional has satisfactorily participated in the PQRS program and/or is a successful electronic prescriber under the eRx Incentive Program.

CMS is planning to include updated administrative information on an EP’s page as well as information regarding physician performance. CMS plans to enhance the administrative data by adding information on whether a physician or other health care professional is accepting new Medicare patients, board certification information, improved foreign language, and hospital affiliation data. CMS also intends to include the names of EPs who are successfully participating in the PQRS, the PQRS Maintenance of Certification bonus program, and the eRx Incentive Program. When feasible, CMS will post the names of EPs who are successfully participating in the Electronic Health Record (EHR) Incentive Program. As noted in the 2013 MPFS final rule, CMS will display an indicator on the profile Web page of an EP to acknowledge satisfactory participation in the incentive programs.

Under the ACA, CMS is required to implement a plan no later than January 1, 2013, and make publicly available on the Physician Compare website information on physician performance that provides comparable quality and patient experience measures. The 2013 fee schedule finalized CMS’ plan to use data from the existing PQRS program as a first step toward making physician measure performance information public on Physician Compare. CMS has finalized the decision to make public on Physician Compare, beginning later in 2013 or early 2014, the performance rates on the quality measures that group practices submit under the 2012 PQRS group practice reporting option Web-interface and the Medicare Shared Savings Program, as well as patient experience of care data.

Moreover, CMS will only post quality measure information on groups of 100 or more EPs and must meet a sample size of 20 patients who prove to be statistically valid and reliable. To ensure that the data are statistically valid, CMS will not report on a measure if a measure meeting the minimum threshold is invalid or unreliable for any reason. Additionally, CMS plans to post on the Physician Compare website in 2014 several composite measures that reflect group performance across related measures. CMS also intends to work with specialty societies in the future to include specialty society data that are already collected for other purposes and go through appropriate testing. Lastly, CMS plans to post information on individual-level data beginning in 2015 but will address the details of doing so in future rulemaking.

Although CMS will start posting physician performance and patient experience of care data in 2014, they will begin by only posting information on groups of 100 or more EPs. Before posting the patient experience of care data, CMS will provide group practices and accountable care organizations with a 30-day period to preview their quality data and how it will appear on the Physician Compare website. Eventually, CMS will include individual-level data on Physician Compare, and specific details on how this information will be presented will be decided in future rulemaking. EPs are encouraged to regularly check their profiles to ensure the accuracy of the information being provided.

Should there be any errors, providers are encouraged to log into their PECOS account, which is available at https://pecos.cms.hhs.gov/pecos/login.do. For more information on PECOS accounts, visit http://www.medicare.gov/find-a-doctor/staticpages/provider-resources/overview.aspx. By providing consumers with quality-of-care information, CMS’ goal is to help consumers make informed decisions about their health care and also encourage clinicians to improve the quality of care that they provide to their patients. 

Ms. Golak is the Quality Associate in the ACS Division of Advocacy and Health Policy in Washington DC.

Sixteen hospitals in North Carolina have signed on to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP^®), a leading model for outcomes-based surgical quality improvement that collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database.

The following North Carolina hospitals have joined ACS NSQIP: Carolinas Medical Center, Charlotte, including branches of Lincoln in Lincolnton, Mercy in Charlotte, Northeast in Concord, Pineville in Charlotte, Union in Monroe, and University in Charlotte; Cleveland Regional Medical Center in Shelby; Columbus Regional Healthcare System Hospital in Whiteville; Grace Hospital in Morganton; Harris Regional Hospital in Sylva; Haywood Regional Medical Center in Clyde; Levine Children’s Hospital in Charlotte; Scotland Memorial Hospital in Laurinburg; Valdese Hospital in Valdese; and Stanly Regional Medical Center in Albermarie.

Go to http://site.acsnsqip.org/ for more information about ACS NSQIP.

Sixteen hospitals in North Carolina have signed on to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP^®), a leading model for outcomes-based surgical quality improvement that collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database.

The following North Carolina hospitals have joined ACS NSQIP: Carolinas Medical Center, Charlotte, including branches of Lincoln in Lincolnton, Mercy in Charlotte, Northeast in Concord, Pineville in Charlotte, Union in Monroe, and University in Charlotte; Cleveland Regional Medical Center in Shelby; Columbus Regional Healthcare System Hospital in Whiteville; Grace Hospital in Morganton; Harris Regional Hospital in Sylva; Haywood Regional Medical Center in Clyde; Levine Children’s Hospital in Charlotte; Scotland Memorial Hospital in Laurinburg; Valdese Hospital in Valdese; and Stanly Regional Medical Center in Albermarie.

Go to http://site.acsnsqip.org/ for more information about ACS NSQIP.

Sixteen hospitals in North Carolina have signed on to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP^®), a leading model for outcomes-based surgical quality improvement that collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database.

The following North Carolina hospitals have joined ACS NSQIP: Carolinas Medical Center, Charlotte, including branches of Lincoln in Lincolnton, Mercy in Charlotte, Northeast in Concord, Pineville in Charlotte, Union in Monroe, and University in Charlotte; Cleveland Regional Medical Center in Shelby; Columbus Regional Healthcare System Hospital in Whiteville; Grace Hospital in Morganton; Harris Regional Hospital in Sylva; Haywood Regional Medical Center in Clyde; Levine Children’s Hospital in Charlotte; Scotland Memorial Hospital in Laurinburg; Valdese Hospital in Valdese; and Stanly Regional Medical Center in Albermarie.

Go to http://site.acsnsqip.org/ for more information about ACS NSQIP.

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surgical Care survey is now available on the American College of Surgeons (ACS) website.

The ACS, in partnership with other surgical and anesthesia organizations and the Agency for Healthcare Research and Quality’s (AHRQ) CAHPS® Consortium, developed the survey to assess surgical patients’ experiences before, during, and after operations to identify opportunities for improving quality of care, surgical outcomes, and patient experience of care, as well as for purposes of public reporting.

The CAHPS® Surgical Care survey is a standardized patient survey that produces clear and usable comparative information for both consumers and health care providers. The CAHPS® Surgical Care Survey is the only National Quality Forum-endorsed measure designed to assess surgical quality from the patient’s perspective. Go to www.facs.org/ahp/cahps/index.html to access the survey.

The ACS is interested in learning about surgeons’ experiences in administering the CAHPS® Surgical Care Survey. To share your experience, contact Jill Shelly at [email protected] or 202-672-1507.☐

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surgical Care survey is now available on the American College of Surgeons (ACS) website.

The ACS, in partnership with other surgical and anesthesia organizations and the Agency for Healthcare Research and Quality’s (AHRQ) CAHPS® Consortium, developed the survey to assess surgical patients’ experiences before, during, and after operations to identify opportunities for improving quality of care, surgical outcomes, and patient experience of care, as well as for purposes of public reporting.

The CAHPS® Surgical Care survey is a standardized patient survey that produces clear and usable comparative information for both consumers and health care providers. The CAHPS® Surgical Care Survey is the only National Quality Forum-endorsed measure designed to assess surgical quality from the patient’s perspective. Go to www.facs.org/ahp/cahps/index.html to access the survey.

The ACS is interested in learning about surgeons’ experiences in administering the CAHPS® Surgical Care Survey. To share your experience, contact Jill Shelly at [email protected] or 202-672-1507.☐

The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Surgical Care survey is now available on the American College of Surgeons (ACS) website.

The ACS, in partnership with other surgical and anesthesia organizations and the Agency for Healthcare Research and Quality’s (AHRQ) CAHPS® Consortium, developed the survey to assess surgical patients’ experiences before, during, and after operations to identify opportunities for improving quality of care, surgical outcomes, and patient experience of care, as well as for purposes of public reporting.

The CAHPS® Surgical Care survey is a standardized patient survey that produces clear and usable comparative information for both consumers and health care providers. The CAHPS® Surgical Care Survey is the only National Quality Forum-endorsed measure designed to assess surgical quality from the patient’s perspective. Go to www.facs.org/ahp/cahps/index.html to access the survey.

The ACS is interested in learning about surgeons’ experiences in administering the CAHPS® Surgical Care Survey. To share your experience, contact Jill Shelly at [email protected] or 202-672-1507.☐

More than 70 percent of the clinicians who participated in a survey conducted earlier this year identified the following barriers to their ability to effectively exchange electronic health care information: lack of interoperability, lack of an information exchange infrastructure, and the cost of setting up and maintaining interfaces and exchanges.

The survey was conducted earlier this year by Doctors Helping Doctors Transform Health Care in collaboration with the Bipartisan Policy Center, the American College of Physicians, and other stakeholder groups. The American College of Surgeons sent out the survey.

A report summarizing the survey findings, titled Clinicians Perspectives on Electronic Health Information Sharing for Transitions of Care, contains the following additional findings:

• Most clinicians surveyed believe that electronic exchange of health information will have a positive impact on improving the quality of patient care, coordinating care, meeting the demands of new care models, and participating in third-party reporting and incentive programs.

• More than half of respondents prefer that information they view as "essential" get "pushed" to them, with the ability to access the rest of the information through a query.

• Most respondents consider "within 24 hours" a reasonable timeframe for the exchange of information when a patient requires follow-up care or is being treated for an urgent problem.

• When updating the electronic health record with information received from an external source, clinicians prefer to be able to selectively pick and choose the information they want integrated.

• Clinicians indicated that access to medication lists and relevant laboratory and imaging test results are commonly recognized as high priorities when patients change health care providers.

Go to http://bipartisanpolicy.org/library/report/accelerating-electronic-information-sharing-improve-quality-and-reduce-costs-health-c to review the report and survey results.

More than 70 percent of the clinicians who participated in a survey conducted earlier this year identified the following barriers to their ability to effectively exchange electronic health care information: lack of interoperability, lack of an information exchange infrastructure, and the cost of setting up and maintaining interfaces and exchanges.

The survey was conducted earlier this year by Doctors Helping Doctors Transform Health Care in collaboration with the Bipartisan Policy Center, the American College of Physicians, and other stakeholder groups. The American College of Surgeons sent out the survey.

A report summarizing the survey findings, titled Clinicians Perspectives on Electronic Health Information Sharing for Transitions of Care, contains the following additional findings:

• Most clinicians surveyed believe that electronic exchange of health information will have a positive impact on improving the quality of patient care, coordinating care, meeting the demands of new care models, and participating in third-party reporting and incentive programs.

• More than half of respondents prefer that information they view as "essential" get "pushed" to them, with the ability to access the rest of the information through a query.

• Most respondents consider "within 24 hours" a reasonable timeframe for the exchange of information when a patient requires follow-up care or is being treated for an urgent problem.

• When updating the electronic health record with information received from an external source, clinicians prefer to be able to selectively pick and choose the information they want integrated.

• Clinicians indicated that access to medication lists and relevant laboratory and imaging test results are commonly recognized as high priorities when patients change health care providers.

Go to http://bipartisanpolicy.org/library/report/accelerating-electronic-information-sharing-improve-quality-and-reduce-costs-health-c to review the report and survey results.

More than 70 percent of the clinicians who participated in a survey conducted earlier this year identified the following barriers to their ability to effectively exchange electronic health care information: lack of interoperability, lack of an information exchange infrastructure, and the cost of setting up and maintaining interfaces and exchanges.

The survey was conducted earlier this year by Doctors Helping Doctors Transform Health Care in collaboration with the Bipartisan Policy Center, the American College of Physicians, and other stakeholder groups. The American College of Surgeons sent out the survey.

A report summarizing the survey findings, titled Clinicians Perspectives on Electronic Health Information Sharing for Transitions of Care, contains the following additional findings:

• Most clinicians surveyed believe that electronic exchange of health information will have a positive impact on improving the quality of patient care, coordinating care, meeting the demands of new care models, and participating in third-party reporting and incentive programs.

• More than half of respondents prefer that information they view as "essential" get "pushed" to them, with the ability to access the rest of the information through a query.

• Most respondents consider "within 24 hours" a reasonable timeframe for the exchange of information when a patient requires follow-up care or is being treated for an urgent problem.

• When updating the electronic health record with information received from an external source, clinicians prefer to be able to selectively pick and choose the information they want integrated.

• Clinicians indicated that access to medication lists and relevant laboratory and imaging test results are commonly recognized as high priorities when patients change health care providers.

Go to http://bipartisanpolicy.org/library/report/accelerating-electronic-information-sharing-improve-quality-and-reduce-costs-health-c to review the report and survey results.

Staff from the American College of Surgeons Division of Advocacy and Health Policy recently attended a Magnet Safety Stakeholder Meeting at the American Academy of Pediatrics.

The group convened to address the growing number of injuries experienced by children and teens who swallow multiple high-powered, rare-earth magnets. According to studies, 10 to 20 percent of such magnet ingestions require endoscopic retrieval; approximately 1 percent require surgical intervention after multiple magnets attract inside the body causing obstruction or perforation.

Rare-earth magnets are marketed to adults as "desk toys," but according to the Consumer Product Safety Commission (CPSC), neither warning labels nor voluntary recall efforts have been effective in preventing ingestion in children. The CPSC recently proposed banning certain high-powered magnet sets due to the unreasonable risk of injury.

While most manufacturers have complied with voluntary recalls, some argue that the current safety warnings on packaging and websites are sufficient, and a safety ban is unwarranted. Comments on this proposed rule are due by November 19 to the CPSC.

To view additional information or to submit comments, go to www.cpsc.gov/info/magnets/index.html.

The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has also set up a Facebook page with supplementary information.

Surgeons who have been asked to treat magnet ingestion may report cases to the CPSC.

Do you have experience with cases of magnet ingestion that have required surgical intervention? If you have expertise in this area, contact Matthew Coffron at [email protected].

Staff from the American College of Surgeons Division of Advocacy and Health Policy recently attended a Magnet Safety Stakeholder Meeting at the American Academy of Pediatrics.

The group convened to address the growing number of injuries experienced by children and teens who swallow multiple high-powered, rare-earth magnets. According to studies, 10 to 20 percent of such magnet ingestions require endoscopic retrieval; approximately 1 percent require surgical intervention after multiple magnets attract inside the body causing obstruction or perforation.

Rare-earth magnets are marketed to adults as "desk toys," but according to the Consumer Product Safety Commission (CPSC), neither warning labels nor voluntary recall efforts have been effective in preventing ingestion in children. The CPSC recently proposed banning certain high-powered magnet sets due to the unreasonable risk of injury.

While most manufacturers have complied with voluntary recalls, some argue that the current safety warnings on packaging and websites are sufficient, and a safety ban is unwarranted. Comments on this proposed rule are due by November 19 to the CPSC.

To view additional information or to submit comments, go to www.cpsc.gov/info/magnets/index.html.

The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has also set up a Facebook page with supplementary information.

Surgeons who have been asked to treat magnet ingestion may report cases to the CPSC.

Do you have experience with cases of magnet ingestion that have required surgical intervention? If you have expertise in this area, contact Matthew Coffron at [email protected].

Staff from the American College of Surgeons Division of Advocacy and Health Policy recently attended a Magnet Safety Stakeholder Meeting at the American Academy of Pediatrics.

The group convened to address the growing number of injuries experienced by children and teens who swallow multiple high-powered, rare-earth magnets. According to studies, 10 to 20 percent of such magnet ingestions require endoscopic retrieval; approximately 1 percent require surgical intervention after multiple magnets attract inside the body causing obstruction or perforation.

Rare-earth magnets are marketed to adults as "desk toys," but according to the Consumer Product Safety Commission (CPSC), neither warning labels nor voluntary recall efforts have been effective in preventing ingestion in children. The CPSC recently proposed banning certain high-powered magnet sets due to the unreasonable risk of injury.

While most manufacturers have complied with voluntary recalls, some argue that the current safety warnings on packaging and websites are sufficient, and a safety ban is unwarranted. Comments on this proposed rule are due by November 19 to the CPSC.

To view additional information or to submit comments, go to www.cpsc.gov/info/magnets/index.html.

The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition has also set up a Facebook page with supplementary information.

Surgeons who have been asked to treat magnet ingestion may report cases to the CPSC.

Do you have experience with cases of magnet ingestion that have required surgical intervention? If you have expertise in this area, contact Matthew Coffron at [email protected].

The American College of Surgeons (ACS) in October held the ACS Surgical Health Care Quality Forum Philadelphia, the ninth stop in a national tour to drive discussions on effective quality improvement methods used by surgeons, physicians, and hospitals to improve patient safety and reduce costs.

The Philadelphia forum focused on the importance of physician-led quality improvement initiatives in sustaining better outcomes, using the ACS National Surgical Quality Improvement Program (ACS NSQIP) as a leading model that provides surgeons with reliable data to help pinpoint areas for improvement.

"We’re all faced with the challenges of navigating a complex and ever-changing health care system," said Marshall Z. Schwartz, MD, FACS, professor of surgery and pediatrics at Drexel University, pediatric surgeon-in-chief at St. Christopher’s Hospital for Children, Philadelphia, a member of the ACS Board of Regents, and event co-host. "The good news is we don’t have to re-invent the wheel to achieve the level of quality improvement and cost savings we need for health reform to be successful."

"Using proven quality improvement methods like ACS NSQIP is a perfect example of what we, as physicians, can do together to support health reform," added Howard M. Snyder III, MD, FACS, attending urologist at Children’s Hospital of Philadelphia, professor of urology in surgery at the University of Pennsylvania School of Medicine, Philadelphia, a member of the ACS Board of Regents, and event co-host.

Keynote speaker U.S. Rep. Jim Gerlach (R-PA), a member of the influential House Ways and Means Committee, cited parallels between the government’s health care reform efforts and quality improvement programs such as ACS NSQIP, which collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database. He also addressed the need to link higher quality care to reimbursement.

"The mission of the Ways and Means Committee right now is to prevent the 27 percent cuts in Medicare reimbursement and extend it until we can come up with a proper formula for reimbursing physicians," said Representative Gerlach. "You [surgeons] bring a credibility and knowledge that legislators don’t have, and I would encourage you to advocate for these changes we need to have and the programs you want to save because they work."

A 2009 study published in the Annals of Surgery determined that hospitals participating in ACS NSQIP each prevented 200-500 complications annually and saved an average of 12-36 lives per year by reducing complications. With the average cost of medical complications equaling $11,000 per occurrence, the combined potential savings of 4,500 hospitals could add up to $13-26 billion each year, amounting to an estimated total savings of $260 billion over a period of 10 years (Ann. Surg. 2009; 250:363-76).

The forum emphasized the reduction of complications with a focus on surgical outcomes – an objective that is not new in Pennsylvania.

"Pennsylvania was the first state to publicly report hospital-acquired infections and that transparency has improved the appetite for quality improvement programs in our state and around the country," said Larry R. Kaiser, MD, FACS, senior executive vice president for health services, dean, Temple University School of Medicine; and president and chief executive officer, Temple University Health System.

"Surgeons trust and embrace clinical data which is why the Society of Thoracic Surgeons National Database and ACS NSQIP have been successful tools to reduce complications and improve patient care," he added.

"For ten years, Geisinger has focused on an intervention framework to identify variation in care and re-engineer best practices, resulting in decreased costs and improved quality," said Glenn D. Steele Jr., MD, PhD, FACS, president and chief executive officer, Geisinger Health System, Danville, PA. "Surgery departments present a clear opportunity to define complications and implement and assess solutions, as there is a distinct starting and end point to support accurate measurement."

Beyond improving patient care and reducing costs, ACS NSQIP is a valuable source of information that is leveraged by surgeons to compare themselves with their colleagues and that can be used by individuals to differentiate hospitals in their community.

"Using a program like ACS NSQIP allows us to benchmark ourselves against our colleagues as well as other hospitals across the country and create a national standard," said John S. Kukora, MD, FACS, FACE, chairman, department of surgery, program director, general surgery residency program, Abington Memorial Hospital (PA). "This [type of] reporting isn’t just for surgeons and hospital administrators. It can also inform consumers’ choices as they are armed with knowledge and can choose a hospital based on its performance record."

While much of the panel focused on the profession’s quality improvement successes, one panelist pointed out enhanced ways to study and measure the successes of ACS NSQIP in hospitals around the country.

"From a business school perspective, continuous quality improvement [CQI] is a good idea in theory but rarely works in practice," said Mark V. Pauly, PhD, Bendheim Professor, professor of health care management, professor of business economics and public policy, The Wharton School, University of Pennsylvania. "However, based on what I’ve seen thus far, I’m encouraged to believe ACS NSQIP is an exception to the rule, though more empirical evidence comparing outcomes data between hospitals with the program and those without is needed to convince health economists that CQI can be effective."

The ACS has hosted community forums across the nation throughout 2012. To view the archived forum video and follow updates on upcoming tour locations, please visit InspiringQuality.FACS.org or the College’s YouTube channel.

The American College of Surgeons (ACS) in October held the ACS Surgical Health Care Quality Forum Philadelphia, the ninth stop in a national tour to drive discussions on effective quality improvement methods used by surgeons, physicians, and hospitals to improve patient safety and reduce costs.

The Philadelphia forum focused on the importance of physician-led quality improvement initiatives in sustaining better outcomes, using the ACS National Surgical Quality Improvement Program (ACS NSQIP) as a leading model that provides surgeons with reliable data to help pinpoint areas for improvement.

"We’re all faced with the challenges of navigating a complex and ever-changing health care system," said Marshall Z. Schwartz, MD, FACS, professor of surgery and pediatrics at Drexel University, pediatric surgeon-in-chief at St. Christopher’s Hospital for Children, Philadelphia, a member of the ACS Board of Regents, and event co-host. "The good news is we don’t have to re-invent the wheel to achieve the level of quality improvement and cost savings we need for health reform to be successful."

"Using proven quality improvement methods like ACS NSQIP is a perfect example of what we, as physicians, can do together to support health reform," added Howard M. Snyder III, MD, FACS, attending urologist at Children’s Hospital of Philadelphia, professor of urology in surgery at the University of Pennsylvania School of Medicine, Philadelphia, a member of the ACS Board of Regents, and event co-host.

Keynote speaker U.S. Rep. Jim Gerlach (R-PA), a member of the influential House Ways and Means Committee, cited parallels between the government’s health care reform efforts and quality improvement programs such as ACS NSQIP, which collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database. He also addressed the need to link higher quality care to reimbursement.

"The mission of the Ways and Means Committee right now is to prevent the 27 percent cuts in Medicare reimbursement and extend it until we can come up with a proper formula for reimbursing physicians," said Representative Gerlach. "You [surgeons] bring a credibility and knowledge that legislators don’t have, and I would encourage you to advocate for these changes we need to have and the programs you want to save because they work."

A 2009 study published in the Annals of Surgery determined that hospitals participating in ACS NSQIP each prevented 200-500 complications annually and saved an average of 12-36 lives per year by reducing complications. With the average cost of medical complications equaling $11,000 per occurrence, the combined potential savings of 4,500 hospitals could add up to $13-26 billion each year, amounting to an estimated total savings of $260 billion over a period of 10 years (Ann. Surg. 2009; 250:363-76).

The forum emphasized the reduction of complications with a focus on surgical outcomes – an objective that is not new in Pennsylvania.

"Pennsylvania was the first state to publicly report hospital-acquired infections and that transparency has improved the appetite for quality improvement programs in our state and around the country," said Larry R. Kaiser, MD, FACS, senior executive vice president for health services, dean, Temple University School of Medicine; and president and chief executive officer, Temple University Health System.

"Surgeons trust and embrace clinical data which is why the Society of Thoracic Surgeons National Database and ACS NSQIP have been successful tools to reduce complications and improve patient care," he added.

"For ten years, Geisinger has focused on an intervention framework to identify variation in care and re-engineer best practices, resulting in decreased costs and improved quality," said Glenn D. Steele Jr., MD, PhD, FACS, president and chief executive officer, Geisinger Health System, Danville, PA. "Surgery departments present a clear opportunity to define complications and implement and assess solutions, as there is a distinct starting and end point to support accurate measurement."

Beyond improving patient care and reducing costs, ACS NSQIP is a valuable source of information that is leveraged by surgeons to compare themselves with their colleagues and that can be used by individuals to differentiate hospitals in their community.

"Using a program like ACS NSQIP allows us to benchmark ourselves against our colleagues as well as other hospitals across the country and create a national standard," said John S. Kukora, MD, FACS, FACE, chairman, department of surgery, program director, general surgery residency program, Abington Memorial Hospital (PA). "This [type of] reporting isn’t just for surgeons and hospital administrators. It can also inform consumers’ choices as they are armed with knowledge and can choose a hospital based on its performance record."

While much of the panel focused on the profession’s quality improvement successes, one panelist pointed out enhanced ways to study and measure the successes of ACS NSQIP in hospitals around the country.

"From a business school perspective, continuous quality improvement [CQI] is a good idea in theory but rarely works in practice," said Mark V. Pauly, PhD, Bendheim Professor, professor of health care management, professor of business economics and public policy, The Wharton School, University of Pennsylvania. "However, based on what I’ve seen thus far, I’m encouraged to believe ACS NSQIP is an exception to the rule, though more empirical evidence comparing outcomes data between hospitals with the program and those without is needed to convince health economists that CQI can be effective."

The ACS has hosted community forums across the nation throughout 2012. To view the archived forum video and follow updates on upcoming tour locations, please visit InspiringQuality.FACS.org or the College’s YouTube channel.

The American College of Surgeons (ACS) in October held the ACS Surgical Health Care Quality Forum Philadelphia, the ninth stop in a national tour to drive discussions on effective quality improvement methods used by surgeons, physicians, and hospitals to improve patient safety and reduce costs.

The Philadelphia forum focused on the importance of physician-led quality improvement initiatives in sustaining better outcomes, using the ACS National Surgical Quality Improvement Program (ACS NSQIP) as a leading model that provides surgeons with reliable data to help pinpoint areas for improvement.

"We’re all faced with the challenges of navigating a complex and ever-changing health care system," said Marshall Z. Schwartz, MD, FACS, professor of surgery and pediatrics at Drexel University, pediatric surgeon-in-chief at St. Christopher’s Hospital for Children, Philadelphia, a member of the ACS Board of Regents, and event co-host. "The good news is we don’t have to re-invent the wheel to achieve the level of quality improvement and cost savings we need for health reform to be successful."

"Using proven quality improvement methods like ACS NSQIP is a perfect example of what we, as physicians, can do together to support health reform," added Howard M. Snyder III, MD, FACS, attending urologist at Children’s Hospital of Philadelphia, professor of urology in surgery at the University of Pennsylvania School of Medicine, Philadelphia, a member of the ACS Board of Regents, and event co-host.

Keynote speaker U.S. Rep. Jim Gerlach (R-PA), a member of the influential House Ways and Means Committee, cited parallels between the government’s health care reform efforts and quality improvement programs such as ACS NSQIP, which collects clinical, risk-adjusted, 30-day outcomes data in a nationally benchmarked database. He also addressed the need to link higher quality care to reimbursement.

"The mission of the Ways and Means Committee right now is to prevent the 27 percent cuts in Medicare reimbursement and extend it until we can come up with a proper formula for reimbursing physicians," said Representative Gerlach. "You [surgeons] bring a credibility and knowledge that legislators don’t have, and I would encourage you to advocate for these changes we need to have and the programs you want to save because they work."

A 2009 study published in the Annals of Surgery determined that hospitals participating in ACS NSQIP each prevented 200-500 complications annually and saved an average of 12-36 lives per year by reducing complications. With the average cost of medical complications equaling $11,000 per occurrence, the combined potential savings of 4,500 hospitals could add up to $13-26 billion each year, amounting to an estimated total savings of $260 billion over a period of 10 years (Ann. Surg. 2009; 250:363-76).

The forum emphasized the reduction of complications with a focus on surgical outcomes – an objective that is not new in Pennsylvania.

"Pennsylvania was the first state to publicly report hospital-acquired infections and that transparency has improved the appetite for quality improvement programs in our state and around the country," said Larry R. Kaiser, MD, FACS, senior executive vice president for health services, dean, Temple University School of Medicine; and president and chief executive officer, Temple University Health System.

"Surgeons trust and embrace clinical data which is why the Society of Thoracic Surgeons National Database and ACS NSQIP have been successful tools to reduce complications and improve patient care," he added.

"For ten years, Geisinger has focused on an intervention framework to identify variation in care and re-engineer best practices, resulting in decreased costs and improved quality," said Glenn D. Steele Jr., MD, PhD, FACS, president and chief executive officer, Geisinger Health System, Danville, PA. "Surgery departments present a clear opportunity to define complications and implement and assess solutions, as there is a distinct starting and end point to support accurate measurement."

Beyond improving patient care and reducing costs, ACS NSQIP is a valuable source of information that is leveraged by surgeons to compare themselves with their colleagues and that can be used by individuals to differentiate hospitals in their community.

"Using a program like ACS NSQIP allows us to benchmark ourselves against our colleagues as well as other hospitals across the country and create a national standard," said John S. Kukora, MD, FACS, FACE, chairman, department of surgery, program director, general surgery residency program, Abington Memorial Hospital (PA). "This [type of] reporting isn’t just for surgeons and hospital administrators. It can also inform consumers’ choices as they are armed with knowledge and can choose a hospital based on its performance record."

While much of the panel focused on the profession’s quality improvement successes, one panelist pointed out enhanced ways to study and measure the successes of ACS NSQIP in hospitals around the country.

"From a business school perspective, continuous quality improvement [CQI] is a good idea in theory but rarely works in practice," said Mark V. Pauly, PhD, Bendheim Professor, professor of health care management, professor of business economics and public policy, The Wharton School, University of Pennsylvania. "However, based on what I’ve seen thus far, I’m encouraged to believe ACS NSQIP is an exception to the rule, though more empirical evidence comparing outcomes data between hospitals with the program and those without is needed to convince health economists that CQI can be effective."

The ACS has hosted community forums across the nation throughout 2012. To view the archived forum video and follow updates on upcoming tour locations, please visit InspiringQuality.FACS.org or the College’s YouTube channel.

The ACS Health Policy Research Institute (HPRI) has released updated maps that illustrate the distribution of surgeons and general surgeons per 100,000 population across the U.S. in 2006 and 2011. To access the HPRI website, go to acshpri.org.

The maps track the "absolute" and "percentage" change in surgeons per population for the same period. The data are reflective of all 3,107 counties in the United States. Similar maps for surgical subspecialties will be added this year.

Thomas C. Ricketts, III, PhD, MPH, Managing Director of the ACS HPRI, and other HPRI staff also are working to distribute an updated Surgery Workforce Atlas – a web-based set of maps that shows, county-by-county and state-by-state, where shortages of surgeons and other physicians threaten patient access to high-quality, affordable care. To obtain more information about the Surgery Workforce Atlas, go to acshpri.org/atlas.

The ACS Health Policy Research Institute (HPRI) has released updated maps that illustrate the distribution of surgeons and general surgeons per 100,000 population across the U.S. in 2006 and 2011. To access the HPRI website, go to acshpri.org.

The maps track the "absolute" and "percentage" change in surgeons per population for the same period. The data are reflective of all 3,107 counties in the United States. Similar maps for surgical subspecialties will be added this year.

Thomas C. Ricketts, III, PhD, MPH, Managing Director of the ACS HPRI, and other HPRI staff also are working to distribute an updated Surgery Workforce Atlas – a web-based set of maps that shows, county-by-county and state-by-state, where shortages of surgeons and other physicians threaten patient access to high-quality, affordable care. To obtain more information about the Surgery Workforce Atlas, go to acshpri.org/atlas.

The ACS Health Policy Research Institute (HPRI) has released updated maps that illustrate the distribution of surgeons and general surgeons per 100,000 population across the U.S. in 2006 and 2011. To access the HPRI website, go to acshpri.org.

The maps track the "absolute" and "percentage" change in surgeons per population for the same period. The data are reflective of all 3,107 counties in the United States. Similar maps for surgical subspecialties will be added this year.

Thomas C. Ricketts, III, PhD, MPH, Managing Director of the ACS HPRI, and other HPRI staff also are working to distribute an updated Surgery Workforce Atlas – a web-based set of maps that shows, county-by-county and state-by-state, where shortages of surgeons and other physicians threaten patient access to high-quality, affordable care. To obtain more information about the Surgery Workforce Atlas, go to acshpri.org/atlas.

The ATLS Ninth Edition was released in September, and through its enhanced presentation of quality educational content, the Ninth Edition offers another example of the College’s commitment to improving the care of surgical patients over the last 100 years. The Ninth Edition is also available as an app for mobile devices. Designed to serve as both a bedside reference tool and supplemental educational resource, the mobile app for the new Advanced Trauma Life Support (ATLS) Ninth Edition has both Universal iOS and Android compatibility and consists of interactive algorithms, calculators, animations, Just in Time videos demonstrating key skills, and an interactive pdf version of the Student Manual. Application teasers and resources for course faculty also are available on MyATLS.com.

The ATLS companion application, which is available as a free download with the purchase of an ATLS Ninth Edition Student Manual or as a stand-alone product, may also be obtained on MYATLS.com.

Every four years, the ATLS course is revised to ensure that users can stay abreast of the latest medical knowledge and practical skills. This edition comes with an improved visual presentation of content that has been revised and that comprises updated references. Content changes include the new information on the concept of balanced resuscitation, an emphasis on the pelvis as a source of blood loss, more advanced airway techniques for the difficult airway, optional expanded content on heat injury, and team training. Format changes include a new Focused Assessment Sonography in Trauma skill station, the optional use of diagnostic peritoneal lavage and pericardiocentesis, seven new Initial Assessment scenarios, and new instructor course content.

Other Ninth Edition features include newly written multiple-choice exam questions, new images, and skills videos. Visit the ATLS website at www.facs.org/trauma/atls to purchase the Ninth Edition Student Manual. To order a Ninth Edition Faculty Manual, contact your local course site.

The ATLS e-course is expected to be released in the coming months. Students eventually will have the option of completing the didactic portion of the course online and will be required to attend a live, hands-on skills course, offered in both one-day and two-day formats.

To date, ATLS has trained more than one million health care professionals in 63 countries. ATLS will continue to serve the ongoing mission of providing a common language for the early care of trauma patients worldwide.

The ATLS Ninth Edition was released in September, and through its enhanced presentation of quality educational content, the Ninth Edition offers another example of the College’s commitment to improving the care of surgical patients over the last 100 years. The Ninth Edition is also available as an app for mobile devices. Designed to serve as both a bedside reference tool and supplemental educational resource, the mobile app for the new Advanced Trauma Life Support (ATLS) Ninth Edition has both Universal iOS and Android compatibility and consists of interactive algorithms, calculators, animations, Just in Time videos demonstrating key skills, and an interactive pdf version of the Student Manual. Application teasers and resources for course faculty also are available on MyATLS.com.

The ATLS companion application, which is available as a free download with the purchase of an ATLS Ninth Edition Student Manual or as a stand-alone product, may also be obtained on MYATLS.com.

Every four years, the ATLS course is revised to ensure that users can stay abreast of the latest medical knowledge and practical skills. This edition comes with an improved visual presentation of content that has been revised and that comprises updated references. Content changes include the new information on the concept of balanced resuscitation, an emphasis on the pelvis as a source of blood loss, more advanced airway techniques for the difficult airway, optional expanded content on heat injury, and team training. Format changes include a new Focused Assessment Sonography in Trauma skill station, the optional use of diagnostic peritoneal lavage and pericardiocentesis, seven new Initial Assessment scenarios, and new instructor course content.

Other Ninth Edition features include newly written multiple-choice exam questions, new images, and skills videos. Visit the ATLS website at www.facs.org/trauma/atls to purchase the Ninth Edition Student Manual. To order a Ninth Edition Faculty Manual, contact your local course site.

The ATLS e-course is expected to be released in the coming months. Students eventually will have the option of completing the didactic portion of the course online and will be required to attend a live, hands-on skills course, offered in both one-day and two-day formats.

To date, ATLS has trained more than one million health care professionals in 63 countries. ATLS will continue to serve the ongoing mission of providing a common language for the early care of trauma patients worldwide.

The ATLS Ninth Edition was released in September, and through its enhanced presentation of quality educational content, the Ninth Edition offers another example of the College’s commitment to improving the care of surgical patients over the last 100 years. The Ninth Edition is also available as an app for mobile devices. Designed to serve as both a bedside reference tool and supplemental educational resource, the mobile app for the new Advanced Trauma Life Support (ATLS) Ninth Edition has both Universal iOS and Android compatibility and consists of interactive algorithms, calculators, animations, Just in Time videos demonstrating key skills, and an interactive pdf version of the Student Manual. Application teasers and resources for course faculty also are available on MyATLS.com.

The ATLS companion application, which is available as a free download with the purchase of an ATLS Ninth Edition Student Manual or as a stand-alone product, may also be obtained on MYATLS.com.

Every four years, the ATLS course is revised to ensure that users can stay abreast of the latest medical knowledge and practical skills. This edition comes with an improved visual presentation of content that has been revised and that comprises updated references. Content changes include the new information on the concept of balanced resuscitation, an emphasis on the pelvis as a source of blood loss, more advanced airway techniques for the difficult airway, optional expanded content on heat injury, and team training. Format changes include a new Focused Assessment Sonography in Trauma skill station, the optional use of diagnostic peritoneal lavage and pericardiocentesis, seven new Initial Assessment scenarios, and new instructor course content.

Other Ninth Edition features include newly written multiple-choice exam questions, new images, and skills videos. Visit the ATLS website at www.facs.org/trauma/atls to purchase the Ninth Edition Student Manual. To order a Ninth Edition Faculty Manual, contact your local course site.

The ATLS e-course is expected to be released in the coming months. Students eventually will have the option of completing the didactic portion of the course online and will be required to attend a live, hands-on skills course, offered in both one-day and two-day formats.

To date, ATLS has trained more than one million health care professionals in 63 countries. ATLS will continue to serve the ongoing mission of providing a common language for the early care of trauma patients worldwide.

Wrong site surgery is considered a rare event; however, some estimates put the national rate as high as 40 per week. The costs are many, including the loss of public trust and the threat of malpractice suits that can result in multimillion dollar judgments. For Joint Commission–accredited ambulatory surgery centers (ASCs), tested wrong site surgery solutions are now available and used in real-world situations.

The Joint Commission Center for Transforming Healthcare’s Targeted Solutions Tool (TST) guides ASCs through a no-cost, step-by-step process to identify, measure, and reduce risks in key processes that can contribute to a wrong site surgery. Rather than a checklist or bundle, the Web-based application uses a six-step process to help organizations measure their performance in the areas of surgical booking, preop/holding, and the operating room. The TST analyzes these data, places the results into a presentation-ready format, and leads an organization to solutions targeted to address the risks that emerged from the data analysis, according to Andrew Ward, MD, the medical director of Algonquin Road Surgery Center, Lake in the Hills, IL – a surgery center that uses TST.

"After having implemented the tool, we’ve gained the acceptance and the buy-in from the surgeons, the staff, and the anesthesiologists to increase our percentage and get close to 100 percent compliance in the operating room and to drastically improve the compliance in the holding room," said Dr. Ward.

The TST provides training tools and resources to prepare select staff members to collect observation data. Observations can be collected on paper forms or input directly into the TST using a tablet device, such as an iPad. Data collection is critical to the project since the focus of improvement stems from the data. Organizations may begin to experience improvements in as little as eight weeks, with most organizations completing the project – and seeing results – in 14 to 16 weeks.

Among the resources provided are training modules, which include videos showing examples of both good and bad practices. There are also interactive training materials that assess staff learning. A benefit is the TST’s ability to provide advanced data analysis and automatically generate charts and graphs that represent organizational performance. This feature allows easy sharing of data and performance charts with leadership and staff.

"The biggest improvement we’ve seen in using the wrong site surgery tool is that we’ve gotten a buy-in from the staff and surgeons at the beginning of cases. Previous to using the tool we would have people working on the Mayo stand, checking gauges, writing things down, and not really paying attention to the time outs. Now, however, everybody does stop, everyone listens, and everyone agrees," said Dr. Ward.

To learn more about the wrong site surgery project and the TST, visit the Joint Commission Center for Transforming Healthcare website, call 630-792-5800, or e-mail [email protected].

Wrong site surgery is considered a rare event; however, some estimates put the national rate as high as 40 per week. The costs are many, including the loss of public trust and the threat of malpractice suits that can result in multimillion dollar judgments. For Joint Commission–accredited ambulatory surgery centers (ASCs), tested wrong site surgery solutions are now available and used in real-world situations.

The Joint Commission Center for Transforming Healthcare’s Targeted Solutions Tool (TST) guides ASCs through a no-cost, step-by-step process to identify, measure, and reduce risks in key processes that can contribute to a wrong site surgery. Rather than a checklist or bundle, the Web-based application uses a six-step process to help organizations measure their performance in the areas of surgical booking, preop/holding, and the operating room. The TST analyzes these data, places the results into a presentation-ready format, and leads an organization to solutions targeted to address the risks that emerged from the data analysis, according to Andrew Ward, MD, the medical director of Algonquin Road Surgery Center, Lake in the Hills, IL – a surgery center that uses TST.

"After having implemented the tool, we’ve gained the acceptance and the buy-in from the surgeons, the staff, and the anesthesiologists to increase our percentage and get close to 100 percent compliance in the operating room and to drastically improve the compliance in the holding room," said Dr. Ward.

The TST provides training tools and resources to prepare select staff members to collect observation data. Observations can be collected on paper forms or input directly into the TST using a tablet device, such as an iPad. Data collection is critical to the project since the focus of improvement stems from the data. Organizations may begin to experience improvements in as little as eight weeks, with most organizations completing the project – and seeing results – in 14 to 16 weeks.

Among the resources provided are training modules, which include videos showing examples of both good and bad practices. There are also interactive training materials that assess staff learning. A benefit is the TST’s ability to provide advanced data analysis and automatically generate charts and graphs that represent organizational performance. This feature allows easy sharing of data and performance charts with leadership and staff.

"The biggest improvement we’ve seen in using the wrong site surgery tool is that we’ve gotten a buy-in from the staff and surgeons at the beginning of cases. Previous to using the tool we would have people working on the Mayo stand, checking gauges, writing things down, and not really paying attention to the time outs. Now, however, everybody does stop, everyone listens, and everyone agrees," said Dr. Ward.

To learn more about the wrong site surgery project and the TST, visit the Joint Commission Center for Transforming Healthcare website, call 630-792-5800, or e-mail [email protected].

Wrong site surgery is considered a rare event; however, some estimates put the national rate as high as 40 per week. The costs are many, including the loss of public trust and the threat of malpractice suits that can result in multimillion dollar judgments. For Joint Commission–accredited ambulatory surgery centers (ASCs), tested wrong site surgery solutions are now available and used in real-world situations.

The Joint Commission Center for Transforming Healthcare’s Targeted Solutions Tool (TST) guides ASCs through a no-cost, step-by-step process to identify, measure, and reduce risks in key processes that can contribute to a wrong site surgery. Rather than a checklist or bundle, the Web-based application uses a six-step process to help organizations measure their performance in the areas of surgical booking, preop/holding, and the operating room. The TST analyzes these data, places the results into a presentation-ready format, and leads an organization to solutions targeted to address the risks that emerged from the data analysis, according to Andrew Ward, MD, the medical director of Algonquin Road Surgery Center, Lake in the Hills, IL – a surgery center that uses TST.

"After having implemented the tool, we’ve gained the acceptance and the buy-in from the surgeons, the staff, and the anesthesiologists to increase our percentage and get close to 100 percent compliance in the operating room and to drastically improve the compliance in the holding room," said Dr. Ward.

The TST provides training tools and resources to prepare select staff members to collect observation data. Observations can be collected on paper forms or input directly into the TST using a tablet device, such as an iPad. Data collection is critical to the project since the focus of improvement stems from the data. Organizations may begin to experience improvements in as little as eight weeks, with most organizations completing the project – and seeing results – in 14 to 16 weeks.

Among the resources provided are training modules, which include videos showing examples of both good and bad practices. There are also interactive training materials that assess staff learning. A benefit is the TST’s ability to provide advanced data analysis and automatically generate charts and graphs that represent organizational performance. This feature allows easy sharing of data and performance charts with leadership and staff.

"The biggest improvement we’ve seen in using the wrong site surgery tool is that we’ve gotten a buy-in from the staff and surgeons at the beginning of cases. Previous to using the tool we would have people working on the Mayo stand, checking gauges, writing things down, and not really paying attention to the time outs. Now, however, everybody does stop, everyone listens, and everyone agrees," said Dr. Ward.

To learn more about the wrong site surgery project and the TST, visit the Joint Commission Center for Transforming Healthcare website, call 630-792-5800, or e-mail [email protected].

The ACS submitted comments in August to the Centers for Medicare & Medicaid Services (CMS) concerning the proposed calendar year 2013 Medicare physician fee schedule, notably on these topics:

• A proposal to create a new G-code that can be billed by physicians who coordinate services for a beneficiary after discharge from a hospital.

• A new Physician Quality Reporting System (PQRS) reporting option to use administrative claims to avoid the 2015 and 2016 payment adjustments.

• Implementation of the physician value-based payment modifier, which would apply to some physicians starting in 2015 and all physicians by 2017. This budget-neutral payment modifier will provide for differential payment to a physician or a group of physicians under the physician fee schedule based on the quality of care furnished compared to cost. Go here to view comments and other issues discussed in the letter.

The ACS also submitted comments in August to the CMS concerning the proposed calendar year 2013 Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) payment rule. The letter recommends adding several laparoscopic partial colectomy codes to the list of procedures that may be performed only in an inpatient setting. Also addressed were hospitals treating beneficiaries as outpatients in lieu of admitting them and 16 procedures that the CMS proposed to add to the list of procedures that may be performed in an ASC.

The ACS submitted comments in August to the Centers for Medicare & Medicaid Services (CMS) concerning the proposed calendar year 2013 Medicare physician fee schedule, notably on these topics:

• A proposal to create a new G-code that can be billed by physicians who coordinate services for a beneficiary after discharge from a hospital.

• A new Physician Quality Reporting System (PQRS) reporting option to use administrative claims to avoid the 2015 and 2016 payment adjustments.

• Implementation of the physician value-based payment modifier, which would apply to some physicians starting in 2015 and all physicians by 2017. This budget-neutral payment modifier will provide for differential payment to a physician or a group of physicians under the physician fee schedule based on the quality of care furnished compared to cost. Go here to view comments and other issues discussed in the letter.

The ACS also submitted comments in August to the CMS concerning the proposed calendar year 2013 Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) payment rule. The letter recommends adding several laparoscopic partial colectomy codes to the list of procedures that may be performed only in an inpatient setting. Also addressed were hospitals treating beneficiaries as outpatients in lieu of admitting them and 16 procedures that the CMS proposed to add to the list of procedures that may be performed in an ASC.

The ACS submitted comments in August to the Centers for Medicare & Medicaid Services (CMS) concerning the proposed calendar year 2013 Medicare physician fee schedule, notably on these topics:

• A proposal to create a new G-code that can be billed by physicians who coordinate services for a beneficiary after discharge from a hospital.

• A new Physician Quality Reporting System (PQRS) reporting option to use administrative claims to avoid the 2015 and 2016 payment adjustments.

• Implementation of the physician value-based payment modifier, which would apply to some physicians starting in 2015 and all physicians by 2017. This budget-neutral payment modifier will provide for differential payment to a physician or a group of physicians under the physician fee schedule based on the quality of care furnished compared to cost. Go here to view comments and other issues discussed in the letter.

The ACS also submitted comments in August to the CMS concerning the proposed calendar year 2013 Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) payment rule. The letter recommends adding several laparoscopic partial colectomy codes to the list of procedures that may be performed only in an inpatient setting. Also addressed were hospitals treating beneficiaries as outpatients in lieu of admitting them and 16 procedures that the CMS proposed to add to the list of procedures that may be performed in an ASC.