CHICAGO: Today, the American College of Surgeons (ACS) and the American Association for the Surgery of Trauma (AAST) announced the launch of the Emergency General Surgery Verification Program (EGS-VP), a new surgical quality program that will help hospitals establish and maintain the highest standards in emergency general surgery. The program was launched during the 81st Annual Meeting of AAST & Clinical Congress of Acute Care Surgery.
EGS-VP is a national quality verification program focused on the care and treatment of patients with emergency general surgery (EGS) diseases. EGS diseases are distinct from traumatic injuries in that EGS patients have not sustained an injury, but their conditions often require the same urgency as trauma patients.
"The ACS has been committed to ensuring the highest standards in quality surgical care for more than 100 years," said ACS Executive Director Patricia L. Turner, MD, MBA, FACS. "This new quality program, developed in collaboration with AAST, will help hospitals ensure that they are delivering optimal care for every patient requiring emergency general surgery. We are confident that by introducing these standards and the new EGS-VP that we will see improved patient care and better outcomes."
The program's standards manual, Optimal Resources for Emergency General Surgery, provides the resources, supports, pathways, and multi-disciplinary involvement necessary for program participation. EGS disease areas specified in the manual are acute abdomen/peritonitis, soft tissue infection, gallbladder disease, gastrointestinal obstruction, pancreatitis, diverticular disease, appendicitis, acute gastrointestinal bleed, perforated peptic ulcer disease, and incarcerated hernia.
"These 43 standards raise the bar of emergency general surgery. We are talking about hospital commitment, appropriate facilities and equipment, dedicated trained personnel and services, clinical care, continuity, robust data collection, quality improvement, education, and research," said Raul Coimbra, MD, PhD, FACS, surgeon-in-chief, Riverside University Health System Medical Center, and professor of surgery, Loma Linda University School of Medicine. "All those components will be analyzed to achieve verification. Not just a hospital's clinical care, but their institutional commitments, the data they collect, how they use the data to improve quality and care delivery, and how they use data for education and research."
EGS-VP has been developed for the unique needs of emergency general surgery patients and providers. Participation in the program addresses the following areas:
- Resources: standards specific to the diverse nature of EGS
- Data: a targeted registry within the ACS National Surgical Quality Improvement Program (ACS NSQIP®) platform designed with EGS outcomes and variables in mind
- Clinical care: development of standardized pathways of care utilizing a multi-disciplinary approach
- Value-added care: recognition that the right team, timeframe, and supports provide the best opportunity to improve outcomes
Pilot sites that have participated in the program have praised the opportunity EGS-VP provides to evaluate and improve emergency general surgery services.
"It has been tremendously helpful to take a critical look at the services we have and don't have, the performance improvement programs, the registries that we do or don't have, and package it all together, present it to some outside experts, and get very valuable feedback on how we can improve our program," said Patrick M. Reilly, MD, FACS, FCCP, C. William Schwab Professor of Surgery, Perelman School of Medicine at the University of Pennsylvania. The Hospital of the University of Pennsylvania was an EGS-VP pilot site.
A key aspect of EGS-VP is the role of data collection in improving care. Alongside the EGS Verification Program, the EGS Targeted Module of the ACS NSQIP registry has been developed to bring hospitals the data they need to advance their quality processes. The first registry of its kind to capture both operative and non-operative cases, the module offers participating hospitals access to targeted EGS variables and reports designed specifically to support outcomes measurement and improvement. Leveraging the features of the ACS NSQIP platform allows participants to capture clinically relevant, risk-adjusted data and benchmark their outcomes in a national registry.
"Acquiring data is critical. We have some data on emergency general surgery patients that we treated surgically. But 50 percent of EGS patients don't undergo surgery during their index hospitalization. We don't know how many times they have to come back to the hospital before they ultimately undergo an operation or if they never come back to the hospital and never undergo an operation," said Kimberly A. Davis, MD, MBA, FACS, FCCM, professor of surgery and chief of the division of general surgery, trauma, and surgical critical care, Yale School of Medicine.
"EGS-VP follows in the strong tradition of surgical quality improvement programs administered by the ACS. The program is built on the College's quality principles to provide hospitals with a framework to create a culture of patient safety and develop highly reliable care delivery," said Clifford Y. Ko, MD, MS, MSHS, FACS, FASCRS, Director, ACS Division of Research and Optimal Patient Care. "By following these program standards, EGS-VP hospitals will raise the bar on the immediacy and quality of care that can be delivered to patients-improving outcomes and saving lives."
