American College of Surgeons Bariatric Surgery Center Network Accreditation Program (ACS BSCN): An Evolution in Quality

by Angela Armijo, MBA, CAE

Angela Armijo is from ACS NSQIP, Marketing, Business Development
Division of Research and Optimal Patient Care, Chicago, Illinois.

Bariatric Times. 2011;8(10):22

Since 2005, the American College of Surgeons Bariatric Surgery Center Network Accreditation Program (ACS BSCN) has been accrediting facilities in the United States and Canada that have undergone an independent, voluntary, and rigorous peer evaluation in accordance with nationally recognized bariatric surgical standards. ACS BSCN accreditation not only promotes uniform standard benchmarks, but also supports continuous quality improvement.

The ACS BSCN offers five different levels of accreditation to bariatric surgery centers throughout the United States and Canada. ACS BSCN Level 1 Accreditation recognizes high-volume centers that provide the highest level of care and comprehensive medical specialty services to bariatric patients, including the management of high-risk patients.In addition, the ACS BSCN is committed to offering other levels of accreditation that recognize and encourage top-performing rural, community, and outpatient centers that have also demonstrated the highest level of commitment to bariatric surgery quality improvement.

ACS BSCN accredited centers report outcomes data to an improved ACS BSCN data registry. Data are collected by a dedicated bariatric data collector who has completed training specific to the ACS BSCN data registry.

Among the many benefits of ACS BSCN Accreditation are the following:
•    On-site evaluation (within the United States) conducted by board-certified bariatric surgeons
•    All-inclusive, three-year accreditation fee, including use of the database
•    Streamlined clinical data variables that minimize the data collection burden
•    Ability to automatically push information from any bariatric case collected through the ACS National Surgical Quality Improvement Pogram (NSQIP) sampling process to the ACS BSCN database
•    ACS BSCN training of data abstractors to ensure consistent, high-quality data
•    Online reports, including non-risk adjusted benchmarking of surgical outcomes
•    Potential for reimbursement by the Centers for Medicare and Medicaid Services (CMS) for Level 1-Accredited Bariatric Centers
•    Recognition by The Joint Commission’s Quality Check Website™ (www.qualitycheck.
org).

ACS BSCN has undergone several recent advancements to the program that foster an enduring commitment to quality by bariatric centers accredited by ACS BSCN. In the spring of 2010, the ACS BSCN began an exciting transition to the newly enhanced ACS BSCN Workstation. This new database offers a web-based platform with improved functionality, online data reports with national comparison data, and a more parsimonious data set. The data variables have been streamlined to limit the burden of data collection while increasing the quality and integrity of the data set.

The ACS BSCN data collection system was created for the purpose of quality assessment. However, the availability of longitudinal data measuring the effects of intervention on a patient’s weight, diabetes, and hypertension, as well as other comorbid conditions, also offer the opportunity for comparative effectiveness research.

At the 131st annual meeting of the American Surgical Association (ASA) April 2011, ACS BSCN presented the first research of its prospective, longitudinal outcomes database compiled to study the outcomes of bariatric surgery. For the first time, a nationwide, multi-institutional, bariatric-specific data report comparing the laparoscopic sleeve gastrectomy (LSG) procedure to three other well-utilized procedures for treatment of morbid obesity and metabolic disease was presented to a national surgical audience. LSG, a newer surgical procedure being performed with increasing frequency, was compared to the laparoscopic adjustable gastric band (LAGB) and laparoscopic Roux-en-Y gastric bypass (RYGB) by researchers from the ACS BSCN.

“The sleeve gastrectomy was found to be positioned between the band and the bypass with regards to morbidity and effectiveness,” said Dr. Matt Hutter, the Director of the Codman Center for Clinical Effectiveness in Surgery at the Massachusetts General Hospital and the lead author of the study, which was published in the September issue of the Annals of Surgery. “We are quite excited that these high-quality data, which are collected to promote quality improvement and assurance, can also provide critical research information to patients and providers.”

Another recent change made to the program was a significant modification to the BSCN program standards for Level 1 accreditation approved by the ACS BSCN Advisory Committee. The standards for Level 1 accreditation now require only one surgeon to meet the individual volume requirement of 100 weight-loss operations in the previous 24 months. Previously, this standard required two surgeons to meet the individual volume requirement, creating a barrier to ACS BSCN accreditation for many leading, high-volume centers. We encourage new centers as well as existing Level 2 centers to review their program volume data to see if they now meet new Level 1 criteria.

To learn more about the exciting new developments with the ACS BSCN, please visit www.acsbscn.org.

Category: Brief Report, Past Articles