An Update on the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP): A unified program of the ACS and ASMBS

An Update on the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP):  A unified program of the  ACS and ASMBS

by Teresa R. Fraker, MS, BSN, RN

Teresa R. Fraker, MS, BSN, RN, is Program Administrator, MBSAQIP, American College of Surgeons, Chicago, Illinois.

Bariatric Times. 2013;10(11):22.

About the American Society for Metabolic and Bariatric Surgery
The American Society for Metabolic and Bariatric Surgery was founded in 1983 to establish educational and support programs for surgeons and integrated health professionals. Our mission is to improve the care and treatment of people with obesity and related disease; to advance the science and understanding of metabolic surgery; to advocate for health care policy that ensures patient access to high-quality prevention and treatment of obesity. For more information, visit www. ASMBS.org. If you are interested in becoming a member or have questions about ASMBS, please contact Georgeann Mallory, the ASMBS Executive Director, via phone: (352)-331-4900 or e-mail: [email protected].

About the American College of Surgeons
The American College of Surgeons is dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment. The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the quality of care for surgical patients. For a century, ACS has developed nationally recognized programs to improve surgical care quality through its Commission on Cancer, Committee on Trauma, National Surgical Quality Improvement Program (ACS NSQIP®), and now its joint program with the ASMBS called the Metabolic Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). The College has more than 79,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

 

In 2004, the American Society for Metabolic and Bariatric Surgery (ASMBS) developed the Bariatric Surgery Centers of Excellence (BSCOE) Program in an effort to improve patient safety. In 2005, the American College of Surgeons (ACS) formed a separate but similar accreditation program with the ACS Bariatric Surgery Center Network (BSCN). Using the best available data in quality, both programs focused on three key principles: a threshold volume of surgery, the need for appropriate equipment to care for the morbidly obese working in conjunction with a multidisciplinary team, and the need for reporting of outcomes to a national registry.

Since the inception of both programs, we have witnessed a remarkable reduction in mortality for bariatric surgery patients. This improvement in patient safety for bariatric surgery patients strongly illustrates the impact and continuing need for an accreditation and quality improvement program for bariatric surgery centers.

The ACS and ASMBS have had discussions over the years regarding the possibility of unifying their respective accreditation programs. As each program’s standards evolved, they have grown more similar as a reflection of their shared values. By early 2012, the ACS and ASMBS were able to move forward with establishing a Memorandum of Understanding (MOU) to unite to form the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).  Effective April 1, 2012, the MOU grandfathered all existing ACS BSCN and ASMBS BSCOE accredited centers into the unified program and called for all participating centers to report their outcomes data to the existing ACS Bariatric Data Registry Platform.

The MBSAQIP committee structure allows for equal representation from both the ACS and ASMBS and is housed and staffed under the Division of Research and Optimal Patient Care at the ACS. The Committee on Metabolic and Bariatric Surgery (CMBS) functions as the main advisory committee to the MBSAQIP. The co-chairs for the CMBS are Dr. Ninh Nguyen, Chair of the ACS BSCN Advisory Committee and President-Elect of the ASMBS, and Dr. John Morton, Member of the ACS BSCN Advisory Committee and Secretary/Treasurer of the ASMBS. The CMBS membership is made up of the co-chairs of three subcommittees—Standards, Verification, and Data Registry.

The CMBS and Standards Subcommittee convened almost immediately to do the serious work of transforming the first generation accreditation programs into a single, unified program where the accreditation standards are based on a composite of process, structure, and outcomes measures. This process involved a critical evaluation of the current literature, evaluating the most up-to-date model of quality assessment, an extensive review of new collaborative models both in bariatric and general surgery, and discussion of the advantages and disadvantages of the current system with surgical leadership, and integrated health team members. Through committee discussion, the MBSAQIP identified the goal of utilizing reported outcomes to be used as a metric for accreditation and to guide quality improvement efforts. Standards development was guided by this principle, recognizing that it would require a step-wise approach by committee leadership and participating centers to fully achieve this goal.

The initial draft of the standards was released for public comment in December 2012, with multiple changes made as a result of the feedback collected. The second release of the standards for public comment after modification occurred in August 2013. The three subcommittees along with the leadership of the CMBS are committed to guiding the transition and announcing the new unified standards during the first quarter of 2014. The CMBS also continues its work with major payors/insurers to ensure continued commitment to the standards and accreditation of bariatric surgery facilities. The CMBS looks forward to leveraging the standards and data registry to provide quality improvement initiatives, such as decreasing readmissions.

Please stop by the MBSAQIP booth during Obesity Week 2013 in Atlanta, Georgia, for further details regarding the transition, an update on the new standards, or information on becoming an accredited bariatric surgery center.

Category: ASMBS News and Update, Past Articles