Third Version of MBSAQIP Standards and Pathways Manual Embraces, Reflects Growth of Obesity Medicine

by John M. Morton, MD, MPH, MHA, FACS, FASMBS, ABOM

Clinical Editor of Bariatric Times; Vice-Chair of Quality and Division Chief of Bariatric and Minimally Invasive Surgery in the Department of Surgery at Yale School of Medicine in New Haven, Connecticut.

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Dear Friends and Readers,

As 2019 marks the five-year anniversary of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Standards and Pathways Manual, we reflect on the program’s progress since its release in 2014.¹ The inaugural standards served as the catalyst for facilities seeking to either obtain or maintain MBSAQIP accreditation to build the structure that enables them to provide safe, high-quality care to all metabolic and bariatric patients. And with the launch and subsequent success of quality improvement (QI) projects and collaboration focused on achieving the best possible outcomes, MBSAQIP-accredited centers continue to, as quoted in both the 2016 and 2019 standards, “demonstrate an uncompromising pursuit of quality that has earned the confidence, respect, and trust of patients making a commitment to healthier living.”²

The third version of the standards, which will take effect October 2019, further answers the obvious question asked by patients and healthcare providers a like when considering a facility’s accreditation status: Does it matter?

In short, yes, accreditation matters because it provides an “objective and measurable means in which a center can demonstrate that it offers high-quality care in a multidisciplinary format.” Accreditation status holds facilities to the highest standards in which benchmarking performance against other participating hospitals allows them to pinpoint areas for improvement. Larger targeted QI initiatives, such as Decreasing Readmissions through Opportunities Provided (DROP),³ ENERGY (Employing New Enhanced Recovery Goals in Bariatric Surgery),⁴ and now Bariatric Surgery Targeting Opioids (BSTOP),⁵ generate data-driven feedback, which is necessary to creating and ensuring optimal patient care.

The 2019 Standards also demonstrate the importance of evolving processes based not only on surgical data, but also the general landscape of healthcare. The new designation level for facilities offering nonsurgical treatment for obesity is a direct reflection of how the obesity care continuum has changed in just the past five years. From the rise in United States Food and Drug Administration (FDA) approved medications, devices, and procedures to the burgeoning number of certified Obesity Medicine Specialists, the nonsurgical treatment of obesity has been established as one of the fastest growing fields in healthcare. By offering this new designation and, for the first time ever, inviting Obesity Medicine Physician Contributors to be involved alongside metabolic and bariatric surgeon and ACS staff contributors, MBSAQIP outwardly recognizes the growth of obesity medicine as a discipline and the value of including it in quality obesity care.

As we’ve seen in other fields such as oncology or cardiology, care is best when it is multi-modal and multidisciplinary. In combination, obesity medicine and bariatric surgery can enhance the safety and efficacy of precision treatment for the patient with obesity.

Sincerely,

John M. Morton, MD, MPH, FACS, FASMBS

References

1. American College of Surgeons. Resources for Optimal Care of the Metabolic and Bariatric Surgery Patient: 2014. Chicago, Illinois.
2. American College of Surgeons. Optimal Resources for Metabolic and Bariatric Surgery: 2019 Standards. https://www.facs.org/-/media/files/quality-programs/bariatric/2019_mbsaqip_standards_manual.ashx?la=en. Accessed August 1, 2019.
3. Morton JM, Brethauer SA, Fraker T, et al. Decreasing Readmissions through Opportuni-ties Provided (DROP): The First National Quality Improvement Collaborative from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Surg Obes Relat Dis. 2016;12 (Suppl 7): S1–S2.
4. Brethauer, SA, Petrick A, Grieco A, et al. Employing New Enhanced Recovery Goals for Bariatric Surgery (ENERGY): A Metabolic and Bariatric Surgery Accreditation and Quality Improvement (MBSAQIP) National Quality Improvement Project. Surg Obes Relat Dis. 2018;14(Suppl 11):S6).
5. Petrick A, Gadaleta D. Raising the Standard: Bariatric Surgery Targeting Opioids (BSTOP): The Third MBSAQIP National Quality Improvement Project. Bariatric Times. 2019;16(7):12.

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