About the Program

Scrutiny of contemporary weight loss surgery reveals a need for organization, standards, and data on outcomes. The decision to recommend surgery for obese patients requires multidisciplinary input to evaluate the indications for operation and to define and manage co morbidities properly. Institutions providing weight loss surgery must have certain commitment, organization, leadership, human resources, and physical resources to provide optimal care. The professionals must have the necessary training, skills, and experience demonstrable. And, high quality surgical care requires documentation with reliable measurements of outcomes.

For all of these reasons, the American College of Surgeons will recognize and commend those facilities, which implement defined standards of care, document their outcomes, and participate in periodic reviews and verifications of their programs in bariatric surgery. The American College of Surgeons Bariatric Surgery Center Network (ACS BSCN) Accreditation Program manual describes these standards and delineates four levels of inpatient facilities (1a, 1b, 2a and 2b) as well as standards for outpatient surgical care. Level 1a and 2a hospitals must agree to enroll in the ACS NSQIP as a means of measuring their surgical outcomes. Level 1b, 2b, and outpatient facilities will use an ACS in-house database to collect their outcomes.

The American College of Surgeons will recognize certain hospitals as Level 1a and 1b Bariatric Centers. Such hospitals will provide complete tertiary care, physical and human resources devoted to bariatric surgery. These hospitals can manage the most challenging and complex patients with optimal opportunity for safe and effective outcome. They will have high volume practices conducted by professional services of breadth and depth.

Recognizing the need for access to Bariatric Surgery and recognizing that high quality surgical care occurs in other than high volume tertiary centers, the American College of Surgeons will designate certain facilities as Level 2a and 2b Bariatric Surgery Centers. These centers will provide high quality care to a lower volume of patients having lesser obesity and lesser comorbidities.

Outpatient surgery centers will provide for the application and adjustment of laparoscopic gastric bands. Furthermore, laparoscopic gastric bypass can be done with discharge from the unit in less than 24 hours. For those reasons the American College of Surgeons will recognize as Outpatient Bariatric Surgery Centers those facilities which implement stipulated standards, maintain physical and human resources, and document their outcomes.

Hospitals that meet the ACS bariatric accreditation program criteria may submit an application to the program for consideration by the ACS Bariatric Advisory Committee. If approved by the advisory committee, the hospital must then submit a signed participation agreement along with the program fee of $10,000. Once these items have been received, the hospital becomes a Provisional Member of the program. Within six months of Provisional Membership, the facility must undergo a site visit to affirm that the level appropriate high-quality standards of the ACS bariatric accreditation program have been met. After a favorable site review and approval by the advisory committee, the hospital will receive full accreditation status. The period of accreditation is for three years, however, centers must maintain their accreditation status during this period by submitting an annual report documenting their continued compliance with the program's requirements and must also report its outcomes. For re-accreditation, the institution must repeat the program's application and site review process tri-annually.

Benefits of ACS Bariatric Surgery Center Network Accreditation

The greatest benefit of ACS accreditation is the demonstration to bariatric patients and the medical community that your Bariatric Surgery Center provides the highest level of care. Other benefits include:

• Patients will recognize your center as having established high quality performance measures for bariatric care.
• Eligible patients who seek bariatric surgical care in fully approved Level 1 facilities as accredited by the American College of Surgeons may qualify for coverage under the terms set by the Centers for Medicare & Medicaid Services (CMS).
• Your center will be able to provide bariatric surgery data expected by clinicians, health care professionals, third-party payers, managed care organizations, and the general public.
• Your center will receive national public recognition as the ACS will publicize accredited centers on its Web site and through its many publications.
• Your center will remain abreast of the latest standards and best practices including performance improvement information.

Online March 22, 2006 

Bariatric Surgery Center Network Program

Continuous Quality Improvement