Patricia L. Turner, MD, MBA, FACS
February 7, 2024
The American College of Surgeons is the largest organization of surgeons in the world, representing surgeons in 144 countries. As such, we expect our members to hold a wide range of opinions on various issues.
There are areas, however, on which everyone worldwide seems to agree. Our collective interest in prioritizing the well-being of children is one such topic.
The ACS was founded in 1913, several years before pediatric surgery first emerged in the US (under the influence of the legendary pediatric surgeon William E. Ladd, MD, FACS). The ACS’s motto, “To Heal All with Skill and Trust,” which has been in use since our founding, of course includes patients of all ages.
Because we are the House of Surgery, our experiences with and contributions to pediatric surgery go well beyond a slogan. In October, we initiated a pediatric surgeon, Henri R. Ford, MD, MHA, FACS, as ACS President. He brings an impressive track record of achievements in surgery, research, and leadership to the role, including in neonatology and pediatric global surgery. “I chose pediatric surgery because that’s the discipline where I felt I could make the biggest difference,” Dr. Ford said in his Presidential Address. Later, in conversation, he added, “Pediatric surgeons ought to play a role in the entire spectrum of activities that the American College of Surgeons represents.”
In many ways, they do. In addition to Dr. Ford’s leadership, we enjoy the presence of three pediatric surgeons on our Board of Regents (Don K. Nakayama, MD, MBA, FACS, Diana L. Farmer, MD, FACS, and Andrea A. Hayes Dixon, MD, FACS), as well as several on the Board of Governors, Committee on Trauma, and elsewhere. A pediatric surgeon, Patrick V. Bailey, MD, MLS, JD, FACS, serves as Medical Director of our Division of Advocacy and Health Policy. These surgeons help lead the ACS as we work toward improving the care all children receive.
Quality improvement programs are central to the ACS mission, and in 2017, the ACS began offering Children’s Surgery Verification (CSV). The CSV Program offers site visits and consultations that help ensure healthcare institutions meet quality standards for children’s surgical care, as reflected in Optimal Resources for Children’s Surgical Care, an ACS standards document. There are 59 hospitals with current CSV verifications.
At many sites, the CSV Program incorporates use of the ACS National Surgical Quality Improvement Program® (NSQIP) Pediatric registry, a complex database that expands on the original NSQIP, which included only adult patients. NSQIP is a standard-bearing Quality Program with a long history—one of several at the ACS—and it provides valuable benchmarks for individual institutions and surgeons to understand and improve their surgical outcomes. Our NSQIP Pediatric registry includes data from more than one million pediatric surgical cases since 2012, including pediatric neurosurgery, plastic surgery, orthopaedic surgery, and more.
Our pediatric surgery offerings extend into Trauma Quality Programs as well. In 2022, we released Resources for Optimal Care of the Injured Patient, which includes a pediatric verification standard that addresses how to evaluate pediatric trauma readiness. A pediatric trauma readiness score quantifies how ready a healthcare institution is to address the unique needs of injured children. In October 2023, the Annals of Surgery published a study examining 66,588 pediatric cases in 630 hospitals, using ACS Trauma Quality Improvement Program models of pediatric trauma readiness. The study found the greater the readiness scores at a given facility, the lower the mortality risk for pediatric patients.
There is work to be done to ensure healthcare centers are adequately prepared. Ronald M. Stewart, MD, FACS, a past-Chair of the ACS Committee on Trauma, has said: “At least one-third of Americans today live in an area without a complete trauma system, and tens of thousands of lives are lost unnecessarily each year. This is the most important health problem facing our children.”
With this in mind, the ACS has steadily advocated for a National Trauma and Emergency Preparedness System. The intention is for pediatric patients, as well as all others, to benefit from improved coordination in trauma care. Indeed, the number one cause of death for US children is now firearm injuries, which underscores the importance of this work. This initiative is one of several pediatric surgery-related efforts our Advocacy and Health Policy team has pursued.
Beyond awareness of these efforts, there are many opportunities for pediatric surgeons in all specialties to engage with the ACS. Like me, Dr. Ford began his journey toward ACS leadership as an ordinary ACS member—in his case, of the Pittsburgh Chapter. Describing Clinical Congress, chapter participation, and contact with the ACS Advisory Council, he has said, “My message to my fellow pediatric surgeons is, ‘Let’s get involved early on with the College because we have so much to offer.’”
Each year, hundreds of surgeons gather in Washington, DC, for our 3-day Leadership & Advocacy Summit, which is followed by Capitol Hill Day, when surgeons visit Congressional offices to share insights into surgical issues affecting their districts. Please join us to become part of positive change for surgeons and surgical patients, including in pediatrics. Register now at facs.org/summit.
Our annual Quality and Safety Conference (QSC) also highlights pediatric surgery. This year, we will meet in Denver, Colorado, July 18-22. If you’d like to present, please submit your abstract by February 29, at facs.org/qsc2024.
Clinical Congress 2023 also featured many pediatric surgery presentations. Conference content and dozens of continuing medical education credits remain available until May 1, 2024, for all registrants. If you did not attend, registration for on-demand content remains open at facs.org/clincon2023.