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News from the American College of Surgeons

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Optimal Resources for Metabolic and Bariatric Surgery manual presents updated program standards for overweight and obese patients

Third version of nationally recognized standards manual includes a designation for bariatric and metabolic surgery centers to now offer patients non-surgical interventions along with a quality improvement project requirement.

CHICAGO (July 11, 2019): The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a joint quality program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS), has released its third version of program standards to take effect in October 2019. The updated standards, outlined in Optimal Resources for Metabolic and Bariatric Surgery, include a new designation level for facilities offering non-surgical treatment for obesity, as well as a requirement for accredited centers to implement one new quality improvement initiative each year.

In the United States, more than 11 million people suffer from severe obesity and an estimated 93 million people are obese. The comorbidities associated with obesity range from diabetes and heart disease to certain types of cancers. Bariatric surgical procedures have been shown to reduce obesity, improve mortality, and decrease the health risks from chronic diseases like cardiomyopathy and diabetes.

The MBSAQIP standards provide guidance for facilities to build the structure that enables them to provide safe, high-quality care to all metabolic and bariatric patients. Programs seeking MBSAQIP accreditation are required to meet eight overarching standards which outline the framework for program scope and governance, facilities and equipment resources, patient care protocols, data surveillance, and more.

Accredited centers are required to enter every metabolic and bariatric procedure performed for the treatment of obesity-related diseases into the MBSAQIP Registry. This Registry collects prospective, risk-adjusted, clinically rich data based on standardized definitions. Reports from the Registry provide site-specific data that gives participating centers the ability to benchmark their outcomes and compare their results with aggregate national comparison data in the system.

Currently, there are more than 800 MBSAQIP-accredited centers in the United States and Canada, and more than 200,000 bariatric cases are captured annually in the MBSAQIP Registry. The program is celebrating its five-year anniversary in 2019.

An important new accreditation level in the 2019 standards manual is the Obesity Medicine Qualification Accreditation option. This accreditation option provides an additional designation level for facilities that offer non-surgical treatment for patients who are overweight or have Class I, II, or III obesity. Centers with this designation employ nutritional interventions, physical activity, behavioral change, and pharmacotherapy to treat patients. Additionally, these centers will collect and document  specific data elements in which they will monitor patient outcomes against medical weight loss interventions.

“Obesity is a chronic, pervasive disease that requires involvement from the entire ‘house of medicine.’ Our new designation of the obesity medicine qualification is in recognition of new treatment options and providers available to our patients in need,” said John Morton, MD, MPH, FACS, FASMBS, Chair of the ACS Committee for Metabolic and Bariatric Surgery. Dr. Morton is also the incoming vice chair for quality and division chief of bariatric and minimally invasive surgery at the Yale School of Medicine, New Haven, CT.

“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,” Dr. Morton said.

Another standard which has been enhanced requires all accredited centers to measure, evaluate, and improve their performance through at least one quality improvement initiative each year. Centers that are high outliers on the semiannual risk-adjusted report, or SAR must develop initiatives to address their high outlier status. These initiatives can target areas for improvement including patient experience or education, internal processes, clinical pathways, or other issues related to providing high-quality care to patients.

“These updated standards will help the bariatric and metabolic surgery programs build on our already established success with surgical quality improvement for overweight and obese patients,” said ACS Executive Director David B. Hoyt, MD, FACS. “By implementing these program standards, participating centers, as well as new centers seeking accreditation, will be able to raise the bar on surgical quality for their patients.”

“With these standards, we have identified specific strategies for bariatric surgery centers to improve their outcomes for patients who seek surgical treatment and for those who seek to achieve weight loss non-surgically in a medically supervised, supportive environment. Patients who seek treatment at an accredited center will receive care that it is tailored to their individual needs, and is based on the best evidence available in the field,” explained Clifford Y. Ko, MD, MS, MSHS, FACS, FASCRS, Director, ACS Division of Research and Optimal Patient Care.

MBSAQIP is no longer accepting applications under the 2016 standards, and instead will begin accepting applications from new centers in August of 2019. All centers currently accredited under MBSAQIP must be in compliance with the 2019 standards by October of 2019.

More information on the application process is available here. For further information, please contact mbsaqip@facs.org.

 

“FACS” designates that a surgeon is a Fellow of the American College of Surgeons.

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About the American College of Surgeons
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 improve the quality of care for surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 82,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

About the American Society for Metabolic and Bariatric Surgery
The ASMBS is the largest organization for bariatric surgeons in the nation. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in obesity, while maintaining a steady exchange of experiences and ideas that may lead to improved outcomes for morbidly obese patients. For more information, visit www.asmbs.org.