American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Eileen M. Bulger, MD, FACS

A Note of Thanksgiving

As Thanksgiving has passed and we begin to wrap up 2019, I want to express my gratitude to all the members of the Committee on Trauma who continue to work tirelessly to achieve our vision of eliminating preventable death and disability from injury across the globe. 2019 has been a remarkable year and I would like to highlight just a few of the many accomplishments this past year.

Highlights from 2019

January—In early January, the COT Executive Committee and Committee Chairs met to continue our strategic planning process that prioritizes projects for each pillar, including education, trauma center quality, trauma systems, injury prevention, and advocacy. In addition, we launched several projects to improve membership engagement and support our international growth. One of the key projects for the quality pillar is to develop a feasible strategy to understand the long-term functional outcomes of our patients through the collection of patient-reported outcome measures. To that end, we hosted a conference to bring multidisciplinary experts from around the globe to explore the optimal outcome metrics and approaches to data collection.

February—As part of our ongoing strategic action plan to support firearm injury prevention, we hosted a Medical Summit in February which brought together 44 major medical organizations and the American Bar Association to identify opportunities to reach consensus on a public health approach and to build collaborative efforts. This meeting was a tremendous success and has fostered ongoing projects to support these efforts.

March—Our Spring COT meeting in Chicago was incredibly productive and we hosted a special session on trauma systems as the framework for disaster response. We were honored to have Robert Kadlec, Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health & Human Services (HHS) as our keynote speaker to share his vision for the future organization of regionalized disaster response networks, and we heard about the lessons learned from Nebraska, Massachusetts, and Texas, where these efforts are underway. The ATLS Global symposium followed and provided an opportunity for networking ATLS course directors and coordinators from around the world as we complete the rollout of the 11th edition.

April—In April, we joined in the ACS Leadership and Advocacy Summit to continue to promote our approach to firearm injury prevention, including advocating for dedicated research funding to the CDC and NIH to help us understand the best practices for firearm injury prevention.

May—The Proceedings from the Medical Summit on Firearm Injury Prevention were published online in JACS.

June—In June, the Executive committee and committee chairs met with ACS staff for formal project management training to establish a structured framework to advance the strategic initiatives. In addition, a multidisciplinary panel of experts was convened to review the current evidence and update our joint statement on the clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA). This statement was endorsed by the ACS COT, American College of Emergency Physicians (ACEP), the National Association of Emergency Medical Services Physicians (NAEMSP), and the National Association of Emergency Medical Technicians (NAEMT), and it was subsequently published in Trauma Surgery and Acute Care Open.

July—In collaboration with the Coalition for National Trauma Research (CNTR), we hosted a Research Methodology Conference focused on innovative approaches to the future of clinical trauma research. We learned about implementation science, pragmatic clinical trials, novel trial designs, and lessons learned from the Canadian Critical Care Trials Network. The scientific advisory council for CNTR was convened and is exploring funding opportunities to leverage the TQIP platform to support multicenter investigation and improve outcomes for our patients.

August—In August, we achieved the incredible milestone of over 1 million people trained in Stop the Bleed! Thanks to your efforts, this program continues to grow exponentially and has been a great opportunity to build relationships in the community. Legislation has passed in several states to support implementation in school systems, and we have now organized state and regional champions through our regional committee structure to continue to support these efforts. Thanks to everyone who has continued to support the growth of this program in their local communities!

September—In September, we announced the creation of a new opportunity to support a Clinical Scholar in Residence at the ACS focused on firearm injury prevention. This position is fully funded and will support career development for young surgeon including a Master's degree from Northwestern. This effort is supported by the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM), American Association for the Surgery of Trauma (AAST), Eastern Association for the Surgery of Trauma (EAST), Western Trauma Association (WTA), and the ACS. Applications are open now! Also in September, we were awarded a grant from the National Highway Transportation and Safety Administration (NHTSA) to conduct and evidence-based update to the Field Triage Guidelines for Trauma Patients, which will take place over the next two years.

October—October was focused on the busy Clinical Congress meeting, where we were excited to highlight the Future Trauma Leaders (FTL) Program, which has been an incredible success in engaging our next generation of trauma surgeons in all the COT has to offer. We announced the FTL100 campaign, which seeks to raise $1 million by 2022 in celebration of the 100th anniversary of the COT. Thanks to your support, we are well on our way, having raised $65,000 at the end of October. As we approach the year's end, please consider a gift to support this effort.

November—The 9th annual TQIP meeting was held November 16–18 in Dallas, TX, with more than 1,900 trauma program managers, medical directors, and registrars in attendance. This was an incredible networking opportunity focused on practical quality improvement activities. Some of the highlights from the meeting included Dr. Todd Maxson sharing his experience as a trauma patient after a life threatening motorcycle collision; a focus on how to create high reliability teams through simulation with a live trauma resuscitation simulation by a team from Parkland, ongoing discussion about the implantation of Patient reported outcome measures; and the rollout of our latest Best Practices Guidelines for Trauma Center Recognition of Child Abuse, Elder Abuse, and Intimate Partner Violence.

December—We successfully concluded our first in-person meeting of our new Improving Social Determinants of Health to Attenuate Violence (ISAVE) team on December 12. This multidisciplinary team will focus on practical projects to promote trauma informed care and address social determinants in our communities. Our Firearm Strategy Team (FAST) also continues to meet to advance responsible firearm ownership and safety. In addition, we are convening a new COT Advisory Workgroup on Equity, Diversity, and Inclusion, which will develop strategic priorities and projects to incorporate into our next planning session in January.

As you can see, it has been an incredible year, and it is thanks to all of you for your commitment that this work is possible. I want to thank our medical directors, Dr. Stewart and Dr. Nathens, for their tireless efforts; Jean Clemency and all the ACS Trauma staff who keep us on track; my Vice-Chair, Dr. Pat Reilly and all executive committee leaders and committee and workgroup chairs who have developed and continue to execute our strategic vision; Dr. Hoyt and the Board of Regents for supporting these efforts; and finally, all of you for the work you do every day. I hope you enjoy some time with your friends and family over the holidays and look forward to another exciting year in 2020!

Eileen Bulger, MD, FACS
Chair, ACS Committee on Trauma

Wishing you a joyous holiday season with peace and cheer in the New Year!

Eileen M. Bulger, MD, FACS, Chair, Committee on Trauma; Ronald M. Stewart, MD, FACS, Medical Director Trauma Programs; and the COT staff in Chicago and Washington, DC.