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

Grant-Funded Clinical Trials and Research Projects

ACOSOG Community Clinical Oncology Program Research Base

Funding Source: National Institutes of Health National Cancer Institute via subcontract from Mayo Clinic
Project Period: 11/1/2013-5/31/16
Funding Amount: $610,907
PI: David Winchester, MD, FACS

In 2011, the Mayo Clinic was awarded a five-year grant from the National Institutes of Health National Cancer Institute (NIH NCI). The PIs for Mayo—Drs. Nelson and Sloan—chose the American College of Surgeons (ACS) as a subcontractor for part of the work in November 2013. The ACS will lead the expansion of Alliance for Clinical Trials in Oncology (Alliance) research activities to include health services and cancer care delivery research. Some of the areas ACS will focus on are: system and care redesign, investigating effectiveness of current approaches to care, & cost analyses.

Evaluating Cancer Survivorship Care Models

Funding Source: Patient-Centered Outcomes Research Institute via subcontract from George Washington University
Project Period: 7/1/2013-6/30/2014
Funding Amount: $5,334
PI: Nina Miller MSSW, OSW-C

The ACS will participate as part of an advisory board and provide strategic direction for the Project. The majority of Ms. Miller’s time is budgeted for the creation and dissemination of a survey to provide feedback on the Patient-Reported Measure of Quality Survivorship. The ACS will assist with dissemination of project results as appropriate.

LIVESTRONG Treatment Summary and Survivorship Care Plan

Funding Source: LIVESTRONG Foundation via subcontract from University of Pennsylvania
Project Period: 12/18/2012-12/31/2014
Funding Amount: $124,445
PI: Erica McNamara, MPH

The ACS, through the Commission on Cancer (CoC), entered into a two-year subcontract with the University of Pennsylvania (UPenn) to participate in a project to compare the feasibility and implementation of treatment summaries (TS) and survivorship care plans (SCP) at two sites: UPenn and Baptist Memorial Hospital. The UPenn TS/SCP will be populated using data available from their electronic medical records. The Baptist TS/SCP will be populated from the cancer registry, using the CoC National Cancer Data Base (NCDB) Rapid Quality Reporting System (RQRS). The RQRS database will be used to develop files that will populate treatment summary care plans at Baptist, and a user interface will also be developed. Dr. Linda Jacobs from the University of Pennsylvania is the principle investigator for the overall project.

Engaging Patients and Hospitals to Expand Public Reporting in Surgery

Funding Source: Agency for Healthcare Research via subcontract from Northwestern University
Project Period: 9/30/2012-8/31/2015
Funding Amount: $88,664
PI: Dr. Clifford Ko, MD, FACS

The prime contract is through Northwestern University, and the prime principal investigator is Karl Bilimoria, MD, FACS, a former ACS Clinical Scholar in Residence. For the subaward, the ACS National Surgical Quality Improvement Program (ACS NSQIP®) will provide data to allow comparison between public-reporting hospitals and non-public-reporting hospitals. The ACS will also provide expertise in the methodology of hospital quality comparisons.

Prospective Payment System-Exempt Cancer Hospitals Quality Reporting Program

Funding Source: Centers for Medicare & Medicaid Services
Project Period: 9/28/2012-9/27/2015
Funding Amount: $1,726,957
PI: David Winchester, MD, FACS

The Centers for Medicare & Medicaid Services (CMS) has contracted with the ACS to plan and implement the reporting of cancer care measures to CMS on behalf of the 11 Prospective Payment System-exempt cancer hospitals (PCH) through the CoC NCDB’s Rapid Quality Reporting System (RQRS). The requirement for public reporting by the PCHs is defined in Section 3005 of the Patient Protection and Affordable Care Act, and must begin effective Fiscal Year 2014.

The High Fives Project

Funding Source: Agency for Healthcare Research & Quality via subcontract from Joint Commission International
Project Period: 3/1/2011-9/24/2012 and 9/30/2012-9/29/2014
Funding Amount: $316,370
PI: Karen Richards

The High Fives Project is a partnership with The Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), and the American Hospital Association (AHA). Designed to confront the five most challenging patient safety problems in five countries over five years (hence the project name), the project strategy is straightforward: safety will improve through consistent use of safety protocols based on science and process engineering principles. Now the initiative has expanded to 12–15 countries. In the United States, the ACS is the lead technical agency (LTA) with the safety issue being wrong-site surgery. Data is collected to demonstrate whether or not changes result in a significantly safer health care delivery system. The ACS provides technical support to the other countries’ lead agencies as well on the safe surgery protocol. As the LTA, the College was originally awarded a two-year grant from AHRQ and The Joint Commission for $176,000 in support of this mission.

Voluntary Public Reporting on Hospital Compare

Funding Source: Centers for Medicare & Medicaid Services
Project Period: 9/16/2011-9/15/2013 and 9/30/2013-9/29/2014
Funding Amount: $766,581
PI: Clifford Ko, MD, FACS

This is a sole source contract from CMS, which was awarded in September 2011. The original contract purpose was to pilot test the voluntary public reporting of three surgery-related, risk-adjusted outcomes performance measures in hospitals participating in the ACS NSQIP. The public reporting was performed on the Hospital Compare website.

The three surgery-related outcomes performance measures are the following NQF-endorsed measures:

  • Risk-adjusted, lower extremity bypass surgery outcomes
  • Risk-adjusted, case-mix adjusted elderly surgery outcomes
  • Risk-adjusted, case-mix adjusted colorectal surgery outcomes

Based on the success of the pilot project, the ACS was awarded a new sole source contract to continue displaying the three above-named measures.

Development and Demonstration of a Surgical Unit-Based Safety Program (SUSP) to Reduce Surgical Site Infections and Other Complications

Funding Source: Agency for Healthcare Research & Quality (AHRQ) via subcontract from Johns Hopkins University
Project Period: 9/1/2011-8/31/2015
Funding Amount(s): $1,428,984
PI: Clifford Ko, MD, FACS

This is a four-year AHRQ task order with the Quality and Safety Research Group (QSRG) at Johns Hopkins University serving as Prime Contractor and the ACS as the subcontractor. Besides providing ACS NSQIP data, the ACS will provide ongoing surgical perspectives, and technical expertise for the development of interventions to reduce surgical complications, specifically for colorectal surgery. The ACS will also co-lead discussions among the QSRG and the Centers for Disease Control and Prevention (CDC) regarding best ways to leverage ACS NSQIP data, National Healthcare Safety Network data, and project-specific data.

Collaborative Stage Data Collection System

Funding Source: Centers for Disease Control Prevention
Project Period: 9/30/2008-9/29/2013 and 8/20/2013-8/29/2018
Funding Amount(s): $3,458,151
PI: David P. Winchester, MD, FACS

The American Joint Committee on Cancer (AJCC), headquartered at and staffed by the ACS, provides the program management for the development and maintenance of the Collaborative Staging (CS) system—a tumor, node, and metastasis coding system used by cancer registries to collect information on the extent of disease for cancer patients seen at their facility. Originally, the ACS received a five-year CDC cooperative agreement to provide staff and committee support to revise the current CS System and release a version 2 compatible with the new AJCC Cancer Staging Manual 7th edition. Based on its success, the ACS was awarded a new five-year cooperative agreement July 2013 for continued support and maintenance of CS.