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President's Message
Operative Competency Evaluation Committee
Why the Society is developing a case log system for MOC
Nominate journalists for 2011 National Media Awards
Washington Update

Four granted Great Comebacks® Award

Website update
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ASCRS seeks nominations for 2011 Community Impact Award

Vancouver to host Society's 2011 Annual Meeting, May 14 - 18

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Why the Society is developing a case log system for MOC

By Dr. Conor P. Delaney, Cleveland, OH

Dr. Conor Delaney

Dr. Conor Delaney

The Society is developing a case log system for Maintenance of Certification (MOC), and we plan to have a working model ready for review at the Vancouver Annual Meeting, May 14-18. The ASCRS case log system needs to be sufficiently complex to be a valid tool for certification, without being overly burdensome for the membership.

The current American College of Surgeons (ACS) case log is a very complete system that enables ASCRS members to track their own cases, but it is generic and probably not ideally suited for certification with the American Board of Colon and Rectal Surgery (ABCRS).

We started by using a modified Delphi method to identify key operations to include in the case log. The Delphi method uses “rounds” of anonymous, open-ended questionnaires. Our panels identified six key operations for the case log: colectomy (laparoscopic and open), rectal cancer resection, hemorrhoidectomy, anal fistula and abscess, colonoscopy, and rectal prolapse.

Recognizing that endpoints for quality assessment of colorectal surgical care are poorly defined, we continued with the modified Delphi to rank the endpoints for each of these procedures/diagnoses. Standardized, consensus-derived parameters are needed for case reporting and quality improvement. We also wanted to be sure the case log endpoints would integrate closely with the CREST Committee’s plans for online education.

After initial development of endpoints by a core group of eight surgeons, the endpoints were expanded and scored in three successive rounds of 8, 18, and 28 members from the ABCRS, Executive Council, and the Society’s Quality and CREST (online education) Committees. We have now developed a consensus-derived listing of 90 endpoints for these six key operations in colorectal surgery. These data provide a framework for development of case reporting and quality-based initiatives for colon and rectal surgery, and should be suitable endpoints for use in prospective studies.

Common endpoints are complications, mortality (30-day), reoperation (30-day), comorbidities, readmission (30-day), American Society of Anesthesia (ASA) score, Body Mass Index (BMI), hospital stay, and demographics. Specific endpoints have been ranked for each procedure.

We have worked closely with Dr. Clifford Ko, Los Angeles, CA, an ASCRS Fellow who developed the ACS case log system to be sure our system will integrate well with the ACS system. We plan to have a working model available for members to view by the time of the Annual Meeting.