FEBRUARY 2011 Volume 96, Number 2 FEATURES Stephen J. Regnier Olga M. Jonasson Lecture: Editor Women in the professions 12 Linn Meyer Nina Totenberg Director, Division of Integrated Communications 2010 federal elections: ACSPA-SurgeonsPAC backs champions of surgical patients 24 Tony Peregrin Sara Morse Associate Editor Diane S. Schneidman 2010 state election outcomes 29 Contributing Editor Charlotte Grill Tina Woelke Advocating for state injury prevention laws 31 Graphic Design Specialist Peter T. Masiakos, MD, FACS, FAAP Charles D. Mabry, Revised statement on recommendations for use of real-time MD, FACS ultrasound guidance for placement of central venous catheters 36 Leigh A. Neumayer, MD, FACS Marshall Z. Schwartz, MD, FACS Mark C. Weissler, DEPARTMENTS MD, FACS Editorial Advisors Looking forward 4 Tina Woelke Editorial by David B. Hoyt, MD, FACS, ACS Executive Director Front cover design What surgeons should know about... 6 PQRS reporting in 2011 Future meetings Caitlin Burley Clinical Congress Socioeconomic tips 38 2011 San Francisco, CA, Coding for debridement October 23-27 Jenny Jackson, MPH 2012 Chicago, IL, Advocacy advisor 41 September 30– Surgeons as advocates October 4 Charlotte Grill and Catharine Harris 2013 Washington, DC, October 6–10 Letters to the Editor should be sent with the writer’s name, address, e-mail ad- dress, and daytime tele- phone number via e-mail to [email protected], or via mail to Stephen J. Regnier, Editor, Bulletin, American College of Surgeons, 633 N. Saint Clair St., Chicago, IL 60611. Letters may be edited for length or On the cover: National Public Radio correspondent Nina Totenberg addresses clarity. Permission to publish letters is assumed unless the the challenges women have had to overcome when pursuing careers in business, author indicates otherwise. law, or medicine. (See article, page 12.) NEWS Bulletin of the American College of Surgeons (ISSN Can Twitter campaigns increase awareness 0002-8045) is published about health issues? 44 monthly by the American Col- by Marcos E. Pozo Jatem; Kathleen Casey, MD, FACS; lege of Surgeons, 633 N. Saint Clair St., Chicago, IL 60611. It and Adam L. Kushner, MD, MPH, FACS is distributed without charge to Fellows, Associate Fellows, Did you know... 45 Resident and Medical Student Members, Affiliate Members, Time to Tweet: Social networking for surgeons 46 and to medical libraries and al- Tony Peregrin lied health personnel. Periodi- cals postage paid at Chicago, Sir Bernard Ribeiro appointed to UK’s House of Lords 50 IL, and additional mailing of- fices. POSTMASTER: Send ad- Fellows receive AMA Foundation awards 51 dress changes to Bulletin of the American College of Surgeons, Dr. Malangoni hired as ABS associate executive director 51 3251 Riverport Lane, Maryland Heights, MD 63043. Canadian Selected Readings in General Surgery: Publications Mail Agreement An interview with Editor-in-Chief Lewis Flint, MD, FACS 53 No. 40035010. Canada returns Stephen J. Regnier to: Station A, PO Box 54, Wind- sor, ON N9A 6J5. Trauma meetings calendar 55 The American College of Surgeons’ headquarters is lo- A look at The Joint Commission: cated at 633 N. Saint Clair St., JCI introduces international quality measures 57 Chicago, IL 60611-3211; tel. 312-202-5000; toll-free: 800- 2012 Traveling Fellowship to Germany announced 59 621-4111; e-mail:postmaster@ facs.org; website: www.facs. Letters 60 org. Washington, DC, office is located at 20 F Street N.W. Correction 60 Suite 1000, Washington, DC. 20001-6701; tel. 202-337- NTDB® data points: 2701; website: www.tmiva. Annual Report 2010: The rurality of pediatric trauma 63 net/20fstreetcc/home. Unless specifically stated Richard J. Fantus, MD, FACS; and Avery B. Nathens, MD, PhD, FACS otherwise, the opinions ex- pressed and statements made Chapter news 66 in this publication reflect the Rhonda Peebles authors’ personal observations and do not imply endorsement by nor official policy of the American College of Surgeons. ©2011 by the American College of Surgeons, all rights reserved. Contents may not be reproduced, stored in a retrieval system, or transmit- ted in any form by any means without prior written permis- sion of the publisher. Library of Congress number 45-49454. Printed in the USA. Publications Agreement No. The American College of Surgeons is dedicated to improving the care of the sur- 1564382. gical patient and to safeguarding standards of care in an optimal and ethical practice environment. Looking forward ince its inception nearly 100 years ago, the American College of Surgeons (ACS) and its Fellows have pledged “to serve all with Sskill and fidelity.” Embedded firmly within those words is a commitment to constantly improve the quality of care we provide to our patients, and ’’ to assist the surgeons who deliver that care in continually enhancing their skill and expertise. For Fellows of the College, a focus on quality is an integral part of daily practice. What is new, however, is the health care community’s emerging appreciation of the potentially positive impact that ‘Inspiring Quality’ is at the a fully integrated, continuous, quality improvement program can have on patient care and health care heart and soul of what it costs. Quality improvement fundamentals in our databases and our accreditation and verification means to be a Fellow. programs are increasingly understood as being essential elements in surgical patient care, and these programs help create the infrastructure for intensity, passion, and dedication that we share a continuous learning environment. in our pursuit of excellent patient’’ care. Just as The demand for these kinds of substantive importantly, it will highlight how others in the outcomes-based concepts will only grow with the health care community “inspire quality” as well. implementation of the Affordable Care Act. Even if The ultimate campaign message is clear: ACS there are changes to the legislation, leaders in gov- systems and programs measurably improve care ernment, business, and health care are still looking and deliver better patient outcomes, and we are for innovative thinking on how we can collectively eager to work with all stakeholders to address drive better quality and value in health care. quality improvement and value in health care. Now is the time for the ACS to more publicly Quality is a shared interest and a shared mission. assert its preeminence in quality improvement Working together, we can deliver inspired health models and performance improvement measures. care solutions. About the campaign The Inspiring Quality campaign provides the communications platform that will allow us to help shape and lead the quality agenda. It will highlight the College’s leadership in the develop- ment and implementation of quality improvement programs and models and will show why our programs are Certainly, the public policy, demographic, and eco- the “gold standard” in this arena. nomic forces are all aligned to create an environ- Our goals will be to inspire and engage stake- ment that is suitable and ready for making great holders across the health care continuum to join strides in health care quality in this country. As the in the effort to improve quality using the most major innovator and promoter of surgical quality fundamental metric: Did the patient have the programs, the College has an opportunity to lead. best outcome we could expect given his or her To take advantage of the current climate, the individual circumstances? We know when we ACS is launching a new campaign this month. focus on the patient, we deliver better care, our The campaign, “Inspiring Quality: Highest Stan- patients heal faster, and we learn more. The job of dards, Better Outcomes,” seeks to capture the this campaign is to rally all stakeholders around 4 VOLUME 96, NUMBER 2, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS this simple, yet sometimes forgotten, principle. campaign. It is the cornerstone for our messaging We want health care stakeholders to value our in all its forms, whether a brochure, speech, video, expertise in quality improvement not because we media interview, or presentation. are hungry for credit, but rather to assure them Much as the white paper serves as the intellectual that while the road to quality is sometimes rocky, foundation for the campaign, an “anthem video” it can be traversed. will be its spiritual equivalent. Designed to touch When stakeholders think about “new models an emotional chord within those of us who care for of care” that work collaboratively across the con- patients, it also carries a universal truth that we tinuum of care, we want them to think of the ACS believe will resonate with all viewers. trauma and cancer programs. While the campaign is designed to appeal to all When the health care policymakers and payors audiences, we are very directly targeting a subset think about new and better ways to measure, track, of health care stakeholders who share a profes- and improve outcomes, we want them to think of sional and financial interest in seeing genuine the ACS National Surgical Quality Improvement and comprehensive quality improvement succeed. Program (ACS NSQIP®) and its positive impact on These audiences include the business community— morbidity, mortality, and preventable costs. health care business purchasers and coalitions, When hospitals look to reduce preventable com- hospitals and health plans—as well as the quality plications and hospital-acquired conditions, we community, including individuals who work in want them to be aware of ACS NSQIP’s ability health plans, insurance companies, hospitals, and to address these problems now and in the future. government agencies. Through one-on-one meet- And, when industry researchers and government ings, news stories, interviews, speeches, and other regulators look for new models of clinical trials communications with key decision makers, we hope that are transparent, ethical, and appropriate, we not only to inform, but to deliver a call to action want them to know that the College has proven that will open the door for future partnerships in systems for measuring safety and efficacy, and for the public and private sectors.