Surgery RRCSurgery RRC

Thomas V. Whalen, MD, ChairThomas V. Whalen, MD, Chair

RRC—Surgery MembersRRC—Surgery Members

■ Thomas V. Whalen, MD, Chair■

■ J. Patrick O’Leary, MD, Vice Chair

■ Adeline Deladisma, MD, Resident

■ Timothy R. Billiar, MD

■ G. Patrick Clagett, MD

■ Peter J. Fabri, MD

■ Linda M. Harris, MD

■ George W. Holcomb, MD

■ Thomas V. Whalen, MD, Chair■

■ J. Patrick O’Leary, MD, Vice Chair

■ Adeline Deladisma, MD, Resident

■ Timothy R. Billiar, MD

■ G. Patrick Clagett, MD

■ Peter J. Fabri, MD

■ Linda M. Harris, MD

■ George W. Holcomb, MD

■ James C. Hebert, MD

■ Mark A. Malangoni, MD

■ Marshall Z. Schwartz, MD

■ Charles W. Van Way III, MD

■ Marc K. Wallack, MD

■ Frank Lewis, MD, Ex-Officio ABS

■ Patrice Blair, MPH, Ex-Officio ACS

■ James C. Hebert, MD

■ Mark A. Malangoni, MD

■ Marshall Z. Schwartz, MD

■ Charles W. Van Way III, MD

■ Marc K. Wallack, MD

■ Frank Lewis, MD, Ex-Officio ABS

■ Patrice Blair, MPH, Ex-Officio ACS

Surgery RRC--MembersSurgery RRC--Members

■ 3 AMA-CME nominees■ 3 ACS nominees■ 3 ABS nominees■ 1 resident■ Ex-Officio Liaisons

(ABS, ACS)

■ 3 AMA-CME nominees■ 3 ACS nominees■ 3 ABS nominees■ 1 resident■ Ex-Officio Liaisons

(ABS, ACS)

RRC—Surgery LeadershipRRC—Surgery Leadership

■ Chair■ Vice-Chair■ Chair-Elect (Chosen during Chair’s 3rd year)■ Executive Committee (Chair, VC, Chair-Elect)

– Interim Administrative Decisions• (Participating Site, Temporary Increases in Complement)

– Review and approve meeting agenda, newsletters, etc.– Meet with ED and Administrator prior to each RRC

meeting

■ Vice-Chair mentors new members

■ Chair■ Vice-Chair■ Chair-Elect (Chosen during Chair’s 3rd year)■ Executive Committee (Chair, VC, Chair-Elect)

– Interim Administrative Decisions• (Participating Site, Temporary Increases in Complement)

– Review and approve meeting agenda, newsletters, etc.– Meet with ED and Administrator prior to each RRC

meeting

■ Vice-Chair mentors new members

Surgery—Program Data 2010Surgery—Program Data 2010Total

ProgramsCont.

Accred.Initial

Accred.Other

Surgery 245 234 4 7

Pediatric Surgery 38 31 7 0

Critical Care 95 82 13 0

Vascular-Independent 100 90 9 1

Vascular-Integrated 21 2 19 0

Hand 1 1 0 0

TOTAL 500 440 52 8

Surgery—Resident Data 2010Surgery—Resident Data 2010Approved Positions

Filled Positions

% filled vs approved

Surgery 8255 7410 89.7%

Pediatric Surgery 76 72 94.7%

Critical Care 211 158 74.8%

Vascular-Independent 262 246 93.8%

Vascular-Integrated 115 40 34.8%

Hand 8 8 100%

TOTAL 8927 7934 88.9%

Site Visit Results 2008-2009Site Visit Results 2008-2009

■ 124 programs were surveyed– 110 administrative requests at meetings– 283 administrative interim decisions

■ 237 citations issued by RRC– (1.91 citations per program)

■ Average cycle length: 3.43 yrs.■ Common Citations

– Education Program – Procedural Experience– Evaluation– Residents, Faculty, Program

■ 124 programs were surveyed– 110 administrative requests at meetings– 283 administrative interim decisions

■ 237 citations issued by RRC– (1.91 citations per program)

■ Average cycle length: 3.43 yrs.■ Common Citations

– Education Program – Procedural Experience– Evaluation– Residents, Faculty, Program

2009 RRC Activity2009 RRC Activity

■ 152 programs reviewed (post site-visit)■ 3.68 year average cycle length■ 261 citations■ 3.43 citations per program review■ 72 administrative requests■ 328 interim requests (PD changes,

participating site change, temporary increases)

■ 152 programs reviewed (post site-visit)■ 3.68 year average cycle length■ 261 citations■ 3.43 citations per program review■ 72 administrative requests■ 328 interim requests (PD changes,

participating site change, temporary increases)

Surgery RRC InnovationSurgery RRC Innovation

■ Collaboration with SCORE■ Milestones■ Use of Reviewer Templates■ Use of Citation Glossary (core only)■ Adoption of Grovesite

– Program workups (excluding PIF)– Submission of Reviewer Notes

■ Collaboration with SCORE■ Milestones■ Use of Reviewer Templates■ Use of Citation Glossary (core only)■ Adoption of Grovesite

– Program workups (excluding PIF)– Submission of Reviewer Notes

RRC MeetingsRRC Meetings

■ Meet 3 times annually (1.5 days)■ Chair uses ED’s reconciliation sheet to

alert members to widely discordant recommendations prior to meeting.

■ Meet 3 times annually (1.5 days)■ Chair uses ED’s reconciliation sheet to

alert members to widely discordant recommendations prior to meeting.

RRC Meetings (cont.)RRC Meetings (cont.)

■ Order of program review– Adverse action rebuttal responses– Consent Agenda (PRs, permanent

increases) • Items recommended by RRC team, members

are asked to pull any items they would like discussed.

– Full Program Reviews– Duty Hour Reports

■ Order of program review– Adverse action rebuttal responses– Consent Agenda (PRs, permanent

increases) • Items recommended by RRC team, members

are asked to pull any items they would like discussed.

– Full Program Reviews– Duty Hour Reports

CommunicationCommunication

■ Stakeholders– ACGME Education Conference—Chair/ED– APDS (2x/yr)—Chair/ED– APDVS (1x/yr)—Member/ED – Pediatric Surgery PDs (1x/yr—Chair or ED– Surgical Critical Care PDs—Member– Coordinator Groups (1x/yr)—ED, OpLog

Staff

■ Stakeholders– ACGME Education Conference—Chair/ED– APDS (2x/yr)—Chair/ED– APDVS (1x/yr)—Member/ED – Pediatric Surgery PDs (1x/yr—Chair or ED– Surgical Critical Care PDs—Member– Coordinator Groups (1x/yr)—ED, OpLog

Staff

Communication (cont.)Communication (cont.)

■ Attendance at RRC meetings– 3 attended in 2009-10– Use of Evaluations

■ Newsletters– 3 times per year (after each RRC meeting)

■ Attendance at RRC meetings– 3 attended in 2009-10– Use of Evaluations

■ Newsletters– 3 times per year (after each RRC meeting)

Committee QICommittee QI

■ Member Evaluation■ Program Reviews■ New Member mentoring■ Process monitoring at conclusion of

each meeting

■ Member Evaluation■ Program Reviews■ New Member mentoring■ Process monitoring at conclusion of

each meeting

Strategic Planning ProcessStrategic Planning Process■ Retreats

– February 2007 Retreat• Topics

– Communication with stakeholders– Process improvements– Consistency among Core and sub PRs

– Next Retreat ???????????

■ Use of Subcommittees– PR revisions– Op Log Revisions

■ Retreats– February 2007 Retreat

• Topics– Communication with stakeholders– Process improvements– Consistency among Core and sub PRs

– Next Retreat ???????????

■ Use of Subcommittees– PR revisions– Op Log Revisions

RequirementsRequirements

■ ECA Experience at Integrated Sites■ PD Appointment■ NDP and DP Residents■ Formal Transplant Rotation■ Definition of Resident as “Surgeon”

– Operative minimums to be reset

■ “New Patient” definition■ No 88 hour exemptions

■ ECA Experience at Integrated Sites■ PD Appointment■ NDP and DP Residents■ Formal Transplant Rotation■ Definition of Resident as “Surgeon”

– Operative minimums to be reset

■ “New Patient” definition■ No 88 hour exemptions

Future OpportunitiesFuture Opportunities

■ Development of new sub-specialty– Advanced Surgical Oncology

■ Additional RRC member– Number of total programs has grown from

457 in 2003 to 500 in 2009 (9%)

■ International Rotations■ Residency Training Restructuring

Committee

■ Development of new sub-specialty– Advanced Surgical Oncology

■ Additional RRC member– Number of total programs has grown from

457 in 2003 to 500 in 2009 (9%)

■ International Rotations■ Residency Training Restructuring

Committee