Create Committee Update

We are enjoying a very successful year on the Acute Care Committee.  Our highlights include:

1. Continued collaboration with the AAST on lap-endoscopic approaches to emergency general surgery patients.  Eric Pauli gave a tremendous hands-on course on endoscopic bleeding control and Brent Matthews gave a masterful talk on hernia management in the acute setting, both at the 2019 AAST annual meeting.  There has been a request to conduct an advanced endoscopic course with AAST every year to give exposure to the Trauma/CC fellows.  Plans have already been made for their meeting next fall.
2. Established a collaboration with EAST on lap-endoscopic approaches to emergency general surgery patients.  Past SAGES president Steve Eubanks and several SAGES members Sharona Ross, Andrea Pakula, Matt Martin, Micheal Cripps, Sara Hennessey, and Kimberly Davis gave tremendous lectures at the 2020 EAST annual meeting.  The feedback has been overwhelmingly positive and there were several requests for another course next year.
3. We've been asked by the World Society of Emergency Surgery (WSES) to provide similar expertise and faculty to their annual meeting  and we are in discussions about making this a possibility in 2021.
4. We are on schedule to have a 5 society acute care session at SAGES to include SSAT, EAST, AAST, ASCRS, and SAGES.
5. We continue to have a Facebook journal club that offers CME.
6. We have started and hope to publish by December 2020, our best practice guidelines on management of surgical oncology emergencies.

The Community Practice Task Force is growing and ever-evolving.  We have recently updated our goals as follows:

• Organize the efforts regarding Community Practice Surgery.
• Promote the SAGES member participation of Community Practice Surgeons.
• Create novel and innovative ways to engage our Community Practice Members.
• Establish a forum for Community Practice Surgery members to identify and address specific concerns. Broadly, the task force will encompass topics such as:
  • Career Development
    • Leadership skill development
    • Mentorship
  • Advocacy and Policy
    • Billing/coding
    • Credentialing
  • Business of Surgery
    • Operational and financial matters, marketing, recruitment
    • Contract Negotiations (personal, institutional, insurance-related, etc)
  • Research Support

We will communicate yearly with the Program Chairs to help promote sessions that will be of particular interest to the Community Practice Surgeon.  We are in the works of creating a White Paper highlighting the Community Practice Surgeon.

This Fall 2020 at SAGES, San Francisco, TAVAC engaged in small-group strategic planning on two fronts:

A research project. The preliminary areas of interest were:

1. AI to drive technology (with AI Task Force); algorithms for medical and surgical care.

2. Carbon footprint of technology (Green tech, biodegradables).

3. Bias in publications regarding devices; re-validate current devices in regard to bias. 

4. Evaluate Non-FDA Approved procedures.

6. Best practices (ERAS), drive best practice use (work with VA).

7. Value of Weight Loss Interventions (Cost per Lb).

8. ICG in Colorectal Surgery.

TAVAC Goals. Using Value as the over-riding mission, and considering the “P’s”of stakeholders - Patients, Payors, Providers, Public - and the drivers of value - outcomes, safety, cost, choice, accessibility, physician health:

What is TAVAC trying to answer?

1. How to we define/measure value for different stakeholders? (Patients, providers, payers) – Find common/overlapping ground between groups, and Perception for each stakeholder group

2. What outcome measures are there, and which ones matter, and to who?

3. Absolute value versus relative value

4. How do we improve value? Can we change/improve practice? And to Whom to do improve value for? (What do our statements do; what’s its purpose; the perception of these statements)

5. Change “cost” to “value” in committee goals

6. Algorithm for defining value (quality/cost) and identifying quality and cost measures

7. Defining value relative to the overall healthcare system

TAVAC in the coming months will narrow these questions to a new, concise strategic plan that will guide it’s key products moving forward.

Ongoing Projects Update:

1. Tech alerts of new FDA devices published bi-montlhy

2. TAVAC documents on WATS3D, Cellvisio, VBA, endoluminal bariatric, microinstruments, stents, mesh are forthcoming.
3. A new futures technologies blog is forthcoming.

Thank you to my co-chairs Sharona Ross and David Renton, and all of the committee members.

Shawn Tsuda MD

SAGES Bylaws Fall Meeting Summary

October 27, 2019

Request for approval:

1. Insertion of a general code of conduct statement into Article XIII. Membership, Section 1
   • Suggested revision to be inserted at the end of this section
     • SAGES is dedicated to providing a safe, inclusive, and welcoming experience for all members. We encourage diversity of thought and expression. Civility and professionalism are expected from all SAGES members. SAGES members will neither engage in, nor condone, any discrimination or harassment that contributes to an uncomfortable, ineffective or hostile environment.
   • Suggest adding the graphic describing the balance of attributes SAGES members should strive for - presented previously during a similar discussion during the We R SAGES task force Spring meeting.

3. Insert an additional item into Article XIII. Membership, Section 13. Maintenance of SAGES Membership
   • Suggested revision of adding the new item number would adjust the current numbering, based on the executive committee’s review. The Bylaws committee suggests inserting the recommended item as “#4”.  Thereby pushing the current “#4” – Failure or refusal to cooperate, to now become the new “#5”.
   • Suggested revisions to the current text
     • Item 4 – Violation of the SAGES Code of Conduct during SAGES Annual Meetings and Events
     • SAGES is dedicated to providing a safe, including, and welcoming experience for everyone at every SAGES sponsored event. We encourage diversity of thought and expression. Civility and professionalism are expected at every SAGES sponsored event.  SAGES members, meeting/event attendees and guest will neither engage in, nor condone, any discrimination or harassment that contribute to an uncomfortable, ineffective or hostile environment.
     • SAGES members, meeting/event attendees and guests have an obligation to act if they notice unethical or inappropriate conduct in other SAGES members, attendees of SAGES meetings/events or their guests. If directly approaching the individual(s) is insufficient to resolve the problem, this obligation includes reporting the conduct to any member of the SAGES Executive Committee, Executive Director or any member of the Ethics Committee. The disciplinary process outlined in SAGES Bylaws, Article XIII, Section 13 will then be followed.
4. Suggest changing references to the “Ethics Liaison Group” to the more current “Ethics Committee” in Article XIII, Section 13

Background:

• The committee recommends that a statement describing a general code of conduct expected from SAGES members be inserted into Article XIII. Membership. Additional comments regarding expected conduct when attending SAGES Annual Meetings and Events were also specifically recommended.
• Please refer to the Code of Conduct that the Board had previously approved and circulated to annual meeting attendees in the Spring 2019.

Budget request (if any): Not applicable

Timeline and metrics:

Sallie Matthews will assist with coordinating the presentation of these recommendations through the appropriate processes/protocols to allow for potential approval during our next scheduled meeting during ACS 2020.

Collaborators (if any – other committees/organizations):

• Executive Board
• Executive Director
• Ethics Committee