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Bariatric Surgery Center Standards

The American Society & Metabolic and Bariatric Surgery (ASMBS) and the American College of Surgeons (ACS) historically has each had an accreditation program for Bariatric Surgery Centers of Excellence. These two professional organizations have joined in forming The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) committee which released their proposed new Quality Program Standards on December 19, 2012.

Standards Related to the Position of Metabolic and Bariatric Coordinator

The WM DPG, with the strong support of the Academy of Nutrition and Dietetics, diligently communicated with the MBSAQIP Committee as they developed the Metabolic and Bariatric Coordinator (MBC) Definitions and Requirements.  We are pleased to announce that though our combined efforts, the proposed standards clearly state that a registered dietitian may fulfill the designation of Metabolic Bariatric Coordinator! Below is an excerpt from the 79 page proposal:

2.3 Metabolic and Bariatric Coordinator (MBC) Definitions and Requirements

  • Metabolic and bariatric surgery programs must have a designated Metabolic and Bariatric Coordinator who reports to and assists the Metabolic and Bariatric Surgery Director.
  • The MBC position of an institution’s metabolic and bariatric surgery program must be given to a single individual.
  • The MBC must be a full-time position if the metabolic and bariatric program performs 150 metabolic and bariatric procedures or more annually.
  • The MBC assists in program development, managing the accreditation process and ensuring continuous compliance with MBSAQIP requirements, maintaining relevant policies and procedures, patient education, outcomes data collection, quality improvement efforts, and education of relevant institution staff in the various aspects of the metabolic and bariatric surgery patient with a focus on patient safety.
  • The MBC supports the development of written protocols and education of nurses detailing the rapid communication and basic response to critical vital signs that is specifically required to minimize delays in the diagnosis and treatment of serious adverse events. 
  • The MBC serves as the liaison between the institution and all surgeons performing metabolic and bariatric surgery at the institution and, if applicable, all general surgeons providing call coverage.
  • The MBC assists in maintaining the call schedule between all covering surgeons.
  • The Coordinator works closely with the Metabolic and Bariatric Surgery Clinical Reviewer (MBSCR) to assure timely submission of outcomes data.
  • It is required that a licensed health care professional or registered dietitian fills this position.
  • The institution’s organizational framework must incorporate the Coordinator position, and the Coordinator must have the authority and resources to fulfill the above listed duties. 

The MBSAQIP received, collated, and discussed comments that were received during the public comment period. The Standards Committee has announced that they are nearing the final stage of the second draft and are on target with the timeline for the completion of the standards. The timeline is as follows:

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CMS

ASMBS Response To CMS Facility Certification National Care Analysis

On January 18, 2013, Dr. John Birkmeyer sent a letter to the Centers for Medicare and Medicaid Services (CMS) asking CMS to re-open the National Care Determination for Bariatric Surgery specifically to remove the Facility Accreditation requirement. CMS re-opened the NCD and asked for comments regarding the facility accreditation. In addition to the 212 public comments submitted, ASMBS wrote a letter with peer-reviewed scientific evidence supporting facility accreditation.

Evidence supporting proposed volume standard of 50 stapling bariatric cases/year

The NCA allowed the ASMBS to have an opportunity to submit supporting peer reviewed scientific evidence to support the new proposed annual volume criteria of 50 stapling bariatric cases per year.
A comprehensive literature review on the volume and outcome relationship in bariatric surgery supports the following:

  1. There are ample data to substantiate the volume and outcome relationship in bariatric surgery.
  2. The volume and outcome relationship have only been shown for complex stapling cases.
  3. Volume and outcome relationship in bariatric surgery have been shown for both the institution and the surgeon.

The following is a timeline for the CMS CNA Decision:

Please note that the proposed 50 stapling case volume threshold has not yet been decided by ASMBS/ACS or CMS at this time and all centers currently designated by either the ASMBS BSCOE or ACS BSCN programs must continue to meet their respective standards for accreditation.

Source: adapted from http://bariatrictimes.com/asmbs-news-and-update-april-2013/

Are you a member of ASMBS?

We are trying to identify those members with dual membership (in WM DPG and ASMBS) in order to better communicate key issues. If you have not done so already, please notify Stacy Paine at stacy.paine@yahoo.com

Be sure to participate in the Bariatric Surgery Subunit to take advantage of more great member benefits.

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