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MBSAQIP programme

MBSAQIP updates programme standards for patients with BMI>25

Currently, there are more than 800 MBSAQIP-accredited centres in the US and Canada, and more than 200,000 bariatric cases are captured annually in the MBSAQIP Registry. The programme is celebrating its five-year anniversary in 2019.

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a joint quality programme of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS), has released its third version of programme standards to take effect in October 2019.

The updated standards, outlined in ‘Optimal Resources for Metabolic and Bariatric Surgery’, include a new designation level for facilities offering non-surgical treatment for obesity, as well as a requirement for accredited centres to implement one new quality improvement initiative each year.

In the US, more than 11 million people suffer from severe obesity and an estimated 93 million people have obsity. The comorbidities associated with obesity range from diabetes and heart disease to certain types of cancers. Bariatric surgical procedures have been shown to reduce obesity, improve mortality, and decrease the health risks from chronic diseases like cardiomyopathy and diabetes.

The MBSAQIP standards provide guidance for facilities to build the structure that enables them to provide safe, high-quality care to all metabolic and bariatric patients. Programmes seeking MBSAQIP accreditation are required to meet eight overarching standards which outline the framework for program scope and governance, facilities and equipment resources, patient care protocols, data surveillance and more.

Accredited centres are required to enter every metabolic and bariatric procedure performed for the treatment of obesity-related diseases into the MBSAQIP Registry. This Registry collects prospective, risk-adjusted, clinically rich data based on standardised definitions. Reports from the Registry provide site-specific data that gives participating centres the ability to benchmark their outcomes and compare their results with aggregate national comparison data in the system.

Currently, there are more than 800 MBSAQIP-accredited centres in the US and Canada, and more than 200,000 bariatric cases are captured annually in the MBSAQIP Registry. The programme is celebrating its five-year anniversary in 2019.

An important new accreditation level in the 2019 standards manual is the Obesity Medicine Qualification Accreditation option. This accreditation option provides an additional designation level for facilities that offer non-surgical treatment for patients who are overweight or have Class I, II, or III obesity. Centres with this designation employ nutritional interventions, physical activity, behavioural change and pharmacotherapy to treat patients. Additionally, these centres will collect and document specific data elements in which they will monitor patient outcomes against medical weight loss interventions.

“Obesity is a chronic, pervasive disease that requires involvement from the entire ‘house of medicine.’ Our new designation of the obesity medicine qualification is in recognition of new treatment options and providers available to our patients in need,” said Dr John Morton, Chair of the ACS Committee for Metabolic and Bariatric Surgery. He is also the incoming vice chair for quality and division chief of bariatric and minimally invasive surgery at the Yale School of Medicine, New Haven, CT.

“As we’ve seen in other fields such as oncology or cardiology, care is best when it is multi-modal and multidisciplinary. In combination, obesity medicine and bariatric surgery can enhance the safety and efficacy of precision treatment for the patient with obesity,” he said.

Another standard which has been enhanced requires all accredited centres to measure, evaluate, and improve their performance through at least one quality improvement initiative each year. Centres that are high outliers on the semi-annual risk-adjusted report, or SAR must develop initiatives to address their high outlier status. These initiatives can target areas for improvement including patient experience or education, internal processes, clinical pathways, or other issues related to providing high-quality care to patients.

“These updated standards will help the bariatric and metabolic surgery programs build on our already established success with surgical quality improvement for overweight and obese patients,” said ACS Executive Director, Dr David B Hoyt. “By implementing these program standards, participating centres, as well as new centres seeking accreditation, will be able to raise the bar on surgical quality for their patients.”

“With these standards, we have identified specific strategies for bariatric surgery centres to improve their outcomes for patients who seek surgical treatment and for those who seek to achieve weight loss non-surgically in a medically supervised, supportive environment,” explained Dr Clifford Y Ko, Director, ACS Division of Research and Optimal Patient Care. “Patients who seek treatment at an accredited centre will receive care that it is tailored to their individual needs and is based on the best evidence available in the field.”

MBSAQIP is no longer accepting applications under the 2016 standards, and instead will begin accepting applications from new centres in August of 2019. All centres currently accredited under MBSAQIP must be in compliance with the 2019 standards by October of 2019.

To view the updated Optimal Resources for Metabolic and Bariatric Surgery standards, please click here

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