Accreditation of Hybrid Community Hepato-Pancreato-Biliary Practice in the United States

Abstract

Introduction: Accreditation in hepato-pancreato-biliary (HPB) Surgery has been a topic of much discussion and controversy globally. HPB procedures performed in healthcare systems require the most complex and intricate coordination between ancillary and surgical services. We present two distinct accreditation models available in the Unites States. Methods: We present our experience regarding two distinct accreditation models applicable to a hybrid community practice in the Unites States. Results: Accreditation of most health organization in the U.S. goes through the Joint Commission (JCAHO). In recent years, a new accreditation process for HPB surgery was established. Then proposed guidelines focused on four quality improvement projects including nutritional evaluation, analgesic management, time to treatment initiation within 3 weeks of diagnosis, and quality of life milestones. This pathway was validated and approved by JCAHO. The other accreditation process involves the American College of Surgeons (ACS) pilot program for high risk gastrointestinal (HRGI) surgery. This pilot program requires a site visit that was carried out at the same community practice. It focuses on the components of care that would support a multidisciplinary program. This hybrid program was able to achieve compliance in all domains. Conclusion: Accreditation to perform HPB procedures is available in the U.S. and will help streamline care for the complex HPB surgical patients. Hybrid community practices can also be candidates for accreditation, along with traditional academic programs, as we have shown.