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Duke Children's Hospital Receives Highest Level of Surgical Certification from American College of Surgeons

Wednesday, November 2, 2016
By William Stagg, Jr., Duke Health News & Communications
Jeffrey Marcus, MD, and Alexander Allori, MD

Photo: Jeffrey R. Marcus (right), MD, chief of surgery at Duke Children's, with Alexander Allori, MD, MPH, director of Quality & Safety for Children's Surgery and Surgeon Champion of NSQIP-Pediatric (National Surgical Quality Improvement Program)

Duke Children's Hospital & Health Center has received the American College of Surgeons' (ACS') highest level of certification for children's hospital surgical programs in its recently launched national verification program, signifying its commitment to providing the safest and highest-quality surgical care for pediatric patients.

Duke Children's is one of only five Level 1 centers in the country, and is the only one in the Mid-Atlantic region.

"Duke has made a strong and continuously growing commitment to providing specialized surgical care for children," said Allan D. Kirk, MD, PhD, surgeon-in-chief for Duke Health. "This rigorous review process provides tangible validation of our commitment to children, and our unique capacity to deal with the many specialized needs that children and adolescents have. We are well prepared to deliver care from the routine to the most complicated, with a special ability to treat each child in the manner dictated by their unique circumstance. I am very proud of the exceptional teamwork that has made this possible."

"This is a significant milestone not only for Duke Children's Hospital & Health Center but also for Duke University Health System," said Jeffrey R. Marcus, MD, chief of surgery at Duke Children's. "It further underscores our ongoing commitment to providing the finest possible care to all of our patients – from the very youngest to the very oldest. Although the work to achieve this designation began two years ago, the transformation of the surgical programs at Duke began several years prior. It is a source of great pride for our entire team, but the true winners are the children who will benefit from the changes that were required to reach this goal."

The certification and accompanying standards stem from the ACS' new Children's Surgery Verification Program, which was developed in collaboration with the Task Force for Children's Surgical Care. Supported by the American Pediatric Surgical Association and the Society of Pediatric Anesthesia, the standards are the nation's first and only multispecialty standards for children's surgical care.

The program establishes three levels of certification for children's surgical centers, and defines the resources necessary to achieve optimal patient outcomes. Each level covers criteria for pediatric surgery and anesthesia, pediatric nursing, perioperative care, intensive care services, radiology and specialty pediatric services, emergency department, data collection, and performance improvement and patient safety. To achieve Level 1 certification, centers must offer multiple medical and surgical specialties, with procedures for major congenital anomalies and complex diseases, including those that are uncommon or require significant multidisciplinary coordination.   

"We hope our Level 1 certification will be a visible sign of the commitment of Duke Children's to deliver quality care, efficiently, effectively, and with compassion," said Alexander Allori, MD, MPH, director of Quality & Safety for Children's Surgery and Surgeon Champion of NSQIP-Pediatric (National Surgical Quality Improvement Program). "The Children's Verification Program was modeled after the level system for trauma care, but its implications are much broader and substantial, affecting every aspect of care. Its purpose is to clarify what each hospital is capable of, and thus to facilitate matching children with specific medical needs with the centers that can provide it."

In addition, the ACS envisions creation of a regional network, in which Level 3 and Level 2 centers have an established transfer arrangement with the Level 1 center, and possibly vice-versa, so there are reduced barriers to care in regions.

The ACS verification process also gave Duke Children's Hospital the opportunity to join two collaborative programs for benchmarked, risk-adjusted outcome measures: The NSQIP-Pediatric (National Quality Improvement Program), in which more than 80 hospitals participate, and the SPS (Solution for Patient Safety), a network of more than 100 children's hospitals sharing  the vision that no child will ever experience serious harm while we are trying to heal them.

The verification process effort was led by Marcus and Allori but numerous people contributed to its success and to the ongoing management of Duke Children's.

"Our success is really reflective of a full commitment from every faculty member and from the hospital leadership at large," Marcus said.