Abcarian Lecture to highlight pathways to zero harm

James W. Fleshman, Jr., MD, FACS, FASCRS
James W. Fleshman, Jr., MD, FACS, FASCRS

Quality has been a cornerstone of the American College of Surgeons since its founding. James Fleshman, MD, FACS, FASCRS, Sparkman Endowed Professor and chair, department of surgery, Baylor University Medical Center, Dallas, will share recent strategies that further that vision of continuous surgical quality improvement in the Herand Abcarian Lecture: Quality, Leadership, and Zero Harm, 9:00 am CDT Tuesday, October 6.

The lecture will be available for on-demand viewing through the virtual Clinical Congress meeting platform through December 31.

“Quality, leadership, and zero harm all fit together,” Dr. Fleshman said. “Quality is the bedrock, it requires leadership, and the result is zero harm.”

Evoking the spirit of the Hippocratic oath, the concept of zero harm in relation to errors in medicine and surgery originates from the Institute of Medicine, now known as the National Academy of Medicine. The College provides several new pathways to achieve zero harm, Dr. Fleshman said, starting with the high reliability organization review.

“The members of the Quality group at the ACS will come look at your institution to see if there are quality programs in place that focus on error, failure, and how your data supports the institution of quality programs,” he explained. The ACS also has national accreditation programs for rectal cancer and for breast cancer, standards of operative technique for cancer care, as well as trauma and bariatrics quality programs. “They’re really trying to reach out to all areas.”

Surgeons want to do the best job for their patients, and when they experience a complication, they tend to take it personally and seriously.

“If the hospital or the department of surgery doesn’t have processes and resources available to look at where something went wrong, then the surgeon basically ends up saying, ‘There was nothing I could do about it,’” Dr. Fleshman said. “And nothing changes.”

However, if a quality program is in effect, it can address failures. The program can look at the process that broke down, or review standardized surgical technique or postoperative care that could have been useful to prevent the complication.

“A surgeon can provide leadership in any sized institution using the resources that the ACS has put together,” Dr. Fleshman said. “It’s going to take the leadership of surgeons who believe in ‘quality’ to reach the goal of zero harm.”

Dr. Fleshman also will address how the five phases of care influence quality in hospitals and recent decisions regarding the ACS High-Risk Complex Gastrointestinal Procedure program and the National Accreditation Program for Rectal Cancer.

This lecture, sponsored by the Advisory Council for Colon and Rectal Surgery and given since 2006, honors the contributions of colon and rectal surgeon Herand Abcarian, MD, FACS, FASCRS, whom Dr. Fleshman considers a mentor and a friend.

“He spent his life trying to do quality work and provide leadership,” Dr. Fleshman said. “The best way I could honor him was to talk about what’s going on now in surgery to improve quality.”

The Chicago Society of Colon and Rectal Surgery established this lecture to address issues of relevance to the surgical community at-large and focus on emerging issues in the field.