Amid snowflakes and sub-freezing temperatures, the Interim Meeting of the ASA Board of Directors (BOD) took place this past weekend in Chicago. Many CSA leaders participated, including Peter Sybert MD, Paul Yost MD, Kenneth Pauker MD, Michael Champeau MD, Johnathan Pregler MD, James Moore MD, Christine Doyle MD, Linda Mason MD, Stanley Stead MD, Neal Cohen MD, Zeev Kain MD, CSA’s Executive Director, Julie Kahlfeldt, and myself. Below are some of the highlights.
ASA’s New Headquarters
Amazing as it may seem, it was announced that the new ASA headquarters building in Schaumburg, Illinois, will soon be completed, on schedule, and perhaps even several hundred thousand dollars under budget. The radiant glass and steel facility maximizes the powerful effects of open spaces and natural light. It will include meeting space for committee work, special presentations, and a stunning display area for the treasures of the Wood Library-Museum. A ribbon-cutting ceremony is planned for the August 2014 Annual Board meeting. This is your building and, if ever you are in the Chicago area, it will be worth a visit that you will find welcoming and be proud to have made.
Component Societies’ Calls for Action
Reports were submitted to the BOD from two component societies calling for action. The Georgia Society of Anesthesiologists asked that the ASA “pledge up to $1 million funding toward research investigating the specific and unique impact of anesthesiologists on clinical outcomes, quality of care, economic value and patient safety.” Many individuals testified that irreproachable research was of urgent necessity to distinguish the indispensible role of our specialty and to benefit advocacy for the profession, but that it required careful planning and execution. The report was therefore referred to a committee of the President’s choice for expedient action.
The New Hampshire Society of Anesthesiologists report recommended “that ASA actively engage Anthem in discussions about its policies concerning anesthesia” and “that ASA make every effort to create an ASA liaison/representative position to the Anthem national policy-making body.” This recommendation was based on recent unilateral and inappropriate case reporting and payment policies enacted by the national parent insurance company. Testimony indicated that this was indeed a national priority, and that similar occurrences could and do involve other national health insurance organizations, therefore the ASA BOD approved “that the ASA establish a staff position for private payer (commercial) advocacy.”
Perioperative Surgical Home
The momentum toward establishing the Perioperative Surgical Home (PSH) as a fundamental aspect of the comprehensive role of physician anesthesiologists in patient care and safety continues. The ASA’s PSH Learning Collaborative, approved by the October 2013 ASA House of Delegates, solicited a request for proposals in December 2013 for a “convener” of the Collaborative. Several ASA committees and workgroups have been involved in defining the parameters and goals of this Learning Collaborative. It was announced that Premier, Inc. had been selected as the convener to work with ASA on this important demonstration project. In addition, the BOD approved further collaboration with our surgical colleagues to coordinate and improve patient care and safety, by establishing a formal liaison representation with the Surgical Quality Alliance (SQA) through ASA’s Committee on Performance and Outcomes Measurement (CPOM). The SQA is a collaborative effort among surgical specialty societies that defines the principles of surgical quality measures, collaborates in the development of meaningful tools for quality improvement, and provides a forum for shared and coordinated efforts among the specialties.
Activities and Relationships with other Organizations
The BOD considered other collaborative activities with outside entities. A memorandum of understanding was approved which should establish a joint venture between ASA and the American Congress of Obstetrics and Gynecology (ACOG) to create a platform to measure and improve the quality of maternal care in the US. The Maternal Quality Improvement Program (MQIP) would establish a national performance benchmarking reporting system for obstetrics and obstetric anesthesia, and facilitate comparative effectiveness research.
In addition, American Gastroenterological Association (AGA) has reached out to ASA to explore the creation of a joint registry and measures project focused on the use of the FDA-approved SEDASYS® propofol sedation device. This proposal is being explored by ASA leadership and, in the meantime, ASA’s statement concerning the use of this device can be found on the ASA website in Standards, Guidelines, and Statements.
The VHA Nursing Handbook
The staff from the ASA Washington DC office discussed important federal issues affecting our specialty. Extensive efforts have been made to influence the Veterans Health Administration (VHA) to disapprove the newly proposed VHA Nursing Handbook. This revision of the Handbook conflicts with current VHA policies and would designate all advanced practice registered nurses (APRNs), including nurse anesthetists, as Licensed Independent Practitioners (LIP), in every facility and every state. ASA leadership has met with members of Congress and the VHA about the ASA opposition to these changes, and VA Hospital Anesthesia Chiefs have submitted a letter detailing the detrimental effects of these proposed changes.
'Doc Fix' Legislation
Finally, we were given a glimpse of the future without the recurrent “Doc Fix” legislation that has been required on an almost yearly basis, to avoid the draconian budgetary realities of the unsustainable “Sustainable Growth Rate" (SGR) formula that has defined CMS payment for physician services under Medicare and Medicaid. The forthcoming long-sought (be careful what you wish for) repeal of this law is attached to some comparatively bleak economic constructs. More, of course, will be revealed as this moves forward.