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Q&A with David A. Lanning, MD, PhD

In 2013, the American College of Surgeons (ACS) in collaboration with the Task Force for Children’s Surgical Care developed the first and only set of multispecialty standards for children’s surgical care. The Children’s Surgery Verification program certifies that certain quality improvement standards have been met by children’s hospitals that submit to the voluntary verification process. With a three-year, $837,949 grant from Children’s Hospital Foundation, Children’s Hospital of Richmond at VCU (CHoR) is seeking this verification to become Virginia’s first Level I ACS Children’s Verified Surgery Center.

What is the ACS Children’s Surgery verification, and what does it mean if a hospital has this verification?

The American College of Surgeons is the leading national organization for surgery, and the purpose of the verification program is to improve the quality of children’s surgical care from relatively simple procedures to high-risk cases. A large proportion of children’s surgical care is provided in non-specialized environments, but better clinical outcomes are associated with procedures performed in specialized environments, especially for high-risk and complex cases. The verification program seeks to improve the quality of care by creating a system that matches individual surgical needs with an environment that has optimal pediatric resources to meet those needs.

There are three levels of ACS verification, and we are seeking verification as a Level I surgical center. This verification would mean we have the resources and commitment to providing the highest level of care for all types of pediatric surgical cases including ENT, orthopaedics, trauma, neonatal and congenital heart surgery.


Why is CHoR seeking this verification?

Over the last three years, inpatient and outpatient surgical cases have increased, which is a trend we expect to continue as CHoR increases use of the operating rooms in the Children’s Pavilion and additional pediatric surgical subspecialists join our team. There are currently five children’s hospitals in the U.S. that have received ACS verification, which is endorsed by key surgical and anesthesia programs across the country. We are hoping to be the first hospital in the region and the state to achieve verification, which uses a set of evidence-based guidelines and recommendations to show the best, safest way to care for the most complex surgical patients. Verification shows our commitment to improving safety and outcomes for all children. CHoR is the only hospital in the region that is verified in Pediatric Trauma, Adolescent Bariatric Surgery, and Pediatric Burns. Receiving Level I Children’s Surgery Verification would cement our position as a national leader in Pediatric Quality Improvement Programs and the only children’s hospital in the country to achieve Level I verification in all four areas.


What is involved in the verification process, and how long does the process take?

We are in the process of ensuring we have the support team in place to review performance and document processes. Developing the formal structure, policies and procedures is where we need to focus our efforts. Fortunately, we have great outcomes for what we do, and we are constantly striving to make them better for our patients. The verification process is a rigorous program that requires a handful of people to manage it. Funding from Children’s Hospital Foundation will support the people who manage the program. Once we have the people in place, we expect it to take approximately two years to review cases, document processes, connect with hospital-wide committees and submit our application for a site visit. Once verification is received, it needs to be renewed every three years.


How has the Children’s Surgical Program at CHoR grown over the last few years?

The program has exploded over the last six years as we’ve brought in more than 15 board-certified and board-eligible surgeons. We have six general surgeons as well as surgeons with subspecialties in ENT, plastics, cardiac surgery, urology, orthopaedics and more. None of this growth would have been possible without support from Children’s Hospital Foundation. The Foundation trusts us to know these resources will translate into improved patient outcomes.