MOC Part 4 - Practice Assessment Resources
- MOC Part 4 requires ongoing participation in a local, regional or national outcomes registry or quality assessment program. Diplomates are expected to regularly review their outcomes and complications, address identified areas for improvement, and reassess the results.
- The Part 4 activity should be related to your current practice. Diplomates who hold multiple ABS certificates do not have to repeat Part 4 for each certificate.
- Diplomates are encouraged to find out what programs are available through your hospital. Many hospitals already participate in national registry programs. In addition, some surgical societies have programs available to individual surgeons. See the list below for examples of acceptable programs.
- If there are no hospital-based or individual programs available to you, the ABS expects that you will select a focused area of practice for practice assessment/quality improvement. You should identify an area of practice or types of procedures to study; define the measures to be assessed and goals; track patients' outcomes; analyze the outcomes and compare them with your goals; and identify areas for improvement. You should then reassess your performance after implementing changes to gauge improvement.
Please note: The list below is not meant to be all inclusive, but rather to provide examples of good programs for meeting Part 4. See also "Part 4 Program Guidelines" farther below.
Evidence of Participation
- The online form that must be submitted at the end of each three-year MOC cycle contains a section for diplomates to indicate or describe the type of practice assessment activity they are doing for MOC Part 4. No evidence of participation or operative data is required at that time. However the ABS audits a percentage of the submitted forms each year to verify the information entered.
- Please note that a 12-month operative log is required as part of the MOC exam application (Part 3). Diplomates who use the ACS case log system for MOC Part 4 may transfer their operative data directly to the ABS for this purpose.
Part 4 Resources
- Examples of acceptable programs for Part 4:
- ACS Surgeon Specific Registry (Case Log System)(with tracking of 30-day complications) Now available to non-ACS members
- Mastery of Breast Surgery (ASBS)
- Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)
- Multi-Specialty MOC Portfolio Program (ABMS)
A pathway for health care organizations to have their quality improvement efforts be approved for MOC Part 4 across multiple specialties
- National Burn Repository (ABA)
- National Cancer Data Base
- National Surgical Quality Improvement Program (ACS NSQIP®)
- National Trauma Data Bank®
- Organ Procurement and Transplantation Network
- Statewide Collaboratives (e.g., SCOAP, MSQC, etc.)
- STS National Database
- Trauma Quality Improvement Program (ACS TQIP®)
- VA Surgical Quality Improvement Program (VASQIP)
- Vascular surgery-related programs:
- Pediatric surgery-related programs:
- ACS Surgeon Specific Registry (Case Log System)(with tracking of 30-day complications)
- ELSO Registry
- National Surgical Quality Improvement Program - Pediatric (ACS NSQIP Peds)
- Pediatric Trauma Quality Improvement Program (ACS Peds TQIP)
Part 4 Program Guidelines
- The ABS approved in June 2012 the following parameters to guide the development of Part 4 resources. Going forward, Part 4 programs will be expected to adhere to these criteria.
- Essential Characteristics
- The activity tracks meaningful and measureable patient outcomes. Processes of care or composite indicators associated with improved outcomes, reduced complications, or a better quality of life may be included.
- The parameters assessed are important, scientifically acceptable, useable, relevant, and easy to collect.
- Individual results are provided to the surgeon at least yearly, preferably a minimum of every six months.
- A comparative analysis of individual and group results is provided.
- The method for tracking procedures and outcomes minimizes selection bias.
- The activity includes the ability for re-measurement after implementation of a quality improvement activity based on analysis of the results.
- Desirable Characteristics
- The information is risk-adjusted when possible.
- The time period between recording of data and reporting of results is minimized as much as possible.
- Resources are provided to enable completion of quality improvement activities based on the results.
- The activity provides comparisons over different time periods to track the effect of quality improvement activities.
- Data entry is done by trained third-party personnel when possible.
- The information is subject to audit to assure its validity and reliability.
Updated: January 2015