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 complication rates, address identified weaknesses, 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 their hospital. Many hospitals 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 of the activity; track patients' outcomes; analyze the outcomes and compare them with the activity goals; and identify areas for improvement. You should then reassess your performance after implementing changes to gauge improvement.
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
- Some acceptable programs for practice assessment:
- ACS Surgeon Specific Registry (Case Log System)(with tracking of 30-day complications)
- Burn Registries (ABA affiliated)
- Mastery of Breast Surgery (ASBS)
- Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)
- Multi-Specialty MOC Portfolio Program
A pathway for health care organizations to have their quality improvement efforts be approved for MOC Part 4 across multiple specialties
- National Surgical Quality Improvement Program (ACS NSQIP®)
- Statewide Collaboratives(e.g., SCOAP, MSQC, etc.)
- STS National Database
- Trauma Quality Improvement Program (ACS TQIP®)
- United Network for Organ Sharing (UNOS)
- Veterans Affairs Surgical Quality Improvement Program (VASQIP)
- Vascular surgery-related programs:
- NCDR® CARE Registry® (Carotid Artery Revascularization and Endarterectomy)
- Vascular Quality Initiative®
- Vascular Study Group of New England (VSGNE)
- Pediatric surgery-related programs:
- ACS Surgeon Specific Registry (Case Log) System(with tracking of 30-day complications)
- Children's Oncology Group
- Extracorporeal Life Support Organization (ELSO) Registry
- National Surgical Quality Improvement Program - Pediatric (ACS NSQIP® Peds)
- Trauma Quality Improvement Program (ACS TQIP®)
Part 4 Program Guidelines
- The ABS approved in June 2012 the following parameters to guide the development of Part 4 resources by societies and other organizations. 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.
Note to Program Sponsors: The ABS MOC Program is an initiative of the American Board of Surgery. To avoid confusion, societies and other organizations should not use terms such as "MOC activity" or "MOC credit." Programs that meet the guidelines listed above may state that participation in the activity fulfills Part 4 of the ABS MOC Program.
Updated: February 2014