Metabolic and bariatric surgeries are highly effective in treating severe obesity and its related health issues, such as diabetes, heart disease, and certain cancers. However, to ensure the continued success and safety of these procedures, the quality of care must be closely monitored. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) was established to address this need, setting high standards and driving improvements in patient care.
In this blog, we’ll explore what MBSAQIP is, its history, how it operates, and the essential role it plays in improving metabolic and bariatric surgery outcomes.
What is MBSAQIP?
MBSAQIP is a comprehensive quality improvement and accreditation program for metabolic and bariatric surgery centers. Established through a partnership between the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS), the program sets rigorous standards that accredited centers must meet. These standards cover both physical resources and medical protocols, ensuring that patients receive safe and effective care.
By requiring accredited centers to report their outcomes to a central registry, MBSAQIP provides valuable data that can be used to monitor the quality of care, identify trends, and drive improvements across the industry.
The History of MBSAQIP
The roots of MBSAQIP trace back to the ACS, which has long been involved in setting standards for surgical care. The ACS began accrediting trauma centers in 1987 and cancer programs through the Commission on Cancer in 1930. Recognizing the need for similar standards in bariatric surgery, the ACS launched the Bariatric Surgery Center Network (BSCN) accreditation standards in 2005.
At the same time, the ASMBS, which was founded in 1983, developed its own accreditation program called the Bariatric Surgery Centers of Excellence (BSCOE). While the two programs were separate, both focused on similar principles, including surgeon leadership, multidisciplinary teams, and national registry reporting.
In 2012, the ACS and ASMBS unified their accreditation programs to form MBSAQIP, creating a single, national standard for bariatric surgery accreditation. Today, MBSAQIP continues to lead the way in improving surgical outcomes through its rigorous standards and data-driven approach.
How MBSAQIP Operates
MBSAQIP works by accrediting metabolic and bariatric surgery centers that meet its high standards. To achieve accreditation, a center must undergo a thorough review process that evaluates its resources, staffing, and medical protocols. Once accredited, the center is required to submit detailed data on all bariatric and metabolic procedures to the MBSAQIP registry.
This data includes information on preoperative risk factors, laboratory values, intraoperative variables, and 30-day postoperative outcomes such as mortality and morbidity. Long-term data is also collected to track patient outcomes over time. By analyzing this data, MBSAQIP can assess the quality of care provided by each center and identify areas for improvement.
The Importance of Data Collection and Reporting
One of the key components of MBSAQIP is its robust data collection process. Every accredited center must collect and submit data on every metabolic and bariatric surgery procedure it performs. This data is then subjected to rigorous analysis, including risk adjustment, to ensure fair comparisons between centers.
Risk-adjusted models are computed every six months, and each center receives a biannual report detailing its outcomes. These reports include odds ratios (ORs) that allow centers to see how their outcomes compare to national averages. Centers with consistently low ORs are encouraged to share their best practices, helping to improve care across the entire field of bariatric surgery.
The availability of continuous online reports also allows centers to identify areas for early intervention and quality improvement, ensuring that they remain proactive in enhancing patient outcomes.
Risk Adjustment: Ensuring Fair Comparisons
A crucial aspect of MBSAQIP’s data analysis process is risk adjustment. This process accounts for differences in patient populations and procedure complexity between centers, allowing for fair comparisons. For example, a center that treats a higher proportion of high-risk patients won’t be unfairly penalized in its outcomes data.
MBSAQIP uses advanced statistical techniques, such as forward stepwise logistic regression and hierarchical models, to develop predictive models for various outcomes. These models ensure that each center’s performance is accurately assessed, even if its patient population differs significantly from the national average.
How MBSAQIP Data is Used for Quality Improvement
The data collected by MBSAQIP is not just for accreditation—it’s a vital tool for continuous quality improvement. Biannual reports allow each center to assess its performance, while real-time online reports provide actionable insights that can be used to address any emerging issues.
Centers that consistently perform well are encouraged to share their success strategies with MBSAQIP and other centers. This collaborative approach fosters a culture of learning and improvement, helping to raise the overall standard of care in metabolic and bariatric surgery.
The Role of the MBSCR in MBSAQIP
At the heart of MBSAQIP’s data collection process is the Metabolic and Bariatric Surgery Clinical Reviewer (MBSCR). These specially trained professionals are responsible for gathering and entering all the necessary data into the MBSAQIP registry. Their work is critical to ensuring the accuracy and completeness of the data, which in turn drives the program’s success.
MBSCRs undergo extensive training and participate in ongoing education to stay up-to-date on the latest data collection protocols. By maintaining high standards of data integrity, they help ensure that MBSAQIP remains a trusted source of information for quality improvement in bariatric surgery.
Conclusion
MBSAQIP plays a vital role in improving the quality of care for patients undergoing metabolic and bariatric surgery. By setting high accreditation standards, collecting robust data, and fostering a culture of continuous improvement, MBSAQIP ensures that patients receive safe and effective treatment.
For healthcare providers, participating in MBSAQIP means access to valuable insights and best practices that can help enhance patient outcomes. By staying committed to the program’s rigorous standards and data-driven approach, metabolic and bariatric surgery centers can continue to lead the way in improving the lives of patients with severe obesity.
