A Center of Excellence is not based on size of the surgical group of doctors, hospital facility, or advertising dollars. It, instead, reflects the surgeons, hospitals and staff who are dedicated to the mission and support of the bariatric program.

An article written in the WLS Lifestyles magazine listed the ten specific criteria for excellence according to the Surgical Review Corporation (SRC) and the American Society for Bariatric Surgery (ASMBS) for the Bariatric Surgery Center of Excellence (BSCOE or BCOE) program.

1. Facilities must have commitment to the highest levels of medical staff and administration in the care of bariatric patients. Everyone who comes into contact with bariatric patients, from nurses to radiologists, must have specialized training and understanding in delivering care with compassion and skill.

2. Surgeons must perform at least 125 total bariatric cases in their lifetime with at least 50 cases within a 12-month period. Research reports that surgeons who perform more than 125 surgeries in their lifetime have better results and fewer mortalities, re-operations and revisions than other surgeons.

3. The program must have a designated physician Medical Director for bariatric surgery. This insures that opinions, needs, and ideas of the bariatric program are well represented at the highest level of the institution. It demonstrates that the program is a vital and relevant asset and important to the long-term care of the bariatric patients.

4. The hospital maintains a full staff, services, and immediate availability of an ACLS-qualified physician on site with experience in urgent treatment and life-threatening medical emergencies, including a multi-disciplinary team of specialists such as endoscopists, cardiologists, anesthesiologists, and pulmonologists available within 30 minutes of request.

5. The hospital must have a full line of equipment, instruments, and other suitable facilities specifically designed for the comfort and the safety for morbidly obese patients, including trained staff.

6. The program requires that surgeons don’t just do bariatric surgery, but that they specialize in it. Surgeons must have appropriate board certification.  Centers which offer coverage when the surgeon is not available are required to be board certified and participate regularly in bariatric surgery and continuing medical education courses, as well as assist in a significant number of surgical procedures.

7. The hospital and surgeons must use clinical pathways and orders of standardized care for procedures. This allows for effective evaluations and leads to safer surgery for patients.

8. An excellent program should provide ongoing education for those who elect to have bariatric surgery. Success is a joint effort between patients and caregivers. Nutritional needs, importance of exercise, and behavior modification (such as addictions recovery, self-esteem, body image, relationships, and spiritual issues) are all essential components to ensure safe and appropriate weight loss and long-term weight management success.

9. The bariatric surgery program must have organized and supervised support groups for all patients. The more support patients receive, the more lasting success they will have. Support groups must have a health-care professional in attendance to address concerns and questions.

10. The hospital and surgeons must provide long-term follow-up for patients. Tracking of surgery results ultimately improves bariatric surgery, establishes more rigorous criteria and standards to become a center of excellence, as well as helps identify the most effective methods for performing bariatric surgery, resulting in patient success.

Congratulations to our local Wilmington, NC, BSCOE, Dr. David Miles of Miles Surgical and New Hanover Regional Medical Center, as well as other centers across the country, as well as internationally, for earning this high level of excellence. Through its partnership with ASMBS and SRC, they are creating a gold standard in bariatric surgery and producing information that saves lives. This title is not just a one-time achievement but must be renewed on an ongoing basis. This standard is well deserved and because of this, we, too, are given the opportunity of many more miles to go!