The ISHAWS, aware of the need for the Italian healthcare system to adopt objective quality criteria, has decided to propose an evaluation and accreditation program in abdominal wall surgery for individual professionals as well as surgical facilities. The aim is to identify and certify the level of quality of the healthcare offered. The objective is to specify and verify the possession of specific requirements related not only to the quantity of services provided but also to structural, organizational, operational conditions, the quality of healthcare provided, and outcomes.

To this end, a commission composed of members of the Board of Directors, after careful analysis of systematic reviews of the international literature on various hot topics related to achieving the necessary level of quality to obtain specific accreditation, and after several virtual and conventional meetings aimed at obtaining broad consensus among its members, developed a set of parameters necessary to achieve the accreditation. Moreover, in order to obtain scientific validation of this project, the accreditation protocol, along with the method used (systematic reviews) for its development, was the subject of a significant scientific publication in the "International Journal of Surgery," a highly respected international scientific journal, available at the following links:
https://www.journal-surgery.net/article/S1743-9191(18)30739-8/fulltext
https://www.sciencedirect.com/science/article/pii/S1743919118307398?via%3Dihub

In particular, three progressive levels of accreditation have been identified, which can be requested upon registration with the Society:

• • Level I: ISHAWS Accreditation for the Individual Surgeon; accreditation is granted after completing a specific form, certifying the completion of the learning curve (see table below) and the number of procedures performed annually (in accordance with the criteria listed below), certified by the Health Directorate of the reference Healthcare/Hospital facility. The accreditation is temporary and is renewed annually after verification of the continuity of the surgical activity and the associated results.
  • Level II: ISHAWS Accreditation for the Abdominal Wall Surgery Reference center this refers to a facility (public or private/accredited with the NHS) where at least 2 ISHAWS Level I accredited surgeons operate, and whose accreditation has been confirmed at least once. Therefore, accreditation as a Reference Center can occur only after one year of surgeon accreditation. In addition to the specific parameters listed in the table, the facility must meet the following requirements:
    • Ambulatory surgery service
    • Ability to admit patients in urgent/emergency care who have already been treated
    • On-call surgeon and anesthesiologist 24/7
    • Intensive care unit on-site or available through the healthcare network
    • Active or on-call laboratory, radiology (CT), and transfusion services 24/7 on-site or through the healthcare network
    • On-site or available plastic surgery services within the healthcare network
    • Available service for complex wound treatment (negative pressure, etc.)

Furthermore, the Reference Center must be a training site for the Italian School of Abdominal Wall Surgery, and surgeons working at such a facility must demonstrate active participation (as a speaker/moderator) every year in at least three events on abdominal wall surgery topics (congress/workshop/meeting), as well as at the EHS congress every two years. The Center must also participate in any multicenter studies proposed by the Society.

• Level III: ISHAWS Accreditation for the Abdominal Wall Surgery High-Specialization Center in Abdominal Wall Surgery; this refers to a facility (public or private/accredited with the NHS) where at least 2 ISHAWS Level I accredited surgeons operate, and whose accreditation has been confirmed at least once, and at least 1 surgeon in specialized training. Accreditation as a High-Specialization Center can occur only after one year of accreditation as a Reference Center.
  In addition to the specific parameters listed in the table, the facility must meet the following requirements:
  • Ambulatory surgery service
  • Ability to admit patients in urgent/emergency care who have already been treated
  • On-call surgeon and anesthesiologist 24/7
  • Intensive care unit on-site or available through the healthcare network
  • Active or on-call laboratory, radiology (CT), and transfusion services 24/7 on-site or through the healthcare network
  • On-site or available plastic surgery services within the healthcare network
  • Available service for complex wound treatment (negative pressure, etc.)

  The Reference Center must also be a training site for the Italian School of Abdominal Wall Surgery. Furthermore, the Center must organize at least one event (course/workshop/meeting) annually, and at least two of the following initiatives:

  • Publication of scientific papers on the subject in international journals with IF
  • Organization of multicenter studies
  • Active participation in the EHS congress
  • Research and development of new materials and technologies

The tables below summarize the requirements (including achieving appropriate prior experience and thus a correct learning curve) necessary to request accreditation as an Hernia Surgeon and, consequently, as a Reference Center and High-Specialization Center.