[Barriers to the German Society for General and Visceral Surgery (DGAV) accreditation "Center for bariatric and metabolic surgery"].

Introduction: The certification and accreditation process of the German Society for General and Visceral Surgery (DGAV) aims to improve the quality of care and enhance transparency in accredited centers. To achieve these goals a high level of infrastructural and staffing requirements are set out by the DGAV.

Aims: The Surgical Working Group on Obesity Treatment and Metabolic Surgery (CAADIP) survey 2017 of the members of the German Bariatric Society aimed to identify the perceived and encountered barriers in the DGAV accreditation process.

Methods: Between February and March 2017 an online poll was conducted of all members of the CAADIP on topics pertaining to the accreditation process.

Results: A total of 214 (51%) CAADIP members participated in the poll, 47% reported that they worked at a non-certified center and 53% worked at a DGAV certified center. Of these, 68% reported employment in a unit with the lowest accreditation level, 21% in an intermediate level center, 11% reported employment in a unit with the highest accreditation level (Center of Excellence) and 86% of those currently working in non-accredited units stated that they aimed for future accreditation. Reasons stated for not having obtained accreditation were recent establishment of the new bariatric specialty (54%), lack of bariatric case numbers (71%), lack of human resources and infrastructure (28% and 13%, respectively). Of those surgeons in non-accredited centers 24% stated that the hospital management had no interest in a certification and 12% of the surgeons themselves felt that accreditation was unnecessary.

Conclusion: The majority of CAADIP members strived for DGAV certification. The main barriers encountered and perceived were the specific time (reference years) and caseload requirements.