Requirements to Apply to Become A Center of Excellence

Application Process:

A health care institution/facility, that specializes in women's pelvic floor reconstruction and male genitourinary reconstructive cases, together with two or more individual providers completes the application. Patient satisfaction data collection is initiated and applications are reviewed for Interim Status in a blind process by a Review Committee comprised of providers with Fully Approved COE status. Upon achieving Interim Status, a site visit will be made to the institution/facility to verify application information, and a clinical site investigator will personally interview the individual provider applicants.Applicants will be granted Fully Approved Status by the Review Committee or required to submit additional information within two years. NAFC will make public announcement of Fully Approved Status and include the COE in a searchable online database for consumers. Fully Approved Status is valid for three years before renewal is required with updated information. 

While NAFC is a not-for-profit organization, there are application fees to cover program expenses.


1: Evidence of Overall Commitment to Clinical Program Excellence
An organizational chart reflecting the relationship of the applying physicians (at least two who perform PFD surgery) within the same practice and the relationship of the practice group to other disciplines/healthcare providers participating in the care and treatment of such patients

Information about the facility where the majority of surgical procedures are performed

2: Case Volume of Experience and Scope of Practice
The application facility (acute care hospital or same-day surgery center) handles at least 150 cases (patients) per year in female pelvic medicine and reconstructive surgeries and/or 50 cases (patients) per year of male genitourinary reconstructive surgery and surgical treatment of non-cancerous, enlarged prostate, depending on whether the physician applicants for COE designation specialize in female PFD only or represent a group of physicians treating both male and female patients even if some individuals in the group specilize by patient gender

Each applicant physician will have performed:

At least 150 total female pelvic reconstructive cases in their lifetime with at least 100 such cases non-surgically and/or surgically (minimum 50) in the preceding 12 month period, orIf practicing exclusively with male patients, at least 100 total male genitourinary reconstructive cases lifetime with at least 50 cases of male genitourinary reconstructive surgery and surgical treatment of urethral strictures or other male voiding dysfunction including non-cancerous, enlarged prostate in the preceding 12 month period, orAt least 150 total female pelvic reconstructive cases lifetime and 100 male genitourinary reconstructive cases lifetime, with at least 50 total cases of each gender in the preceding 12 month period.

3: Role of Medical Director
The applicants maintain a designated physician as Medical Director for the organization’s center pursuing the COE designation. The position of the Medical Director is expected to be filled by a qualified, board certified surgeon who is appointed through the institution’s or group's established administrative/medical staffing process, with written minutes documenting his or her participation in program and protocol decisions of the Center.

4: Staff Support and Referral Network
The applicant maintains an alliance for referrals, or as part of its entire staff organization, those various consultative services required for the care of patients with pelvic floor dysfunction with or without organ prolapse in the case of female patients, urinary and/or fecal incontinence with or without urethral stricture disease and injury or trauma to the urethra including post-prostatectomy or radiation procedures in the case of male patients, bladder control symptoms including overactive bladder, or other voiding or bowel dysfunction, the breadth of which is subject to whether female only or male and female patients are served by the applicant.

5: Evidence of Contemporary Technology in Equipment
The applicant maintains a full line of diagnostic and therapeutic equipment and instruments for the care of its patients, considered representative of evidence-based “best practices” and utilizing contemporary, proven technology.

6: Coverage for the Center's Surgeons
The applicant surgeons are expected to spend a significant portion of their efforts in the field of female pelvic floor dysfunction or male genitourinary reconstructive surgery.

7: Patient-Centered Clinical Pathways
The applicant demonstrates the utilization of standard, clinical pathways and orders that facilitate the standardization of perioperative care for the relevant procedure in the case of surgery and of quality assured care in the case of all other diagnostic procedures and examination techniques.  The care path is defined for how intervention decisions are made and customized for each patient.

8: Dedication of the Entire Support Team
The applicant utilizes designated nurses or other allied health professionals who are formally trained and dedicated to caring for patients with pelvic floor dysfunction with or without organ prolapse in the case of female patients, urinary and/or fecal incontinence with or without urethral stricture disease and injury or trauma to the urethra including post-prostatectomy or radiation procedures in the case of male patients, bladder control symptoms, or other voiding or bowel dysfunction.

9: Devotion to Engaged, Patient Education
Through a single individual on the care team or a medley of roles by team members, there is evidence that the applicant provides appropriate patient education content in an engaging manner including interactive means on such topics as pelvic floor muscle training and other behavioral strategies and self-care guidance to all patients prior to discharge from a hospital or ambulatory surgery center.

10: Actionable Reporting of Outcomes
The applicant utilizes a uniform, computerized system for analyzing, reporting, and action upon  patient outcomes and agrees to external audits of this information. In addition, the applicant provides documentation that the Program under which the Center operates is dedicated to a goal of long term patient follow-up of at least two years with a monitoring and tracking system for outcomes in a manner consistent with HIPPA regulations and FDA requirements for post-market surveillance of pharmaceuticals and implanted devices.

11: Evidence of a Commitment to Total Quality Improvement
The applicant should be able to demonstrate examples that organization-wide quality improvement and safety initiatives are routinely operative.

12: Freedom from Penalty
All physician and institutional/facility applicants must attest that no litigation is pending nor have judgments been served against them in the most recent three years involving malpractice cases of intentional abuse or life threatening neglect.

 Download Application Requirements PDF

Download Application Requirements PDF

 Physician Application

Physician Application

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