January 18, 2010
To: Cancer Program Staff in Commission on Cancer-Accredited Cancer Programs:

On behalf of the Commission on Cancer (CoC) membership and staff, I would like to express my appreciation for your continued commitment and dedication to quality cancer patient care as demonstrated through your participation in the CoC’s Accreditation Program. This is an exciting time in oncology, and the CoC is actively working in concert with others to enhance the value of cancer care and of CoC accreditation. I would like to take this opportunity to define several new initiatives the CoC will be pursuing this year.

In the coming weeks, your Cancer Liaison Physician will receive a copy of the 2009 Commission on Cancer Year in Review highlighting the many accomplishments and initiatives of the CoC from the past year – many of which would not have been possible without the efforts of our participating programs. This can also be accessed, when available, on the CoC News page (http://www.facs.org/cancer/cannews.html), and we encourage you to share copies with the members of the cancer committee.

New Directions
Although there are many important initiatives underway within the CoC, I want to specifically highlight six that we believe will benefit your cancer program and staff, and add value to your participation in the CoC’s Accreditation Program.

1. Accreditation Standards Revision: In February 2009 the process to begin the review and revision of the CoC’s standards for accreditation got underway. Five workgroups have been meeting bi-monthly since July 2009 charged with developing standards that encompass the entire continuum of care, focus on performance measurement and outcome, and have a direct patient care benefit. These workgroups include broad representation from all disciplines and organizations committed to improving cancer patient care. The tentative timeline includes release of the standards, pilot testing, and implementation during 2011 with compliance requirements beginning in 2012.

It is the intention of the CoC to maintain an ongoing dialogue with its accredited programs regarding the status of the project and to share new proposals as they become available for comment. We specifically want your input on the proposed changes in the accreditation standards before they are finalized this spring. To facilitate this, we have established the CPS Wiki Page (http://www.socialtext.net/cancer_standards/index.cgi?cancer_standards) to allow review and comment on proposed standards changes and new standards being recommended for inclusion. We will keep you apprised of the status of the project as it evolves. We encourage you to visit the site regularly throughout the first half of this year.

2. Surveyor Meeting with Senior Program Administration: New to the survey process for 2010 is the surveyor meeting with the facility’s administrative leadership. The purpose of this focused meeting will be to convene one or more of the following individuals - CEO, COO, CFO, Chief Nursing Officer, Chief Medical Officer, and the marketing or business development representative – to identify the strengths of CoC accreditation, provide leadership with a taste of the National Cancer Data Base (NCDB) tools and resources, and identify strategies for how these tools can be used to enhance the programs profile with the public, payers, and others through best practice examples.

3. Cancer Liaison Role and Responsibilities: In August 2009 the Cancer Liaison Program Summit was held to re-define the role of Cancer Liaison Physicians (CLPs) and discuss ways to increase CLP engagement. All current activities required of the CLP were evaluated by CoC leadership and key partners, select CLPs, State Chairs, and Surveyors in order to assess the value they provide to the CoC and the accredited facilities. Interventions to improve the CLP program were discussed, and refining the CLP selection criteria and clearly defining CLP duties were deemed key. Pending formal approval by the CoC’s Cancer Liaison and Executive Committee’s in May, it has been determined that the primary responsibilities of the CLP, beginning in 2011, will be to:

• Interpret and monitor their facility’s National Cancer Data Base (NCDB) data and the facility’s plan to employ the information to evaluate and improve quality of care.
• Report NCDB data to the cancer committee on a quarterly basis.
• Report on CoC activities to the cancer committee.
• Serve as liaison for their cancer program with the American Cancer Society and facilitate development of a collaboration plan.

This change in role will be officially communicated to each CLP in June via a series of key communications, and program changes will include new criteria for CLP selection, training and orientation resources, enhanced educational opportunities, and performance assessment.

4. NCDB Reporting Tools: The National Cancer Data Base (NCDB) reporting tools, which include the Hospital Comparison Benchmark Reports, Survival Reports, and Cancer Program Practice Profile Reports (CP3R), were recently updated with 2007 data. The Facility Information Profile System (FIPS) Level II data, which represents your facility’s sites and stage distribution table, will be posted in March for cancer committee review and release to the public – now via the Hospital Locator housed on the CoC’s Web site at http://www.facs.org/cancerprogram/index.html.

Two important initiatives underway within the NCDB this year include active collaborations with many of the CoC’s member organizations to identify new cancer care quality measures. Categorized by organ site, many of these measures will be accountability measures, but most will be expert-consensus based, and will be prioritized by their potential impact on outcomes. Once approved, these measures will be built into the existing CP3R application. The Rapid Quality Report System (RQRS), now in the beta test phase, is an exciting new application planned to come online mid-2010 for voluntary participation by all CoC-accredited cancer programs. The RQRS will enable more timely assessment of quality of cancer care at the local level, and will be driven from the quality of cancer care measures endorsed by the National Quality Forum (NQF) for breast and colorectal cancer. Using data gathered from concurrent abstraction, the RQRS will enable real-time reporting of a facility’s concordance with the NQF measures. This system will also generate status reports and reminders about patients whose adjuvant treatment is pending or late.

5. Staging Revisions and Standards: In October 2009 the American Joint Committee on Cancer Cancer Staging Manual, 7th edition was released, followed by the Commission on Cancer’s Facility Oncology Registry Data Standards (FORDS) Manual in December 2009. The Collaborative Stage Version 2 Data Collection System was released in January. Each of these cancer data collection resources impact cancer registry reporting requirements for patients diagnosed and treated as of January 1, 2010. Clinicians are also affected as they are now required to use and reference the 7th edition, Cancer Staging Manual to select the appropriate working stage for use in treatment planning. Cancer program administration and the cancer committee are encouraged to support the cancer registry staffs’ adjustment to these changes by providing optimal IT support to manage software upgrades, and resources to support appropriate and timely education and training. The FORDS Manual is available for download from the CoC Web site at http://www.facs.org/cancer/coc/fordsmanual.html, and the Staging Manual is available for purchase from the Springer Web site at www.cancerstaging.net.

6. Education Initiatives: To support the staging and coding system changes, the CoC has released new programming on the Online Education Portal. The Online Education Portal was released in April 2009 and has proven to be a very useful resource to cancer program staff. The program fee remains at $50.00 per program offered live or on demand. Program offerings through April are primarily focused on changes to the staging system to assist the medical and cancer registry staffs with adopting these new systems. To review the program offerings and register, visit the Portal at http://eo2.commpartners.com/users/acs/.

As we move forward with these initiatives, we welcome your comments and suggestions. Please feel free to contact us anytime at 312/202-5085 or via e-mail at CoC@facs.org, and visit our Web site at www.facs.org/cancer for additional information on the activities mentioned above.

Sincerely,

Stephen B. Edge, MD, FACS
Chair, Commission on Cancer
Roswell Park Cancer Institute, Buffalo, NY

 

 

Online January 19, 2010

 

Commission on Cancer