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Register Now for 2020 ACS Quality and Safety Conference VIRTUAL

2020 ACS Quality and Safety ConferenceWe are excited to announce our 2020 American College of Surgeons (ACS) Quality and Safety Conference VIRTUAL—a socially-distanced version of the in-person conference.

2020 ACS Quality and Safety Conference VIRTUAL will run from Friday, July 24 through Monday, July 27. Registration will be free of charge and available to all. The program will feature something for everyone! We will offer a variety of compelling video presentations both live and on demand, along with an opportunity to engage in a live chat with session presenters.

Register today and join us for the cancer sessions. CME, CNE, and CE will be available for all sessions.

The Cancer Patient Journey: Lessons Learned from COVID-19

July 25, 2020 | 8:00–8:50 am Central Time

Moderator: Scott Kurtzman, MD, FACS, Waterbury, CT

Speakers: Lawrence Shulman, MD, FCAP, FASCO, Philadelphia, PA; Katharine Yao, MD, FACS, Evanston, IL, NAPBC Advocacy Committee Representative; Sally Werner, RN, BSN, MHA, Washington, DC

Quality Improvement Basics: Using Data to Drive Quality

July 25, 2020 | 10:00–10:50 am Central Time

The session will provide a quality improvement primer that outlines the process for identifying improvement needs, using data to measure performance, prioritizing opportunities for change, and selecting the best tools to manage and document the process.

Moderator: Daniel Boffa, MD, FACS, New Haven, CT

Speakers: Elizabeth Habermann, PhD, MPH, Rochester, MN; Sharon Lum, MD, FACS, Loma Linda, CA; David Foley, MD, FAAP, FACS, Louisville, KY

Building a Quality Improvement Program: The Fundamentals and Practical Solutions from the Field

July 25, 2020 | 11:00–11:50 am Central Time

The session will showcase a variety of improvement projects and tools and the successful changes implemented by accredited programs and centers across the country.

Moderator: Laurie Kirstein, MD, FACS, Westfield, NJ

Speakers: Jennifer Rosen, MD, FACS, Washington, DC; Rebecca Snyder, MD, FACS, Greenville, NC; Timothy Pearman, PhD, Chicago, IL

Breast Cancer Operative Standards and Synoptic Operative Reports: Bringing the Evidence to Your Workflow

July 26, 2020 | 8:00–8:50 am Central Time

The session will review evidence-based surgical techniques and the tools being developed for documenting best surgical practices for breast cancer. A panel of experts will discuss how to incorporate the information and surgical approaches into your daily practice and how they can lead to improved patient outcomes.

Moderator: Kelly Hunt, MD, FACS, Houston, TX

Speakers: Sarah Blair, MD, FACS, La Jolla, CA; Judy Boughey, MBBCh, FACS, Rochester, MN; Diana Dickson-Witmer, MD, FACS, Newark, DE

Colon Cancer Operative Standards and Synoptic Operative Reports: Bringing the Evidence to Your Workflow

July 26, 2020 | 11:00–11:50 am Central Time

The session will review evidence-based surgical techniques and the tools being developed for documenting best surgical practices for colon cancer. A panel of experts will discuss how to incorporate the information and surgical approaches into your daily practice how they can lead to improved patient outcomes.

Moderator: Matthew Katz, MD, FACS, Houston, TX

Speakers: George Chang, MD, FACS, Houston, TX; Arden Morris, MD, FACS, Stanford, CA; Steven Wexner, MD, FACS, Weston, FL

Aligning ACS Cancer Programs Quality Initiatives with Your Hospital Quality Priorities

July 27, 2020 | 8:00–8:50 am Central Time

This session will address how to align the ACS Cancer Programs quality initiatives with hospital quality initiatives by reviewing quality performance measures tracked by hospitals and CMS. It will also explore ways that ACS Cancer Programs quality initiatives can align with these measures.

Moderator: Katharine Yao, MD, FACS, Evanston, IL

Speakers: Richard Bleicher, MD, FACS, Philadelphia, PA; David Dietz, MD, FACS, Bentleyville, OH; Thomas Hensing, MD, Evanston, IL

E-mail cancerprogramsevents@facs.org with any questions regarding these sessions.


Save the Date for Virtual Cancer Program Meetings, Clinical Congress 2020

Clinical Congress 2020As we’ve monitored the trajectory of COVID-19 cases and local restrictions in the conference’s host city of Chicago, IL, across the U.S., and throughout the world, the American College of Surgeons has decided to hold the American College of Surgeons (ACS) Cancer Programs meetings and Clinical Congress 2020 as exclusively virtual events. Cancer Programs meetings will be held on Sunday, October 4, and Clinical Congress will be held October 4–7.

This was not an easy decision to make, but your health, safety, and welfare are of the utmost importance to us. A virtual Clinical Congress will ensure broad participation for all those who want to attend, especially individuals whose institutions have travel bans in place throughout the fall. The virtual Clinical Congress will include a live component and on-demand components beyond the dates of the Clinical Congress.

We are confident we can offer a best-in-class educational event for all attendees, presenters, and exhibitors. Clinical Congress is the largest educational meeting of surgeons in the world. Our program will focus on the latest advances in surgical science, practice, and education, united under this year’s theme, The Joys of Learning, Collaborating, and Giving Back.

Please watch for future communications about the virtual Cancer Programs meetings and Clinical Congress 2020, particularly if you are one of the many surgeons who will be presenting at this year’s meeting. We will share registration details and additional important program information soon.

You have our thoughts and best wishes as many of you resume a more active surgical practice during this unprecedented time. The ACS will continue to support you and be your advocate in the weeks and months ahead as you navigate challenging issues that have profoundly affected our profession and our patients.


New COVID-19 Accreditation Tracker Available for Programs

The American College of Surgeons (ACS) Cancer Programs has developed a COVID-19 Accreditation Tracker for use by accredited programs to assist in documenting the impact of the pandemic on their accreditation activity for the Commission on Cancer (CoC), National Accreditation Program for Breast Centers (NAPBC), and National Accreditation Program for Rectal Cancer (NAPRC). Utilization of these trackers is optional, but programs can use them to capture, in a succinct way, the overall impact on their programs to share with their site reviewers at the time of their next site visit. As previously communicated, programs will not be penalized for standards that cannot be met due to COVID-19.

In addition to a blank version of the COVID-19 Accreditation Tracker for each program (CoC, NAPBC, and NAPRC versions), we have provided an example as a guide on how programs can document the impact of COVID-19 on their ability to meet select accreditation standards. Please note that the example is provided as a guide for using the tracker, not as a representation of the impact on all programs, as the impact for each program is unique.

Trackers and examples are available in the resource sections of CoC Datalinks (Standards Resources Library), the NAPBC Portal, and the NAPRC Quality Portal.


CoC Releases New PRQ Templates

Commission on CancerWe are pleased to announce the release of new templates that correspond with the Pre-Review Questionnaire (PRQ) for use by Commission on Cancer (CoC)-accredited cancer programs to support the Optimal Resources for Cancer Care (2020 Standards). The PRQ templates will be located in two areas: within the specific standard page of the PRQ and on the Datalinks Activity Menu under the PRQ Templates heading. The templates are currently available on Datalinks for downloading and immediate use. Once each template is completed with information or data for each year within the accreditation cycle, programs will be required to upload the template into the PRQ before the on-site review takes place. The PRQ is expected to be released in the fall of 2020 for accredited programs scheduled for 2022 site reviews.

There are 12 templates that cover 15 standards. The templates must be completed by all cancer programs as part of their on-site review. Tabs located at the bottom of each template page can be used to toggle between years for each standard within the accreditation cycle.

To assist programs with organizing accreditation documents, we have released a Folder Structure Tutorial PowerPoint (that includes a folder structure zip file for download). This tutorial is located within the Standards Resource Library (SRL) under the General Chapter. We encourage programs to watch the tutorial to assist with the planning and organization of accreditation documents as well as making these documents available to the Cancer Committee members for ongoing input and review.

We hope that you find the templates useful to your cancer program. Questions and comments on the items included in the templates should be submitted to the CAnswer Forum.


ACS CRP Launches Video Series

Clinical Research ProgramThe American College of Surgeons Clinical Research Program (ACS CRP), in collaboration with the Journal of American College of Surgeons, is excited to announce the launch of the Operative Standards for Cancer Surgery Video Series. A companion to the Operative Standards for Cancer Surgery manuals, each video in the series will demonstrate the proper technical conduct of one Critical Element of a cancer operation as described in the manuals, making it even easier for surgeons to incorporate evidence-based techniques that lead to improved outcomes.

Watch the first video, Pancreatoduodenectomy: Superior Mesenteric Artery Dissection, today and stay tuned for more videos.


ACS CRP Didactic Course from Clinical Congress 2019 Now Available Online

The Designing and Running a Prospective Surgical Clinical Trial course, originally sponsored by the American College of Surgeons Clinical Research Program (ACS CRP) and the ACS Surgical Research Committee at Clinical Congress 2019, is now available for CME Credit online. This course focuses on the methodology of design and implementation of a clinical trial for surgeons interested in developing and leading a prospective trial and includes lectures on hypothesis development, trial design and implementation, statistical concepts, budget development, and dissemination of results. The course is available at a cost of $125 for Fellows and $100 for Resident Members and offers a maximum of 5.5 AMA PRA Category 1 Credits™.


NAPRC Online Portal Moves to New Platform

National Accreditation Program for Rectal CancerThe National Accreditation Program for Rectal Cancer (NAPRC) online portal has moved to a new platform. A helpful user guide is available to assist with navigating the new portal for accredited and applicant NAPRC programs. Instructions for action items related to migrating into the new portal were e-mailed directly to rectal cancer program contacts and are linked on the homepage of the NAPRC section of Commission on Cancer (CoC) Datalinks.

The NAPRC section of CoC Datalinks will be retired on August 31, 2020, and programs will no longer have access to it. No documentation uploaded into the NAPRC section of CoC Datalinks will be transferred to the NAPRC Quality Portal. If a program wishes to save any documentation uploaded in the NAPRC section of CoC Datalinks, it must download copies before August 31, 2020.

Exception: If a program has undergone a NAPRC site visit and is resolving deficiencies, it will continue to utilize CoC Datalinks to manage NAPRC accreditation until deficiencies are resolved. Next steps on transitioning into the new NAPRC Quality Portal will be provided when accreditation is awarded.

Questions? Please e-mail NAPRC@facs.org.


Submit 2020 Call for Data by August 31 Deadline

Due to COVID-19-related adjustments being made by hospitals and registrars across the country, the 2020 Call for Data window will be extended to August 31, 2020 (11:59 pm CST), for submissions and corrections.

Please do not create your final submission files any earlier than December 1, 2019, to ensure that all required cases and updates are properly captured.

  • Submission window opens: January 1, 2020
  • Final date for initial submissions and corrections: August 31, 2020 (11:59 pm CST)

Complete information is available online.


AJCC and NCI SEER Provide Update on Histology Codes and Terms

The American Joint Committee on Cancer (AJCC) and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program (NCI SEER) are dedicated to the collection of meaningful cancer data for patients, medical providers, and researchers. On occasion, data collection requirements of AJCC and NCI SEER have resulted in conflicting cancer coding instructions for cancer registrars. These two organizations, along with other standard setters and stakeholders—Commission on Cancer (CoC), National Program of Cancer Registries (NPCR), National Cancer Registrars Association (NCRA), North American Association of Central Cancer Registries (NAACCR), College of American Pathologists (CAP)—are working together to minimize discrepancies.

The World Health Organization (WHO) series, Classification of Tumours (aka “Blue Books”) is the principal resource for tumor histologic types in the development of the NCI SEER Solid Tumor Rules, the AJCC Cancer Staging System, and the CAP Cancer Protocols.

The International Classification of Diseases, Third Edition, for Oncology (ICD-O-3) has been used for cancer surveillance since 2001, and it remains in use for current cases; however, ICD-O-3 is not aligned with the more recent WHO Classification of Tumours publications. ICD-O-3 is the current NAACCR standard for classifying primary site, histology, and behavior for cancer registries in North America. ICD-O-3.2 will be implemented in the U.S. in 2021 and will align the cancer surveillance community with the current WHO Classification of Tumours used by physicians. AJCC and NCI SEER will work closely together to implement ICD-O-3.2 to minimize issues affecting cancer registrars.

Pathologists using current terminology from the WHO Classification of Tumours, in some instances, have a different histologic code associated with the term. In these scenarios, the current code may differ from what registrars continue to use from the ICD-O-3 reference. These new histologic codes have been incorporated into the AJCC Staging System and the electronic CAP Protocols. When a histologic code is removed from the WHO Classification of Tumours, it should no longer be used by pathologists. The registry community is continuing to use ICD-O-3 codes for consistency rather than adopt the codes from the WHO Classification of Tumours. The registry community’s adoption of new histologic codes often takes a period of time. Registrars must continue to code the histology based on the wording stated in the medical documentation.

The 8th Edition AJCC Cancer Staging System is in alignment with the WHO Classification of Tumours in determining which histologies are eligible for AJCC staging. All cancer registrars in the U.S. must follow the instructions found in the SEER Solid Tumor Rules manual to ensure that data collected across the nation are consistent and valid when combined for national reporting.

Instructions for Cancer Registrars regarding Histology Terminology and Coding

  • Cancer registrars should always code the histology strictly based on the terms used by the pathologist (or managing physician if a pathology report is not available), not based on whether a case is eligible for AJCC staging.
  • Cancer registrars should assign the histology code independent of and before assessing eligibility to stage the case.
  • Do not assess eligibility for AJCC staging until you have assigned the histology code.

The AJCC and NCI SEER ask cancer registrars to disregard web postings or any other instructions contrary to the above-mentioned principles.

Specific instructions regarding the review of coded cases can be found on the NCI website.

In the coming weeks, the AJCC and NCI SEER will work to ensure CAnswer Forum answers direct registrars to use the SEER Solid Tumor Manual rules. Ask A SEER Registrar is the website to ask questions and research clarifications regarding histology coding rules. The AJCC and NCI SEER will continue our important collaboration and involve other national standard setters and cancer registry stakeholders. Ultimately, we are all striving for the same goal: reliable, accurate cancer data.


Submit Your QI Projects to New Resource Library

The Commission on Cancer (CoC) is developing an online resource library of quality improvement projects. Please share any projects that you have conducted to enhance the quality and delivery of care in your cancer program and that may be of benefit to others looking to identify comprehensive quality projects. This information will be compiled into a repository interested programs can access from the CoC website. Please complete the short survey to share very basic information about your project. Feel free to submit multiple projects, and remember to exclude any patient-identifying information from your responses.

If you have any questions about this request, please contact Melissa Leeb at mleeb@facs.org or Danielle Lopez at dlopez@facs.org.


Coming This Summer: New Breast Cancer Surgery Education Program for Patients

The American College of Surgeons (ACS) Patient Education Committee, Division of Education, has created a new Your Breast Cancer Surgery patient education program. The program joins the successful Your Lung Operation in the expanding cancer education series. It includes a booklet, video, checklist, discharge treatment and survivorship plan, and evaluation tool to support the surgical community (including patients and caregivers) with evidence-based education and skills to optimize recovery.

A literature review on informed consent and breast cancer surgery found that only 47 percent of lumpectomy and 67 percent of mastectomy patients felt fully informed and patients felt an urgency to plan (Mitchell, 2018). Breast cancer is the most common cancer among women and the second leading cause of female death, and the treatment for early breast cancer is most often surgery. With recent advances in breast cancer care, there is a need to help patients better understand their treatment decisions and survival benefits from a complex menu of choices.

This program was developed with input from the American Society of Breast Surgeons, the Commission on Cancer (CoC), the American Society of Plastic Surgeons, and the American Physical Therapy Association. All materials meet the guidelines for health literacy, informed consent (ACS), surgical safety (Joint Commission) and the National Accreditation Program for Breast Centers (NAPBC). The ACS recognizes that safety is enhanced when patients/families can anticipate what is likely to happen and have the knowledge and skills needed for decision-making and full participation in care during hospitalization and their recovery. Allowing patients to review disease and procedure information in a multimedia format in advance of meeting with a surgeon supports effective communication and is associated with greater participation, increased satisfaction, and higher rates of compliance.

Your Breast Cancer Surgery explains the breast anatomy; breast cancer diagnosis and staging; the types of surgical procedures, preoperative tests, and imaging; what to expect before, during, and after the surgery; and reconstruction and additional therapies. Preoperative and postoperative guides, images, and video instructions are provided for all exercises, wound and drain care, and lymphedema prevention. The program will be available later this summer on the Patient Education website.

Reference

Mitchell S, Gass J, Hanna M. How Well-Informed Do Patients Feel about Their Breast Cancer Surgery Options? Findings from a Nationwide Survey of Women after Lumpectomy and/or Mastectomy. Journal of the American College of Surgeons. February 2018.


Deadline Extended for CoC Paper Competition

The Commission on Cancer (CoC) has extended the deadline for submissions to the Annual Cancer Research Paper Competition. Submissions for the competition, which recognizes residents and fellows-in-training for their original research, will be accepted through July 15, 2020, at mleeb@facs.org. The first-place winner will receive a $1,000 honorarium and the opportunity to present the research at the CoC’s Annual Meeting on October 4, 2020. The entry will be considered for publication in the Journal of the American College of Surgeons. The authors of the second- and third-place winning abstracts will each receive a $500 cash award.