A monthly news service for Constituents of the Commission on Cancer.
Announcing Release of the New Commission on Cancer Standards for Accreditation
The Commission on Cancer (CoC) announces the formal release of the Cancer Program Standards 2012: Ensuring Patient-Centered Care. You should have received a special issue of the CoC Flash officially announcing the release. This publication is the culmination of more than two years of work by a group of dedicated individuals that include staff of the Accreditation Program at the CoC, including Connie Bura, Asa Carter and her team, Andrew Stewart, and David P. Winchester, MD, FACS. In addition, while it is impossible to list all those who worked on this project, key volunteers in the development of the standards include the project co-chairs, Frederick Greene, MD, FACS, and Diana Dickson-Witmer, MD, FACS, the respective workgroups chairs, vice-chairs and members, and Daniel McKellar, MD, FACS, and Robert Flanigan, MD, FACS, chair and vice-chair of the Accreditation Committee.
Ultimately, we express our gratitude to the accredited cancer programs for the feedback they provided throughout the development process. Thanks to all for your commitment to this project. These standards, scheduled for implementation in 2012, ensure that key elements of quality cancer care are provided to every cancer patient treated in a CoC-accredited facility throughout diagnosis and treatment, including psychosocial support, care for cancer-related pain, palliative care, and hospice care. These standards challenge cancer programs to enhance the care they provide by addressing patient-centered needs and measuring the quality of the care they deliver against national standards. Both areas are critical components of quality cancer care.
Information about the standards, including soon-to-be-released resources to support them, can be found on the CoC website at http://www.facs.org/cancer/coc/cps2011.html, where you can also download a PDF copy or order additional hard copies of the standards.
The National Cancer Data Base (NCDB) works closely with other cancer registry standard setters. An example of that cooperation involves an edit that affects cases diagnosed in 2010 or later. In 2009, the National Program of Cancer Registries (NPCR) performed an audit that checked the accuracy of coding for the Facility Oncology Registry Data Standards (FORDS) data item, Date of the First Course of Treatment (NAACCR Item #1270). The auditors discovered substantial failure to follow coding instructions accurately.
That item requires a date to be entered unless the case was diagnosed at autopsy. The first three instructions for Date of the First Course of Treatment in FORDS: Revised for 2011 read as follows:
Record the earliest of the following dates: Date of First Surgical Procedure (NAACCR Item #1200), Date Radiation Started (NAACCR Item #1210), Date Systemic Therapy Started (NAACCR Item #3230), or Date Other Treatment Started (NAACCR Item #1250).
If active surveillance or watchful waiting is selected as the first course of treatment (RX Summ-Treatment Status [NAACCR Item #1285] = 2), record the date this decision is made.
In cases of nontreatment (RX Summ—Treatment Status [NAACCR Item #1285] = 0) in which a physician decides not to treat a patient or a patient’s family or guardian declines all treatment, the date of first course of treatment is the date this decision is made.
Except for autopsy-only cases, there must be a date entered for Date of the First Course of Treatment or else the Date 1st Crs RX Flag must indicate that the date is unknown (10 or 12).
NPCR requested NCDB to sponsor an edit that controls the use of the Date 1st Crs RX Flag based on Class of Case because the items involved are FORDS items. The resulting edit, “RX Summ--Treatm Stat, Date of 1st Crs RX--COC(COC),” checks that:
For cases for which RX Summ--Treatment Status = 0 (no treatment given), THEN
If Class of Case = 38 (autopsy only), Date of 1st Crs RX Flag must = 11 (autopsy only case)
If Class of Case NOT = 38 (autopsy only), Date of 1st Crs RX Flag must = blank (a date has been coded), 10 (unknown whether any treatment was given), or 12 (a date is applicable, but unknown).
Because the item RX Summ--Treatment Status was defined for use beginning in 2010, the new edit applies to cases diagnosed starting in 2010. NCDB will collect cases diagnosed in 2010 for the first time in January of 2012. However, because a state central registry reported to NCDB that it was seeing a substantial number of current cases failing the edit, we are bringing it to your attention now so you can review your existing cases for accuracy and make any coding procedure changes that might be necessary for the future.
To correct cases that fail the edit, review the date of first course treatment and treatment status as well as the first course treatment date flag and class of case.