by Linda Corrigan, MHE, RHIT, CTR
Commission on Cancer (CoC)-accredited facilities must establish a cancer committee and charge it to develop and monitor all cancer program activities and cancer-education initiatives. The CoC Cancer Program Standards require that the cancer committee has multidisciplinary representation that includes physicians, other allied health professionals, and a cancer registrar.
Cancer registrars play a critical role on the cancer committee, since they are the only member who has a complete picture of the facility’s cancer burden in their database. The cancer registrar can serve as the committee’s data expert by analyzing data and bringing those findings to the committee for use in program planning. Here are eight ways in which cancer registrars can support their organization’s cancer committee in meeting CoC Standards, and more:
- Standard 1.12 Public Reporting of Outcomes is a commendation standard that lists seven possible other standards that can be included and at least three of these are based on cancer registry data. Accountability and quality measures are regularly reviewed by the cancer committee and your registrar may provide guidance on which measures demonstrate the best outcomes.
- Standard 2.1 CAP Protocols and Synoptic Reporting. Most cancer registry databases can be set up to track CAP synoptic summary adherence, allowing the cancer registrar to provide an important piece of needed data.
- Standard 3.3 Survivorship Care Plans. Procedures can be established such that the registrar and nurse navigator work as a team to implement and monitor survivorship care plans (SCPs). In many cases, the registry data can be downloaded directly to create and update the SCP, saving the nurse navigator hours of work and ensuring these plans are up-to-date and patients are kept informed.
- Standard 4.1 Prevention Programs target risk factors that contribute to a diagnosis of cancer. Effective prevention programs start with data, which can be community-wide data or facility-specific data. Either way, your cancer registrar can assist with data collection and also search the CoC Cancer Forum for examples of best practices for this standard.
- Standard 4.2 Screening Programs start with data. Your cancer registrar can create graphs to illustrate and explain which sites of cancer present to your facility at an advanced stage at diagnosis. Then the cancer committee can discuss whether there is an evidence-based intervention your facility could implement to diagnose these cancers earlier. Your registrar may also be able to assist with collecting this screening data and the subsequent lower stage at diagnosis.
- Standard 4.6 Monitoring Compliance with Guidelines. To help meet this requirement, the cancer registrar can look at how many breast cancers are being treated in accordance with the National Comprehensive Cancer Network (NCCN) guidelines and identify the cases not meeting the recommendations.
- Help with the recruitment of new physicians by providing data on the number of cancer sites diagnosed at the facility. For example, a hospital with a high-volume of lung cancer diagnoses may consider hiring more specialists or establishing a lung cancer institute to meet the community’s needs. Registrars can also evaluate in- and out-migration patterns to help hospital administration understand and address patient-retention patterns. For example, if a patient is diagnosed at the facility, but seeking care and treatment elsewhere, this might be an indication that the facility-of-diagnosis does not have the specialists on staff to address patient care. Registrars can also analyze the time from diagnosis to treatment or from biopsy to final surgery to help the cancer committee spot where improvements can be made. Registrars can also review the distances patients travel for their care, what insurance they carry, and other factors that can be barriers to care.
- Serve as a resource on CoC standards by reporting on information learned at the National Cancer Registrars Association’s annual conference. The CoC offers a standard Q&A session at this conference, providing an opportunity for cancer registrars to better understand the intent of the standards and clarify any questions. For example, in 2016 Daniel McKellar, MD, FACS, chair of the Commission on Cancer, explained which standards surveyors are reporting as being “noncompliant” and how to make sure your program is compliant on those standards. This was vital information that attending registrars brought back to their cancer committees.
Your cancer registry is a valuable resource for your cancer committees, housing the data needed to help meet CoC standards and ensure patient-centered care. Key to success, however, is a cancer registrar who knows how to analyze and present the data. Hiring registrars who hold the Certified Tumor Registrar (CTR) credential is a good first step, but providing ongoing training on advancements in cancer treatments and data analysis and informatics is critical.
Contributing blogger ACCC Member Linda Corrigan, MHE, RHIT, CTR, is currently serving as President of the National Cancer Registrars Association.