Update of Cancer Programs. Scott H. Kurtzman, MD FACS

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1 Update of Cancer Programs Scott H. Kurtzman, MD FACS

2 Outline A brief history of the cancer accreditation programs A brief history of the clinical and research oriented programs What s new?

3 The American College of Surgeons is a trusted brand with a commitment to quality and accountability, especially in cancer care. The American College of Surgeons Cancer Program is an elegant organizational support structure that can create, sustain, and advance a cancer program.

4 Cancer Program Accreditation Allows transparency for patients, programs, providers and payers. Defines a consistent framework that refines complex processes so care is coordinated and accountable while keeping the patient first and rooted in a community. Offers cutting edge care through promotion of clinical trials. Provides quality coordinated care with less variation, consistent outcomes and contains the cost. It is a better value. Ensures the right patient, receives the right care, at the right time, and therefore has the potential to have the best outcomes.

5 Accreditation Programs Commission on Cancer National Accreditation Program for Breast Centers National Accreditation Program for Rectal Cancer

6 Domains of Standards 1. Organization 2. Patient Care 3. Research 4. Community Outreach 5. Professional Education 6. Quality Improvement

7 Harmonization Project All standards across the Cancer Programs should: Results in the improvement of patient care Be evidence based Current Clearly interpretable For the benefits of cancer patients Objectively verifiable by experienced site visit reviewers

8 Commission on Cancer The Commission on Cancer (CoC) is a consortium of professional organizations dedicated to improving survival and quality of life for cancer patients through standard-setting, prevention, research, education, and the monitoring of comprehensive quality care.

9 History of CoC ACoS established the CoC in 1922 Current Chair is Lawrence N. Shulman, MD, FACP FASCO Over 1500 accredited programs CoC-accredited facilities diagnose and/or treat more than 70% of all newly diagnosed patients with cancer (American Cancer Society estimates 1.7 million cases of cancer diagnosed in 2018)

10 Member Orgs (57) Commission on Cancer Education Policy Advocacy CoC Accreditation NCDB Quality/Performance CP 3 R, CQIP, RQRS Research Hospital Cancer Programs

11 What s New in CoC Revision and harmonization of standards Updating of SAR Working with NCDB to improve data entry

12 National Accreditation Program for Breast Centers (NAPBC) A consortium of national, professional organizations focused on breast health and dedicated to the improvement of quality care and outcomes of patients with diseases of the breast through evidence-based standards and patient and professional education.

13 History of NAPBC Conceived and started in 2005 First surveys and accredited breast center in centers are currently accredited

14 National Accreditation Program for Breast Centers (NAPBC) The NAPBC is a multidisciplinary organization within the ACS: There are 18 member organizations and 8 advocacy partners Creates a framework for breast centers to use in organizing their programs Establishes and maintains a set of standards to ensure quality care at breast centers Conducts periodic (q3 year) on site surveys to validate implementation of these standards Promotes the use of established national guidelines in support of clinical care for patients with diseases of the breast

15 What s New in NAPBC The Standards Manual has been completely revised The SAR has undergone a major revision Working towards harmonizing the standards with CoC and other accrediting programs James L. Connolly, MD, FCAP is the current Chair A retreat is scheduled for next winter to help establish the new direction for the program

16 National Accreditation Program for Rectal Cancer (NAPRC) The National Accreditation Program for Rectal Cancer (NAPRC) was developed through a collaboration between The OSTRiCh Consortium (Optimizing the Surgical Treatment of Rectal Cancer) and the Commission on Cancer (CoC), a quality program of the American College of Surgeons. The NAPRC s goal is to ensure patients with rectal cancer receive appropriate care using a multidisciplinary approach. The NAPRC is based on successful international models that emphasize: Establishing a rectal cancer multidisciplinary team comprised of trained and qualified physicians and coordinators Researching supported protocols and processes for rectal cancer care Data collection and monitoring to track care processes, treatment, compliance, and patient outcomes Verifying adherence to evidence-based procedures, including total mesorectal excision, pathological assessment, and MRI staging and reporting

17 Non- Accreditation Programs

18 American Joint Commission on Cancer (AJCC) North American effort first organized as the American Joint Committee for Cancer Staging and End Results Reporting (AJC) (1959) Jointly formed by the American College of Surgeons, American College of Radiology, College of American Pathologists, College of Physicians, American Cancer Society & the National Cancer Institute AJC (1970) adopted objectives, rules & regulations of the AJC resulted in formulation and publication of systems of classification of cancer First Edition of AJC staging manual published in 1977 Eighth Edition published November 2016, implemented Jan 2018

19 American Joint Committee on Cancer (AJCC) The American Joint Committee on Cancer provides worldwide leadership in the development, promotion and maintenance of evidence-based systems for the classification and management of cancer in collaboration with multidisciplinary organizations dedicated to cancer surveillance and to improve care.

20 Eighth Edition What s New at AJCC New way of writing the manual including structured authoring and an API Addition of more non-anatomic factors Commitment to rolling updates Current Chair is David R. Byrd, MD, FACS

21 ACS Clinical Research Program Vision Improve cancer care outcomes through high-quality health services research that leverages the multidisciplinary collaboration and research infrastructure of the Alliance and its partners to generate new knowledge and facilitate the implementation and dissemination of research findings throughout the oncology community Improve oncological surgical practice through dissemination of best practices and clinical trial findings Increase interaction and integration between the Alliance, the ACS, and the Commission on Cancer

22 Operative Standards for Cancer Surgery Promote surgical uniformity for clinical trials Recommend evidence-based best practices in surgical oncology Serve as gap analysis for research Volume 1 published in 2015 Volume 2 to be published in 2018

23 National Cancer Database (NCDB) The nationally recognized National Cancer Database (NCDB) jointly sponsored by the American College of Surgeons and the American Cancer Society is a clinical oncology database sourced from hospital registry data that are collected in more than 1,500 Commission on Cancer (CoC)-accredited facilities. NCDB data are used to analyze and track patients with malignant neoplastic diseases, their treatments, and outcomes. Data represent more than 70 percent of newly diagnosed cancer cases nationwide and more than 34 million historical records.

24 Summary The Cancer programs are working to harmonize standards and accreditation processes The Research programs are actively working with the accreditation programs to support the quality missions

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