Accreditation of oncology programs is a critical component of achieving quality cancer care. The American College of Surgeons Commission on Cancer (CoC) revised standards, titled “Optimal Resources for Cancer Care”, are effective January 2020. This update introduces significant change focusing on the provision of high-quality and measurable care.
Role of the CoC
The Commission on Cancer 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 quality cancer care. (facs.org/cancer) The American College of Surgeons (ACoS) has a 100+ year history of promoting quality improvement with CoC accreditation recognizing cancer care programs for their commitment to providing comprehensive, high quality, multidisciplinary patient-centered care.
The CoC accreditation and verification model is based on 1) standards individualized by patient and backed by research, 2) infrastructure including staffing levels, specialists, and processes, 3) rigorous data collection and analysis, and 4) verification by external peer review.
Rationale for the 2020 Revisions
To support their patient-centered mission, the CoC made substantial changes to several standards for cancer care programs for 2020 to ensure results in the improvement of patient care. Based on the successes and ongoing challenges encountered with the delivery of cancer services, the focus has shifted to demonstrating improvement in resource utilization and patient outcomes. The CoC is striving to strengthen interdisciplinary team communications and data sharing in support of quality initiatives and patient engagement.
The revised standards remain patient-focused and provide a blueprint for cancer program development that is customized to meet the needs of their unique practice setting and population served. It’s imperative that those serving in the role of oncology navigator understand these standards for accreditation, as they set the framework for providing personalized patient-centered care through the identification of barriers and appropriate utilization of resources.
Changes Affecting Patient Care
A few notable changes to the standards will be phased in by 2021 to allow for the formulation of strategies to address new requirements. Program administrators are identifying best practices in system processes and infrastructure to meet these standards and continue to provide the best patient experience. Navigation remains integral to meeting the personalized need of patients and their caregivers throughout their cancer journey.
One area that will be under continuous quality review will be Barriers to Care (Standard 8.1). Cancer programs must now identify at least one barrier (annually) and work to impact change at the community level. Analysis of commonly seen barriers to care and a community assessment will guide barrier selection. Oncology navigators have an important role in establishing a patient navigation process and addressing patient- and system-related barriers to ensure patient engagement and timely access to care.
Secondly, a successful Psychosocial Distress Screening program (Standard 5.2) has been redefined to address both the patient and the caregiver and encourages learning from trends seen with baseline and ongoing monitoring. Ideally, by conducting a baseline assessment at diagnosis then during pivotal events, appropriate referrals can be made and interventions initiated to promote quality of life.
The development of a Survivorship Program (Standard 4.8) expands on the previous requirement for completing a survivorship care plan to the development of a survivorship program to ensure that the breadth of a cancer survivor’s needs are being met. The goal is for the survivorship planning process (which includes customized referrals and timeline for followup) and the resulting document to serve as an active plan of action for the patient and their multidisciplinary health care team.
Tools for Administration of Standards
As Navigators and cancer program administrators work to evaluate strategies to ensure the successful implementation of these and other updates to the CoC standards, they will be assessing their own workflow processes, collecting metrics and analyzing data to support quality improvement initiatives. There will be an increasing need for tools to improve their operational efficiency and functional capabilities. There are reporting tools available to aid in benchmarking and reporting but these often lack patient relationship management workflow.
CancerNAV is a patient relationship management solution. This cloud-based tool supports timely patient engagement, communication, and adherence to the treatment plan. Disease-specific checklists in CancerNAV efficiently guide Navigator workflow, fostering patient-provider and inter-team communication to ensure barrier resolution and timely access to care. Navigator dashboards, selection boxes, reminders, and alerts facilitate coordination of care. Quality improvement initiatives and documentation to accreditation standards are further enhanced with actionable point of care metrics allowing oncology programs to demonstrate value, success, and sustainability.
As 2020 CoC revised standards for accreditation will be phased-in over the next 2 years, the new year looks to be quite busy for program administrators of CoC-accredited cancer care centers as they begin their evaluation and development planning. We can expect to see improved outcomes and further focused structuring of oncology services demonstrating continued commitment to providing high-quality, patient-centered cancer care.
Resources for your review:
Optimal Resources for Cancer Care
2017 Oncology Nurse Navigator Core Competencies