Specialty Groups — Oncology
American College of Surgeons Commission on Cancer (ACOS-CoC) Liaison Report
The American College of Surgeons Commission on Cancer held their annual committee meeting in June of 2005 at which time members of the Approvals Committee addressed a number of issues with the 2004 Standards and approved modifications to them. A revised edition of the Cancer Program Standards 2004 will be available December of 2005. In brief, the issues addressed and their outcomes are as followed:
Standard 2.3 required programs to have a Cancer Liaison Physician (CLP) as coordinator of community outreach. This role has been revised and the role given more flexibility. The solutions are to allow facility-based staff appointed as the Community Outreach Coordinator, the CLP appointed as the Community Outreach facilitator who works in concert with facility-based community outreach staff or the CLP appointed to another designated Coordinator role. These solutions will be effective January 1, 2006 for surveys performed in 2006.
Standards
3. 4 and 3. 5 address percentage follow-up rates maintained for all analytic patients from the cancer registry reference date and all patients diagnosed within the last five years, or from the cancer registry reference date, whichever is shorter. The solution to the issues associated with these 2 standards eliminates the requirement to perform follow-up on patients classified as Class of Case O diagnosed on or after January 1, 2006.
Standard 4.2 required cancer programs to have an inpatient medical oncology unit or a functional equivalent to provide specialized care to patients. The solution to the issues surrounding this standard has been implemented immediately for those programs designated as Teaching Hospital Cancer Programs (THCP). THCPs will document a process to refer patients needing hospitalization for specialized medical oncology services to a facility with a designated inpatient medical oncology unit or document that a functional equivalent medical oncology unit is in place at the THCP. A functional equivalent is defined as the provision of specialized medical oncology care regardless of the location of the inpatient bed. Programs surveyed during 2004 and 2005 that received a deficiency for standard 4.2 will have the opportunity to show documentation of either of the above approved options and have their deficiency removed.
Standard 4.
3 addresses AJCC staging being assigned by the managing physician and recorded on a staging form in the medical record on 90 percent of eligible annual analytic cases. The solutions to the issues surrounding this standard include adding the flexibility of allowing Advanced Nurse Practitioners and Specialized Physician Assistants to assign staging, and record and sign staging in the medical record with a managing physician co-signature after January 1, 2006. Also, the revisions would eliminate the AJCC staging requirement for patients diagnosed on or after January 1, 2006 that are classified as Class of Case O.
For more detail on these revisions, the issues provoking the changes and previous standard revisions log on to www.facs.org/cancer .
The ACoS-CoC Report was prepared by ACOA/ACoS-CoC liaison, Jeannie O’Leary. Her role as liaison is to enhance our relationship and collaboration by providing a forum for the exchange of ideas, initiatives, critical issues, and actions that impact cancer care, data collection, and research. We have the opportunity to bring matters of importance for ACOA to the CoC, as well as communicate CoC activities to the ACOA. If you have input on particular issues regarding credentialing and ACoS standards, please contact Jeannie O’Leary.