I think the first problem is whether or not administration is
interested in being educated.

Some hospitals have cancer programs because they feel they "have
to". Everything is cut to the bone until survey is due, then they
spend money and push the registrar to bring everything up to
standards.

Others are more receptive to having a program which meets standards
regardless of when the survey is due. For those administrators, I'd
run reports showing trends in the patient populations, and drop them
off or hand them out at tumor boards or cancer committees to
demonstrate what can be done with our data.

I believe, though, that we will never really have consistent,
reliable support from administration until we can demonstrate a
direct financial benefit from the presence of an active, up to date
registry and program.