On the question of what sort of PCE's we're doing . . . here's a
snapshot of what's on the SAR I'm completing for a survey happening
next month:
2004: Trends & patterns in HSCT outcomes 7/99-6/04 presented to
cancer comm
2004: Sarcoma incidence, treatment, protocols & outcomes presented
to cancer committee
2003: Mgt & outcomes of cancer pts w/ c difficile infections - to
hsp physicians & staff
2003: Concurrent chemo & low dose craniospinal RT followed by
conformal PF boost for avg risk medulloblastoma: Efficacy & patterns
of failure - To cancer committee & posted on external website
2003: VAD QI project (prospective registry) - To cancer committee &
hsp physicians & staff.
2002: Infection control trends & outcomes among hem/onc & BMT pts -
to cancer committee.
2002: Annual report w/ article on parameningeal rhabdomyosarcoma
presented to cancer committee, posted on external web site
2001: Dietary study of pts who become malnourished while on therapy -
presented to cancer program clinical staff & cancer committee.
2001: Annual report with article on treatment outcomes for recurrent
ALL patients presented to cancer committee & to hsp physicians &
staff.

The second question I'm responding to is about use of staging forms
in electronic records. The remainder of this posting is pasted
directly from the October issue of the CoC Flash & eases the
challenge of having a boatload of staging forms turned into
electronic forms that docs are expected to use (correctly).
-- Theresa Hayden :-)

CoC Executive Committee Modifies Standard 4.3
In response to a variety of concerns from CoC-approved cancer
programs, the Executive Committee of the CoC has reviewed and
decided to modify Standard 4.3.
Currently, Standard 4.3 reads-AJCC staging is assigned by the
managing physician and recorded on a staging form in the medical
record on 90 percent of eligible analytic cases.
Problem: The requirement for staging to appear on a form in the
medical record was established to assist the physician with
correctly assigning stage by providing staging details for each site
and to standardize the location for staging within the medical
record; thereby simplifying the monitoring of compliance with the
standard by both programs and cancer program surveyors. Not
considered at the time Standard 4.3 was established was the impact
of requiring a staging form in many facilities.
Action: The CoC Executive Committee voted to modify Standard 4.3 as
follows: AJCC staging (T, N, M elements and Stage Group) is assigned
by the managing physician and recorded in a standardized location(s)
in the medical record on 90 percent of eligible analytic cases.
The definition and requirement for the standard will now include the
following statement: "The cancer committee develops a staging policy
and procedure and works cooperatively with other facility committees
or departments to establish a standardized location(s) for staging
to be recorded in the facility's medical record. The standardized
location(s) is documented in the facility's AJCC Staging Policy and
Procedure."
There is no change to the statement currently in Cancer Program
Standards 2004, "Use of the AJCC staging forms is highly
recommended."
This change enables facility-based flexibility, but still achieves
the overall goal which is to standardize the location(s) for staging
information. The change in this standard will be effective
January 1, 2005, to allow programs adequate time to modify their
AJCC Staging Policy and Procedure.