A new tool to promote and facilitate evidence-based cancer care at the local level makes its debut today as the Commission on Cancer (CoC) of the American College of Surgeons introduces its Rapid Quality Reporting System (RQRS) to the more than 1,500 hospital cancer programs that it accredits. RQRS is a voluntary, web-based data collection and reporting system that is enabled through the National Cancer Data Base (NCDB), a nationwide oncology outcomes database of all CoC-accredited cancer programs in the United States and Puerto Rico. The system launches with 66 test sites at CoC-accredited programs around the country already using RQRS.
RQRS was primarily developed to assess how well CoC-accredited cancer programs adhere to specific cancer care recommendations, called quality measures, when caring for patients with breast, colon or rectal cancer. There are six quality performance measures that are monitored, all are defined by the Commission on Cancer and five are endorsed by the National Quality Forum.
Four of these measures are considered to be the standard of care based on clinical trials evidence (accountability measures) and two are considered to be indicators of good clinical care (used for quality improvement or surveillance purposes). The CoC, through its National Cancer Data Base, has the only system available in the United States to apply these quality measures and feed data back to cancer providers caring for the majority of U.S. cancer patients. This system in turn allows them to evaluate and improve the care they provide across all aspects of cancer care.
The “rapid” quality reporting system is just that. It operates in real clinical time, enabling cancer clinicians to get feedback from NCDB on their submitted cases in real time. Previously, such feedback has taken up to two years to be delivered to a cancer patient's interdisciplinary cancer team. RQRS looks to function as a proactive tool that works to keep patients visible in what can sometimes be a vast cancer care treatment network. RQRS is believed to be the first national system for any disease that tracks care over time, thus ensuring that patients can get the required care they need, when they need it.
The Commission on Cancer anticipates that it will take some time for many cancer registries to readjust their work flow and staffing to accommodate RQRS at their facilities, which is one reason why it is being introduced as a voluntary program. However, after preliminary testing most registry staff reported that RQRS could be implemented and maintained with as little as six hours of extra work per week.
Looking ahead, in a few years the CoC anticipates a viable use for RQRS for other disease sites, including lung, stomach and prostate cancers. However, the CoC’s initial priority is to start enrolling as many of its accredited cancer programs in RQRS as soon as possible. This initiative will give all cancer programs a clearer picture of how well they are doing locally with delivering quality cancer care to all patients seen at their accredited programs.
The Commission on Cancer is a consortium of 47 professional organizations that establish cancer care standards and monitor quality at hospitals that it accredits. More than 1,500 hospitals in the United States and Puerto Rico are CoC accredited, representing only 30 percent of all institutions but more than 70 percent of all new cancer cases diagnosed annually.