P09 SOW-ACS Commission on Cancer.pdf

STATEMENT OF WORK

COMMISSION ON CANCER (COC)

ACCREDITATION SERVICES

INTRODUCTION AND OVERVIEW

The East Orange VA Medical Center wishes to contract for American College of Surgeons’ Commission on Cancer Triennial Cancer Program Survey. The Survey provides an external peer review of all processes involved in the care of Veterans with cancer in the East Orange VA Medical Center catchment area and is necessary for accreditation. CoC accreditation is granted to facilities that are committed to providing the best in cancer care and demonstrate compliance with the CoC standards. CoC accreditation provides real value to cancer programs.

The East Orange VA Medical Center cancer program can proudly demonstrate to our veteran community, providers, and payors that we have invested in systems aimed toward cancer patients receiving high-quality, coordinated care, and that we have made the efforts for supportive services and resources addressing the full continuum of care are available to our patients.

BACKGROUND

The American College of Surgeons’ 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 comprehensive quality care. This history of the Commission on Cancer and standards for cancer care begins with the American College of Surgeons (ACoS). From its creation in 1913, the ACoS has focused on improving the care of the surgical patient through the advancement of surgical skills and physician education. Because surgical intervention was the only available treatment for cancer at that time, it is logical that the ACoS also took the lead to improve cancer care by establishing the Commission on the Treatment of Malignant Diseases (Committee) in 1922. Over time, the Committee has transformed from its original surgical focus to one that involves all aspects of cancer care. In order to recognize this transformation, the name of the Committee was changed to the Commission on Cancer in the mid-1960s.

The initial work was focused on establishing cancer clinics within hospitals where patients could expect to receive consistent diagnostic and cancer treatment services. By 1930, the first set of standards had been developed and released, and an Approvals Program (Accreditation Program) had been established that evaluated a cancer clinic’s performance against the standards. By 1933, 140 clinics had gained accreditation.

Since accreditation of this initial group, the number of Accredited Programs has slowly and steadily increased to encompass more than 1,500 hospitals, freestanding cancer centers, and cancer program networks nationwide.

CoC-accredited programs represent 30% of the general medical-surgical hospitals in the United States and Puerto Rico and provide care to close to 70% of patients who are newly diagnosed with cancer each year.

Veterans’ Health Administration (VHA) presently has 60 CoC accredited cancer programs.

SCOPE

The Commission on Cancer (CoC) is a consortium of professional organizations dedicated to improving survival and quality of life for cancer patients through standard setting, which promotes cancer prevention, research, education, and monitoring of comprehensive quality care.

The multidisciplinary CoC

• Establishes standards to ensure quality, multidisciplinary, and comprehensive cancer care delivery in health care settings

• Conducts surveys in health care settings to assess compliance with those standards

• Collects standardized data from CoC-accredited health care settings to measure cancer care quality

• Uses data to monitor treatment patterns and outcomes and enhance cancer control and clinical surveillance activities

• Develops effective educational interventions to improve cancer prevention, early detection, cancer care delivery, and outcomes in health care settings.

The Contractor must provide access to all resources provided by the CoC and uploaded data for comparison to other sites and to prepare for the reaccreditation visit usually held every 3 years.

SCOPE OF SURVEY

The review process will specifically include the following items:

Eligibility requirements:

1. Review and assess cancer committee responsibilities

2. Facility accreditations

3. Cancer committee authority documents

4. Cancer conference policies

5. Oncology nursing leadership

6. Cancer registry policies and procedures

7. Diagnostic imaging availability

8. Radiation oncology services

9. Systemic services

10. Clinical trial information and education

11. Psychosocial services availability and referral patterns

12. Rehabilitation services

13. Nutrition services

Specific standards for accreditation:

1. Physician credentials

2. Cancer committee membership

3. Cancer committee attendance

4. Cancer committee meetings

5. Goals established

6. Cancer registry quality control plan

7. Monitoring cancer conference activity

8. Monitoring community outreach

9. Clinical trials accrual

10. Annual educational activity

11. Cancer registrar education

12. Public reporting of outcomes

13. College of American Pathologists’ protocols

14. Nursing care

15. Risk assessment and genetic testing and counseling

16. Palliative care services

17. Patient navigation

18. Psychosocial distress screening

19. Survivorship care plan

20. Prevention program

21. Screening program

22. CLP responsibilities

23. Accountability measures

24. Quality improvement measures

25. Assessment of evaluation and treatment planning

26. Studies of quality

27. Quality improvements

28. Cancer registrar credentials

29. Abstracting timeliness

30. Follow-up of all patients

31. Follow-up of recent patients (within 5 years)

32. Data submissions to the National Cancer

33. Data Base 5.6 Accuracy of data

34. Commission on Cancer special studies

PERIOD OF PERFORMANCE

The performance period for this procurement will begin 10/1/2023 and expires 09/30/2024.

PLACE OF PERFORMANCE

NJ Healthcare System 385 Tremont Avenue E Orange, NJ 07018-1095