CRM Standard Setters Chapter 25 DONE
What are the goals of The Joint Commission (TJC)? Response: A. To improve the safety of patient care B. To improve the quality of care C. Both (a) and (b) D. Neither (a) nor (b)
C. Both (a) and (b) Rationale: The mission of The Joint Commission (TJC) is to work continuously to improve the quality and safety of care to patients.
How long does an established cancer program have to resolve a Commission on Cancer (CoC) deficiency if it received a "Three-Year Accreditation with Contingency" award following a survey? Response: A. 12 months B. 9 months C. 6 months D. 1 month
A. 12 months Rationale: Established cancer programs that receive a "Three-Year Accreditation with Contingency" award following a Commission on Cancer (CoC) survey have 12 months to submit the required documentation proving compliance with the standard(s) that was deficient. The certificate of accreditation is issued after resolution of any deficiency; the program is surveyed at a three-year interval.
Which organization is the administrative sponsor for the Collaborative Stage Data Collection System? Response: A. American Joint Committee on Cancer (AJCC) B. American College of Surgeons (ACoS) C. National Program of Cancer Registries (NPCR) D. Surveillance, Epidemiology, and End Results (SEER)
A. American Joint Committee on Cancer (AJCC) Rationale: The American Joint Committee on Cancer (AJCC) is the administrative sponsor for the Collaborative Stage Data Collection System.
What is required to be collected by all central cancer registries? Response: A. Demographic information B. Smoking status C. Both (a) and (b) D. Neither (a) nor (b)
A. Demographic information Rationale: Data that cancer registries are required to collect includes cancer incidence, demographic information (e.g., age, race, gender), administrative information including date of diagnosis and source of information, and pathologic data including cancer site, stage at diagnosis and type of treatment. Although whether a patient smokes cigarettes, doesn't smoke cigarettes, or has smoked cigarettes, is occasionally collected by registries, it isn't required.
Which agency is responsible for conducting the Canadian census every 5 years? Response: A. Statistics Canada B. Canadian Cancer Registry (CCR) C. Public Health Agency of Canada (PHAC) D. Canadian Partnership Against Cancer (CPAC)
A. Statistics Canada Rationale: Statistics Canada, founded in 1971 and headquartered in Ottawa, is the Canadian federal government agency charged with producing statistics to help better understand Canada, its population, resources, economy, society and culture. The CCR is housed within this agency. Generating statistics is a federal responsibility in Canada and Statistics Canada produces statistics for all the provinces as well as the federal government. This agency is also responsible for conducting the Canadian census every 5 years on the first and sixth year of each decade. All 13 provincial and territorial registries have reported their data annually to the Canadian Cancer Registry (CCR) since 1992. The primary objective of the CCR is to provide a database to study cancer patterns and trends and to monitor differences in cancer risks among the country's different populations. Information about cancer incidence and survival in Canada is generated by the CCR. The Public Health Agency of Canada (PHAC), formed in 2004, is an agency of the government responsible for disease control and detection, health safety (e.g., immunizations and vaccines, health promotion, injury prevention, emergency preparedness, travel alerts), and research and statistics. The Canadian Partnership Against Cancer (CPAC), formed in 2007, was created to implement Canada's vision for cancer control. Its three priorities regarding cancer surveillance include: 1) expansion of core surveillance data collection, 2) improving analytic capacity and 3) increasing access to and use of registry data. CPAC is an independent organization funded by the federal government to accelerate action on cancer control for all Canadians. The Partnership works with cancer experts, charitable organizations, governments, cancer agencies, national health organizations, patients, survivors and others to implement Canada's cancer control strategy.
The Surveillance, Epidemiology, and End Results (SEER) Program registries cover approximately what percentage of the United States population? Response: A. 14% B. 28% C. 56% D. 70%
B. 28% Rationale: Surveillance, Epidemiology, and End Results (SEER) Program collects and publishes cancer incidence and survival data from population-based cancer registries covering approximately 28% of the population from the following regions in the United States: Alaska Native Tumor Registry Arizona Indians Cherokee Nation Connecticut Detroit Georgia Center for Cancer Statistics Atlanta Greater Georgia Rural Georgia Greater Bay Area Cancer Registry San Francisco-Oakland San Jose-Monterey Greater California Hawaii Iowa Kentucky Los Angeles Louisiana New Jersey New Mexico Seattle-Puget Sound Utah An important aspect of the SEER database is its coverage of disparate populations within the United States which includes 26 percent of African Americans, 38 percent of Hispanics, 44 percent of American Indians and Alaska Natives, 50 percent of Asians, and 67 percent of Hawaiian/Pacific Islanders.
Which organization does not participate in the preparation of the Annual Report to the Nation on the Status of Cancer? Response: A. American Cancer Society (ACS) B. American College of Surgeons (ACoS) C. Centers for Disease Control and Prevention (CDC) D. North American Association of Central Cancer Registries (NAACCR)
B. American College of Surgeons (ACoS) Rationale: The Annual Report to the Nation on the Status of Cancer provides an update of cancer incidence, mortality, and trends in the United States. The following organizations have collaborated since 1998 to create the report: American Cancer Society (ACS) National Cancer Institute (NCI) Centers for Disease Control and Prevention (CDC) North American Association of Central Cancer Registries (NAACCR)
In the four steps that comprise the cancer control model, which step(s) involves the use of central registry data? Response: A. Selecting the target population B. Evaluating the impact of the intervention C. Both (a) and (b) D. Neither (a) nor (b)
B. Evaluating the impact of the intervention Rationale: There are two steps in the model for cancer control that require the use of central registry data: Step 1: Identifying the problem. (Done using central registry data). Step 2: Select the target population and develop an intervention strategy. (Done by health care providers.) Step 3: Implement the intervention plan. (Done by health care providers.) Step 4: Evaluate the impact of the intervention. (Done using central registry data.)
Surveillance, Epidemiology, and End Results (SEER) Program produces an annual Data Quality Profile (DQP) for each of its member registries. What is the DQP data quality goal related to the allowable percentage of death certificate only cases that should be reflected in the database by year of diagnosis? Response: A. Less than 1.5% B. Less than 1.5% and greater than 0.0% C. Less than 3% D. Less than 3% and greater than 0.0%
B. Less than 1.5% and greater than 0.0% Rationale: Surveillance, Epidemiology, and End Results (SEER) Program central registries must strive to meet the standards of data quality to help ensure data accuracy and reliability. Examples of quality control goals include having death clearance cases accounting for less than 1.5% and greater than 0.0% of the annual caseload submitted. Additional Data Quality Markers include: Greater than or equal to 98% of estimated completeness at 22 months after the end of the diagnosis year and greater than or equal to 95% at 14 months after the end of the diagnosis year. One year reporting delay involves less than 2.5% of the annual cases submitted. Less than 2.5% of the cases missing cause of death information. Less than 2.5% of the cases coded with a non-specific histology. Less than 6% of the cases coded with laterality to unknown. Less than 10% of the cases coded with historic (summary) stage coded to unknown. Less than 2% of the cases with invalid or missing census tract data. Meeting various follow-up standards for in situ disease and by age group for invasive disease (i.e., less than 20; 20-64; 65 and over). The contractual standard for all standards is between 90-95%.
Who runs the National Cancer Data Base (NCDB)? Response: A. Commission on Cancer (CoC) B. American Cancer Society (ACS) C. Both (a) and (b) D. Neither (a) nor (b)
C. Both (a) and (b) Rationale: The National Cancer Data Base (NCDB) is a joint program run by the Commission on Cancer (CoC) of the American College of Surgeons (ACoS) and the American Cancer Society (ACS). NCDB started in 1989, contains 29 million records from hospital cancer registries across the United States from more than 1500 CoC accredited cancer programs. Approximately 70% of all newly diagnosed cancers are captured in the NCDB.
What is a true statement(s) regarding the National Cancer Registrars Association (NCRA)? Response: A. It is a not-for-profit organization representing solely Certified Tumor Registrars (CTR). B. One of the primary focuses of the organization is to serve as a liaison between partner organizations involved in the cancer registry profession. C. Both (a) and (b) D. Neither (a) nor (b)
B. One of the primary focuses of the organization is to serve as a liaison between partner organizations involved in the cancer registry profession. Rationale: The National Cancer Registrars Association (NCRA) is a not-for-profit association representing cancer registry professionals and Certified Tumor Registrars (CTR). NCRA's liaisons serve as the interface between partner organizations involved in the cancer registry profession to communicate and coordinate their activities. In addition, providing educational opportunities and credentialing are included as part of the organization's mission statement.
In Canada, funding for cancer registries is primarily a responsibility at the Response: A. Federal level B. Province/Territory level C. Hospital level D. None of the above
B. Province/Territory level Rationale: In Canada, because health care is primarily the responsibility of individual provinces and territories, federal funding is nonexistent to support the operations of cancer registries. This gives unique challenges to the funding of the cancer registries there. Smaller provinces and territories have greater challenges obtaining adequate funding to perform routine registry options.
Which North American Association of Central Cancer Registries (NAACCR) committee provides a formal mechanism to review and recommend proposed changes in data codes and/or the addition of new items submitted by NAACCR members? Response: A. Standardization and Registry Development Steering Committee B. Uniform Data Standards (UDS) Work Group C. Edits Workgroup D. None of the above
B. Uniform Data Standards (UDS) Work Group Rationale: The Uniform Data Standards Work Group provides the formal mechanism to review and recommend proposed changes in data codes and/or the addition of new items submitted by NAACCR members to ensure that data remain comparable among central registries and other standard setters. In addition, this workgroup provides a formal mechanism for reviewing and recommending edits of NAACCR-approved data items. The EDITS Workgroup provides a formal mechanism to review and make additions/changes to edits and the NAACCR EDITS metafile. The Standardization and Registry Development Steering Committee helps the organization prepare central registries to adapt rapidly and successfully to changing developments in cancer surveillance.
A central registry sending a list to the physician of patients due for follow-up is an example of Response: A. Passive follow-up. B. Lifetime follow-up. C. Active follow-up. D. None of the above
C. Active follow-up. Rationale: Most central registries use a combination of active and passive procedures to follow patients. Active follow-up involves the central registry requesting that either the physician's office staff or hospital cancer registrar contact a patient directly to ascertain the current status of the patient. Passive methods of follow-up do not require central registry contact with hospital registrars, physicians or cancer patients. An example of an active follow-up procedure is the central registry sending a list of patients due for follow-up directly to the physician's office for his staff to contact the patient and report findings back to the central registry. An example of a passive form of patient follow-up is the central registry's data linkage to death certificate files to update the vital status and date of last contact for patients.
Population-based incidence registries must include Response: A. All residents of the catchment area treated at local area facilities. B. All residents of the catchment area treated in another state. C. Both (a) and (b) D. Neither (a) nor (b)
C. Both (a) and (b) Rationale: Population-based central registries are required to include all residents diagnosed with a reportable disease in their registry, regardless of where they are diagnosed and/or treated. One method used to find residents of your area that were treated out of state is to perform data exchanges with the central registries in other geographic areas.
Which Canadian organization helps policy makers assess the changes in policies, practices and processes and helps assess their impact within the health care system? Response: A. Canada Health Infoway (CHI) B. Canadian Cancer Society (CSS) C. Canadian Institute for Health Information (CIHI) D. None of the above
C. Canadian Institute for Health Information (CIHI) Rationale: The Canadian Institute for Health Information (CIHI), established in 1994, is an independent, not-for-profit corporation that aims to contribute to the improvement of the health of Canadians and the health care system by disseminating quality health information. The goals of the organization are to 1) provide others an understanding of the effectiveness and efficiency of the health care system in Canada with respects to the population's needs; 2) relate the health care system's performance to the actual outcomes; and 3) help decision and policy makers assess the changes in policies, practices and processes, and their impacts within the health care system. The Canada Health Infoway (CHI), founded in 2001, is an independent, federally funded, not-for-profit organization charged with accelerating the development of electronic health records (EHR) across Canada. The Canadian Cancer Society (CSS), formed in 1938, is a national, community-based organization of volunteers whose mission is to eradicate cancer and enhance the quality of life of people living with cancer. The Canadian Cancer Society is Canada's largest national cancer charity and the country's largest national charitable funder of cancer research.
What process is used by the Surveillance, Epidemiology, and End Results (SEER) Program to more precisely determine current cancer trends and monitor the timeliness of reporting? Response: A. Participation in Rapid Response Surveillance Studies B. Conducting Cost Tracking Evaluation C. Participation in the Residual Tissue Repository Program D. Modeling Reporting Delay
D. Modeling Reporting Delay Rationale: Modeling the "reporting delay" allows the Surveillance, Epidemiology, and End Results (SEER) Program to more precisely determine current cancer trends and monitor the timeliness of reporting. This type of data modeling allows an adjustment to the current case count by taking into consideration future additions, deletions and corrections to the data that occurred subsequent to initial reporting for a particular diagnosis year. Participation in Rapid Response Surveillance Studies supplements the routine data collection effort by providing a quicker response to scientific issues considered a high priority. Participation in the Cost Tracking Evaluation allows an analysis of various aspects (e.g., staff time allocation, funding sources) of central registry operations across the entire SEER program. Participation in the Residual Tissue Repository Program allows the potential participation in biospecimen research on a representative sample of a geographic area.
Applying for and maintaining Commission on Cancer (CoC) accreditation for a cancer program is Response: A. Mandatory for hospitals with a cancer program. B. Mandatory for comprehensive community cancer programs. C. Both (a) and (b) D. Neither (a) nor (b)
D. Neither (a) nor (b) Rationale: Applying for and maintaining Commission on Cancer (CoC) accreditation is a voluntary commitment by all cancer programs
Which professional is typically not included as part of The Joint Commission (TJC) survey team? Response: A. Physician B. Nurse C. Administrator D. None of the above
D. None of the above Rationale: A typical hospital survey usually involves at least three surveyors: a physician, a nurse, and an administrator. Surveyors evaluate various units within an organization and then meet to discuss their findings based on observation, interviews, and the review of documentation. Accreditation requires a complete system analysis, focusing on the integration and coordination of health care processes.
Which organization established the Commission on Cancer (CoC)? Response: A. American Cancer Society (ACS) B. American Joint Committee on Cancer (AJCC) C. Centers for Disease Control and Prevention (CDC) D. None of the above
D. None of the above Rationale: Commission on Cancer (CoC) was established by the American College of Surgeons (ACoS) in 1922 as a consortium of professional, multidisciplinary organizations dedicated to improving survival and quality of life for cancer patients through standard-setting, prevention, research, education, and the monitoring of comprehensive quality of care (e.g., conducting surveys in healthcare settings, using data to monitor treatment patterns and outcomes, developing education materials to improve cancer prevention, early detection, cancer care delivery, and outcomes in health care settings).
