The American College of Surgeons (ACS) revised the format of the CoC standards to more consistently align with other quality programs that they oversee. For starters, they redistributed the 2016 edition's eligibility requirements and standards across nine new domains in 2020. The CoC outlines this conversion between 2016 and 2020 standards in detail. In addition to significant restructuring, the 2020 standards make several changes to familiar terminology from prior years: the Survey Application Record (SAR), Survey, and Surveyor are now called the Pre-Review Questionnaire (PRQ), Site Visit, and Site Visit Reviewer, respectively. Finally, the 2020 standards eliminate the commendation rating, resulting in a single set of compliance criteria per standard.
Revisions for 2020
The significant restructuring between 2016 and 2020 standards may make compliance seem daunting at first glance. The good news? Many of the changes have relaxed requirements from the previous edition. We've highlighted the most notable changes:
While we've outlined selected changes here (click here for a downloadable version of the table above), we encourage you to closely review the official 2020 Standards, Optimal Resources for Cancer Care, as well as the CoC Overview 2020 Standards Webinar and CAnswer Forum.
Phase-in standards for 2021
Although programs are expected to comply with the majority of changes beginning January 1, 2020, for next year's site visits, three major changes will not be phased in until 2021. These standards are the Oncology Nursing Credentials (Standard 4.2), Survivorship Program (Standard 4.8), and the New Operative Standards for Cancer Surgery (5.3-5.8):
- Nursing credentials requirement increased
All RNs and APRNs providing direct oncology care must hold either cancer-specific certification or earn 36 cancer-related continuing education nursing contact hours each three-year accreditation cycle. The Oncology Nursing Society (ONS) and Oncology Nursing Certification Corporation (ONCC) provide a wealth of additional information and free continuing education options.
- Transition from required survivorship care plans to survivorship program
As we heard from many cancer program leaders, the 2016 CoC survivorship care plan requirement was notoriously one of the most difficult to achieve. The 2020 standards eliminated mandatory survivorship care plans, instead requiring programs to offer a minimum of three services that address the needs of cancer survivors. While providing survivorship care plans can count towards the requirement, examples of additional potential services include screening for recurrence, seminars, support groups, nutrition, and psychiatric services.
- Introduction of new operative standards
New to the 2020 CoC update, Standards 5.3-8 require synoptic reports for six procedures. In our early conversations, several organizations have expressed concerns that these new standards will pose a challenge for compliance. As you prepare for implementation over the course of this year, check back to the CoC's operative standards education page for the release of new resources and tools currently in development, including EHR integration solutions such as premade smart-phrases and synoptic report templates.