Commission on Cancer Revises Its Standards. Here Are the Takeaways for Oncology Nurses.

What Are CoC Standards?

A program from the American College of Surgeons, CoC is a consortium of professional organizations that ensures the delivery of quality cancer care by setting standards to address cancer prevention, research, education, treatment, and survivorship. It also accredits more than 1,200 U.S. cancer programs that demonstrate commitment to delivering high-quality, safe, patient-centered care through a multidisciplinary team. ONS is one of many organizations represented on CoC.

The CoC Cancer Program Standards: Ensuring Patient-Centered Care define the requirements for earning and maintaining cancer program accreditation. In 2018, CoC workgroups—which included ONS representatives—began the process of revising the accreditation standards. Many oncology nurses provided their input during the public comment period on the draft standards, and all public comments were considered and led to further revision before the final version was released in fall 2019.

CoC Standard Revisions That Affect Oncology Nurses

Oncology nursing certification: For the first time, the standard conveys CoC’s strong preference for care delivered by certified oncology nurses. However, it also acknowledges challenges and barriers to realizing the goal of having all certified nurses caring for people with cancer. As such, the standards suggest having nurses on a path to certification, or at least participating in nursing continuing professional development activities to sustain a current knowledge base. Unlike past years, compliance does not require a number or percentage of certified staff; rather, all nurses who provide direct oncology care should be on the same path. This is a phased-in approach for the requirements.

Survivorship programs: Previous CoC survivorship care plan standard requirements seemed to place more importance on the number of plans completed rather than the plans’ effectiveness and role in ensuring quality survivorship care. The revised standard now emphasizes comprehensive survivorship care instead of the quantity of plans completed, requiring coordinated, multidisciplinary survivorship care that is appropriate for the patient population needs in a particular cancer program. Institutions must identify and prioritize the greatest needs, then implement a survivorship program to address three priority services. Survivorship care plans may be on one of those priority services, but it shouldn’t be the only priority.

Addressing barriers to care: Past CoC accreditation requirements for patient navigation have highlighted the value of a navigator, whether a lay patient navigator, nurse navigator, or combination. The revised standard continues to ask cancer programs to use community assessments to find barriers to providing cancer care in their community and choose one as a focus for the upcoming year. An example of a potential community barrier is a shortage of healthcare providers; one approach to reducing it could be instituting a community telehealth program.

Oncology nurses, in a variety of professional roles, have a significant responsibility in a cancer program earning and maintaining CoC accreditation. ONS members have a voice through ONS and your own cancer program’s representation on the commission. Although the revised standards will come with change in some areas, the intent is and always will be to support and acknowledge the delivery of quality, patient-centered cancer care through an interprofessional team approach.

For more information on CoC standards, visit FACS.org (https://www.facs.org/quality-programs/cancer/coc/2020-standards).