Barbara Dearmon, BS, CTR, is president-elect and current secretary of the National Cancer Registrars Association (NCRA). In April, she will assume the role of president. She is also the manager of oncology support services at St. Vincent’s Healthcare in Jacksonville, Fla.
St. Vincent’s is an Ascension Healthcare facility. Ascension is a faith-based health care organization dedicated to transformation through innovation across the continuum of care. It is one of the largest non-profit health systems in the United States and one of the world’s largest Catholic health systems. Ascension is committed to delivering compassionate, personalized care to all patients, with special attention to persons living in poverty and those most vulnerable.
Dearmon, a cancer registry professional for 30 years, spoke with NurseNavigation.com about the history and mission of NCRA, how the work of cancer registrars affects patient care, and ways cancer registrars can help support the objectives of nurse navigation.
Q: What is NCRA?
Barbara Dearmon: NCRA was established in 1974 as the National Tumor Registrars Association to create a non-profit organization representing cancer registry professionals at the national level. The name changed to the National Cancer Registrars Association in 1993.
NCRA is the premiere professional resource for cancer registrars. The organization provides a wide range of services, but one of its main focus areas is training. NCRA offers basic education for registrars just entering the field as well as advanced training for registrars who have earned and need to maintain the Certified Tumor Registrar (CTR) credential. NCRA’s goal is to help its members stay current on innovations related to cancer diagnoses, care, and treatment. NCRA knows that a highly trained workforce will ensure accurate cancer data which leads to better services for cancer patients.
Q: What is the value of cancer registries?
BD: Cancer registries, which are present in most hospitals across the country, maintain a wide range of demographic and medical information on all types of cancer diagnoses treated within a healthcare facility or defined population. The data collected are used in a variety of ways to assist with public health decisions and provide information about cancer diagnosis and treatment.
Public health and medical providers use the data to evaluate patient outcomes and identify areas that need improvement. The data also helps with cancer surveillance, allowing researchers and health professionals to identify cancer clusters, pinpoint jurisdictions that need access to screening programs, and to calculate survival rates. Cancer registry data are vital to developing targeted prevention and screening programs that aid in early detection. The data helps identify the appropriate age for screening and what patient populations are at higher risk.
Q: What is the role of cancer registrars?
BD: The role of the cancer registrar varies depending upon their place of employment. For example, my facility is a community comprehensive cancer program. We are required to meet Commission on Cancer (CoC) standards. I report to a cancer committee, which has oversight over cancer program activities throughout the hospital. Our cancer registry is one area of their oversight. The cancer committee looks at the accuracy of our data collection, how the information is collected, and any opportunities for improvement. It monitors patient outcomes and treatments and makes sure we are treating patients according to national treatment guidelines.
The committee also oversees our cancer conference, where a patient’s diagnosis and treatment is discussed in a multi-disciplinary forum. Physicians from a variety of different disciplines are represented and discuss the plan of care for the patient.
There is a lot we do that can benefit patients. For example, bringing a patient’s case to cancer conferences for active discussion among all of the disciplines provides a patient with a customized care plan. You have several disciplines discussing the best form of care, how to treat a patient according to national guidelines, and whether a patient is eligible for genetic testing or clinical trials. All of that is discussed on cases presented in our cancer conferences on a weekly basis.
Q: How does the use of a cancer registry and cancer registrars help with nurse navigation and care coordination?
BD: The data captured by cancer registrars can help navigators identify all of their cancer patients. The registry is also a resource that nurse navigators can use to ensure patients are receiving treatment according to national quality standards and that the recommended guidelines are being followed.
At St. Vincent’s, we receive a monthly dashboard that identifies patients who meet certain eligibility requirements for treatment who have not received such treatment. We can contact the nurse navigator to follow up to ensure the identified patient receives the needed treatment. For example, some patients may be required to receive radiation within 365 days from date of diagnosis. We have the ability to push our data to a real-time database and identify patients for whom treatment has not yet been administered. Identifying missed treatments is probably one of the most important ways cancer registrars can assist navigators.
As a CoC-accredited facility, St. Vincent’s reports it data to the Rapid Quality Reporting System, a national cancer database which requires participation from all CoC-accredited cancer programs. It is a vehicle for reporting real-time data on breast and colorectal patients and how effective we are in meeting cancer care measures. As an accredited program, St. Vincent’s is responsible for monitoring more than 20 treatment measures covering six cancer sites for compliance. This provides another avenue for making sure patients do not fall through the cracks by allowing us to coordinate with different navigators to ensure patients are being treated accordingly.