Thirty-five pounds of paper and binders, shipped around the country, wouldn't exactly make Mother Nature grin. Lisa Landvogt, administrator, Commission on Cancer (CoC), accreditation and standards, estimates that the average cancer survey materials received weigh in at 10 pounds, and the CoC's received surveys in the past that tip the scales at 35 pounds. The CoC wants to help programs go green by lightening the load and having registries submit survey documents electronically.

Landvogt and Cynthia Bourdreaux, CTR, a consultant to a number of programs, will present on the CoC's green initiatives at the National Cancer Registrars Association conference in New Orleans. Landvogt hopes that registries will jump on board and go green.

The New Process
The CoC surveys approximately 450 programs annually, and each one sends boxes of information. The boxes of papers and binders move on to the surveyor, who schleps it back to the survey site, brings it back to his or her office, puts the scores for the survey in and then ships it back to the CoC's home base in Chicago. "Once we get the documents, we end up shredding almost everything, [because] everything confidential gets shredded," Landvogt said. "If it's something like an annual report, we just dispose of it, so we have to weed out documents we can recycle."

When discussions arose about making surveys greener "we decided to really whittle down the list to things the surveyor would have to review in advance vs. what they can actually review on site," Landvogt said. The survey agenda has changed a bit this year, and surveyors will spend more time in the registries reviewing policies, procedures, certifications and continuing education documents on site. Those documents can then remain in the cancer program, rather than being sent all over the nation.

The next step, Landvogt noted, is to have programs send electronic documents. The CoC's National Accreditation Program for Breast Centers (NAPBC) initiated an application where centers attach documents electronically to the application. The CoC hopes that approach can be adapted to the much larger cancer program surveys. "The only thing that's being transmitted around is an electronic document, and then we would take care of deleting the documents out of the computer system," Landvogt explained.

To streamline the process, cancer programs now must send only the following in paper:

·      One copy of the application

·      Their facility's accreditation papers, such as from the Joint Commission

·      The last 2 years of cancer committee meeting minutes, plus the current year's  minutes

·      An annual report for the last 2 years, if one is published by the program

·      An accession list for the surveyor

On site, the surveyor can review bylaws, policies and procedures, credential certificates, continuing education documents, quality control plans, the physician staging plan, an accession list from the current year and any follow-up reports. Landvogt also suggested that programs won't need to make copies, but if they do, they should make them double-sided. If a program wants to show off other aspects, plan to make a storyboard instead of paper handouts. Put minutes on a CD, and send that if you don't want to send them electronically, and Landvogt discouraged using plastic jackets or tabs. "We have some programs that will put each piece of paper in plastic," she noted. "We want to avoid those kinds of things, and try to get the message out that more is not better."