Obtaining the National Accreditation Program for Rectal Cancer’s stamp of approval is a group effort that requires the dedication of multidisciplinary teams to their work — and to their patients with rectal cancer.
The three-year accreditation is granted only to those programs that are committed to providing the best possible care to patients with rectal cancer. To be recognized by the NAPRC, an institution must develop and operate a high-quality rectal cancer center, and each accredited program follows a model that ensures multidisciplinary, integrated, comprehensive rectal cancer services.
Initially developed through collaboration between the OSTRiCh Consortium (Optimizing the Surgical Treatment of Rectal Cancer and the American College of Surgeons Commission on Cancer (ACS CoC), the NAPRC program grew from several bodies of evidence that indicated—almost unanimously — that rectal cancer treatment’s rates of postoperative mortality, incidence of local recurrence, incidence of construction of permanent colostomy, and five-year survival could be improved with a standardized curriculum.
In fact, the last 20 years have demonstrated that rectal cancer outcomes are tremendously variable and
highly dependent upon specialization, training and volume.
“NAPRC accreditation provides a rubric that encourages every specialty involved in the care of a rectal cancer patient to participate in the process and be at the top of their game for a common goal,” said Thomas E. Read, M.D., FACS, FASCRS, professor and chief of the division of gastrointestinal surgery at the University of Florida College of Medicine. “Receiving this accreditation demonstrates that we have high-quality pathology review of specimens, high-quality review of the radiographic images, and collaboration between all the specialties that treat our patients.”
Having surgical work monitored, Read said, not only creates accountability but ensures patients’ pathologic outcomes are measured using a standardized format.
“I think it helps everyone,” Read said. “Part of the benefit may be achieved via the Hawthorne effect. If your outcomes are being monitored, they are likely to improve.”
The theory behind it is straightforward, but the execution less so. To qualify for accreditation, the compliance and commitment of the institution must be exceptional. Resource allocation (such as equipment, personnel, and administrative support), a commitment to patient safety, and an enduring focus on continuous quality improvement are the hallmarks of strong institutional administrative support that help facilitate success.
“For me, this process has shown just how integral teamwork is to great patient care, and I would like to thank everyone who has participated,” Read said. “From Marsha Hodge, our director of registry operations, to the colorectal cancer nurse navigator, pathologists, radiologists, radiation oncologists, gastroenterologists, medical oncologists and the colorectal surgeons. These people have been the backbone of this entire process.”
The accreditation itself doesn’t demand colorectal surgeons treat rectal cancer in one specific, ironclad way. Rather, it provides a framework each member of the team can refer to.
“The biggest change it makes is providing physicians with a structure to how they discuss and evaluate rectal cancer patients,” Read explained. “Really, it’s just making sure that everyone looks at all the appropriate images and has the appropriate discussions at the appropriate times.”
The standards are laser-focused on patient care, and by design, leave little room for error, said Marsha Hodge, director of registry operations.
“At the end of the day, the goal is that each rectal cancer patient receives the workup and the treatment that they need based on their individual needs and diagnosis,” Hodge said. “Inevitably, treatment plans will vary. But the quality of outcomes and care provided will remain high.”