News in brief - Sept. 19, 2011

Cancer care standards push patient support

The American College of Surgeons' Commission on Cancer has updated its accreditation standards for hospitals to reduce patient barriers to care and improve care coordination. The standards, updated for the first time since 2009 and announced in August, say that accredited cancer centers should implement a patient navigation process to reduce disparities in access, screen patients for psychosocial distress and form care plans to help improve the quality of life for patients who survive their bout with cancer.

The standards also call for access to hospice and palliative care as well as coordination among the many disciplines that work to provide cancer care, including primary care physicians, oncologists, nurses, social workers and rehabilitation specialists. The commission sought input on the standards from the American Cancer Society, the Cancer Support Community, the National Coalition for Cancer Survivorship and the Lance Armstrong Foundation. The commission accredits about 30% of U.S. hospitals providing cancer care. The standards are available at the commission's website (www.facs.org/cancer/coc/programstandards2012.html).

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Higher surgical volume means fewer complications

Hospitals where many abdominal aortic aneurysm repairs, heart bypasses and gastric bypasses are performed are less likely to see patients have complications such as bloodstream infections, postoperative blood clots or bleeding. Patients undergoing these surgeries at high-volume hospitals also have lower death rates, said an observational study of 1.6 million patients between 2005 and 2008.

Hospitals' surgical volume probably serves as a proxy for factors such as surgeons' and anesthesiologists' technical skills and postoperative care, said the study, published online Aug. 31 in the journal Health Services Research (onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2011.01310.x/abstract) It is unlikely that quality rises dramatically above a certain threshold number, the study said, but rather patient outcomes improve gradually as the hospital's volume in a particular procedure rises.

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