Amanda Wilde (Host): One On One with Regional One Health is your inside look at how we're building healthier tomorrows for our patients and our community. Join us as we get to know some of the individuals who help provide life-saving, life changing care for our community. Today we're talking to Leslie Stroud, Oncology Program Accreditation Manager and Surgical Oncologist, Dr. Martin Fleming, about Regional One Health's recent achievement of earning accreditation from the Commission on Cancer. Leslie Stroud, Dr. Fleming, welcome and thank you so much for being here.

Martin Fleming, MD, FACS: Thank you.

Leslie Stroud, MBA, RHIA, ODS-C: Hi, how are you. 

Host: Dr. Fleming, I'd like to start with you. What is the Commission on Cancer and how does an organization go about earning accreditation?

Martin Fleming, MD, FACS: The Commission on Cancer was actually a joint venture approximately 100 years ago between the American College of Surgeons and the American Cancer Society. At that time, the only real treatment for cancer was surgery to remove it, and everyone knew that we needed to make great strides in making cancer care better and saving lives.

So, the American Cancer Society partnered to form the Commission on Cancer, and through that process, they came up with a system that would give accreditation to hospitals providing particularly good cancer care, meeting certain standards that we'll talk about I think in a little bit with Leslie. But there are 1,500 hospitals in the United States and Puerto Rico that have a Commission on Cancer Accreditation for their cancer program.

That means approximately 70 percent of the cancer care in the United States is being provided at one of these accredited hospitals, with the whole intent being assuring that the quality of the care, the level of the care is as high as possible, giving patients the highest quality care that we could possibly give them.

Host: And so Leslie, what do you have to do at Regional One Health Cancer Care in order to achieve this accreditation?

Leslie Stroud, MBA, RHIA, ODS-C: So at Regional One Health, we are partnered with the UT Health Science Center, and so we actually achieved the Academic Comprehensive Cancer Program achievement for the Commission on Cancer. So that equals about 13 percent of those 1500 accredited facilities that Dr. Fleming mentioned. So we are part of that group with the Commission on Cancer and, how we got there is to really form a multidisciplinary team within the hospital and established a multidisciplinary care throughout our program.

So that encompasses everyone between nursing, administration, genetic counseling, physician, surgical oncologist, medical oncologist, pathologist, all different types of services within the hospital, that take care of our cancer patients. And we meet and make sure that we meet all of the standards for the Commission on Cancer.

So there are 36 standards for the Commission on Cancer that we meet in order to successfully each year complete the mission to take care of our patients with high quality. 

Martin Fleming, MD, FACS: I think it is absolutely important to have such a team of dedicated people doing it. First you have to have a very dedicated administrative leader, which is what Leslie is, leading the charge, pulling all this information together, and partnering with a team of physicians that are passionate about elevating the level of cancer care at their facility. We have a cancer committee that meets monthly that involves 25 to 30 people that cover all the different disciplines. That was going on for a year or more before we applied for accreditation looking at all these different aspects. And, Leslie and I couldn't begin to do this as a dyad pair. It's a huge team of people moving care forward.

Host: Yeah, it really strikes me that you have to get a multidisciplinary team of people together. Everyone's invested, everyone's proactive, everyone's partnering, and everyone shares the passion for this.

Martin Fleming, MD, FACS: Yes.

Host: So Dr. Fleming, once you've achieved the accreditation, how does that impact patient care and ensure patients there are receiving the best possible care?

Martin Fleming, MD, FACS: It's interesting. There's some very tangible things it does. And then there's some behind the scenes intangible things that I think are just as powerful. The tangible things are that it assures that we have genetic counseling available to patients. It assures that we have even the pragmatic things where we roll up our sleeves and get to work and things like parking and accessibility and answering the phones.

Those things really impact patient care in a very tangible way. But it also does things like assures that we have a tumor registry that tracks the care of our cancer patients in a very organized, systematic fashion so that we can learn. It also assures that we have a certain level of research going on in our facility.

A certain percentage of our cancer patients have to be entered in research trials. So it raises a whole kind of academic intellectual activity of cancer care as well. So those are the intangible things that patients don't see, but they make the cancer care much more sophisticated and much more state of the art current and application of new ideas and new advances.

Host: So thinking in terms of research and those breakthroughs, Leslie, how will accreditation impact the future of Regional One Health cancer care?

Leslie Stroud, MBA, RHIA, ODS-C: Sure. It also gives us access to national data reporting. So, like Dr. Fleming mentioned, through the establishment of the cancer registry and that cancer specific data reporting, we report our cancer data to the National Cancer Database. So the Commission on Cancer gives us access to that national cancer data for research.

So, we can compare our facility data to that national data through those other 1,500 facilities that are reporting also their data. So that's really a wonderful tool for research in order to be able to pull that data nationally to compare ourselves to or do larger scale, research things.

We have access to quality improvement projects, and quality improvement research tools. We have access to education, all sorts of things that will be tied in to having the networking abilities with those other Commission on Cancer certified programs throughout the country.

Martin Fleming, MD, FACS: We also have direct impact of patient care. One of the standards to be accredited with the Commission on Cancer, is to have ongoing multidisciplinary cancer conferences. So we have 17 cancer specific conferences that happen every month. They're site specific. We have a GI conference, a GYN oncology conference, a cutaneous malignancy conference, a malignant heme conference.

And each of those is a team of people with all the necessary disciplines to care for those patients present while we present those cases. Each patient's case is very specifically presented and talked about in a multidisciplinary fashion as part of their ongoing care. So it brings to the patient's care doctors they never meet along the way as part of the process of deciding what the best care for them is as we move forward.

Host: So, it really expands your resource base in many areas as well as research and acquiring new knowledge. For both of you, I'd love to hear, your passion is obvious. What has been the most rewarding aspect of this process of accreditation?

Leslie Stroud, MBA, RHIA, ODS-C: I think the most rewarding part of the process really, is just seeing and knowing the passion from the group and the dedication to the patients that we serve. The team at Regional One, really cares about the cancer community and the cancer patients that we serve. And not just the patients, but also the caregivers in the community that we serve here at Regional One.

It's very apparent through their participation and their enthusiasm with all of these projects, whether it be small or large, and their willingness to get in there and do whatever needs to be done to accomplish these goals. I will also say that it's very rewarding to accomplish this initial accreditation, but that this is just the beginning.

So, it doesn't stop here. We have to continue to move on. So each year we have to accomplish these 36 standards and that is just the beginning part. The accomplishment of the standards are the beginning. We want to definitely exceed them each year, and we will be resurveyed on a three year basis to continue our accreditation so the work doesn't stop here. We continue on a daily and a yearly basis to continue this cancer program on.

Martin Fleming, MD, FACS: The people that we care for at Regional One, are a great example of the broad people that live in Memphis and the Mid South. There's some very wealthy, insured people. There's some very poor, underinsured or uninsured people, and they're all part of the same cancer care program to bring the highest level of care to all of them. We have the ability to care for people in a way that our community has not seen before. I have patients that they live 100 miles away and they don't have gas money to come see the doctor post op from a big operation. Well, part of our accreditation process is we have social services and a social worker and we have a travel program and we just frankly send a Lyft car out to go pick him up and bring him to my clinic.

I mean, it was 100 miles away, but he needed to come and we can make it happen. The things that I think really impact what we can do in our community in a very powerful way through this program.

Host: And I love what you said, Leslie, about the fact that this is the beginning and you're building on this accreditation and Dr. Fleming, what you are saying is you're also building more and more access to care as you continue your work.

Martin Fleming, MD, FACS: Yeah, and the accreditation process, I've told everybody in the cancer committee from day one, this is the first rung of a large ladder. You this is not where we stop. This is a benchmark of quality that we have achieved. It's very exciting, but there's so much more we can do and we'll continue to do to raise the quality of care we can provide.

Host: Thank you so much, both of you, for sharing your insights today, your dedication and your continued work in excellence in cancer care. 

Martin Fleming, MD, FACS: It's a pleasure to be here. Thank you for having us.

Leslie Stroud, MBA, RHIA, ODS-C: Thank you.

Host: That was Leslie Stroud, Oncology Program Accreditation Manager and Dr. Martin Fleming, Surgical Oncologist with Regional One Health and Chief of the Division of Surgical Oncology at University of Tennessee Health Science Center. To learn more about Regional One Health Cancer Care, visit regionalonehealth.org/cancercare or call 901-515-HOPE. Thanks for making One On One with Regional One Health part of your journey to better health. Join us next time as we introduce you to another member of the Regional One Health family.