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Quality control procedures must be implemented
to ensure complete reporting of all reportable cases.
This quality control function should be performed semiannually,
at a minimum, to allow for immediate correction of identified
underreported areas. If the number of reportable cases
in the database has dropped by midyear, the registrar
should verify that all sources of casefinding have been
reviewed. A monitoring log can help in this process
but is not required. Below is an example of a monitoring
log.
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Sample Casefinding Completeness
Log
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Adm & Dis
Dis Index
Surg Schedule
Path
Cyto
Nucl Med
Rad Onc
Med Onc
Autopsy
Other
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Jan
Feb Mar
Apr May
Jun Jul
Aug Sep
Oct Nov
Dec |
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Other examples of quality control procedures for casefinding
include comparing monthly cases in previous years with the current
period. Again, this type of log can be useful, but is not required.
A sample casefinding completeness log by month and year of diagnosis
is provided below.
Sample Casefinding Completeness
Log by Month and Year of Diagnosis
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Month
January
February
March
April
May
June
July
August
September
October
November
December
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Number of Cases, 2000
60
50
65
58
52
61
45
32
65
62
70
40
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Number of Cases, 2001
85
60
72
50
61
64
57
62
72
78
80
62
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In the example above, the decrease in cases in July and August
2000 might correlate with a primary physician taking an extended
vacation. The decrease in cases for December 2000 and the
increase in January 2001 may be due to a specialty group of
physicians leaving the institution in December and the arrival
of a new oncology group in January. Fluctuations like those
shown in this example should be reviewed and justified when
differences are identified to ensure that casefinding is complete.
The easiest way to accomplish this task is to request the
disease indices again for the month in question so that patterns
that deviate from previous months can be reviewed.
On a hospital and regional level, comparison of sites by
the year of the diagnosis can be helpful. A sample casefinding
completeness log by site and year of diagnosis is also provided
below. This type of evaluation can show a decrease in outpatient
visits, possible lack of coding or change in coding mechanism,
use of a different laboratory for outpatient visits, physician
change in facility preference, or patient movement to an outpatient
physician office setting.
Sample Casefinding Completeness
Log by Site and Year of Diagnosis
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Site
Breast
Prostate
Melanoma
Lymphoma
Cervix
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2000
91
85
26
25
18
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2001
104
61
11
24
2
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On a regional and state level, comparison of facilities by
year could identify increases or decreases in cases. Increases
may be due to the opening of a new cancer center or a different
marketing approach. Decreases can be attributed to a facility
closing, loss of an industry, or physicians leaving the area.
Although these increases or decreases may be explainable,
the reasons should be evaluated. Regularly monitoring casefinding
enables the registrar to identify potential problems and suggest
corrections.
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