Part 3 of a multi-part series on cancer surveillance and data collection in the United States.
Cancer Registries are staffed with Cancer Registrars who have met the stringent and complex requirements for education, training and work experience. While some Registries have non-credentialed staff who perform administrative tasks or are in training for their credentialing exam, most Registrars are certified tumor registrar’s, or CTRs. Only CTRs can abstract from the medical record cancer information that is reported and used for statistical and quality studies.
There are several processes, or phases, to cancer data collection and reporting. It starts with casefinding, or identifying the people with cancer who have been diagnosed or treated at the hospital or other medical facilities. Most patient’s start their cancer journey with a visit to their primary care physician (or PCP) and are then referred to specialists who will diagnose and recommend treatment for their specific type of cancer.
“Casefinding is like casting a net far and wide to “capture” all the reportable cancer cases.” (1)
CTRs look at the medical record and through manual or automated processes enter the cancer site, histologic type, patient demographics (such as gender, race or age) and the extent of disease (or the stage) into the case abstract. Some Cancer Registries will collect additional medical and scientific data elements, such as the type of treatment, and then follow the patient each year to track any reported recurrence and lifetime survival.
(1) Surveillance, Epidemiology and End Results (SEER), National Cancer Institute
One of Emeril’s trademarks is when he uses his special blend of spices to inject flavor and pizzazz into his food. But, have you considered putting the BAAM back into your work? No matter how fulfilling your work as a cancer registrar might be, putting the passion and excitement into the day-to-day work will require regular sprucing up.
While there is no one-size-fits-all approach to putting the BAAM back into your life, here are six things you can do to get started.
Do something bold. Look at your work and department and identify one process that can be improved upon. Propose a bold new idea that will make a difference to your cancer program. Change a policy or workplace process to be more productive or, heaven forbid – fun!
Become a mentor. Developing personal relationships makes your work more meaningful. Use the wealth of experience and knowledge you have gained in the cancer registry to help a student or a new cancer registrar. Sharing your expertise will validate those years of hard work.
Reset your attitude. Are you looking at the cancer registry future with a glass-half-empty kind of perspective? Perhaps you think your job, or the future of cancer registrars is bleak. Look at it another way: even if you were chief widget maker your job would have value. As a cancer registrar you ensure that hospitals, physicians, administrators and researchers have the data they need to best treat cancer patients.
Look for outside inspiration. There is far more to life than your work. Find a new hobby, resurrect an old one, volunteer for a cause you believe in, or sign up for a community “go green” activity. Being part of something beyond yourself brings clarity and purpose to your life.
Focus on the positive, eliminate the negative. Look for the good in the people in your cancer program. Give earned compliments and praise freely. Replace “I can’t…we can’t…” with “How can I help…or Let me figure out how we can make that happen.”
Reconnect with your faith. You may be surprised at how many high profile people and celebrities find that religious faith adds purpose and meaning to their lives. They believe that they are God’s instrument and that they find purpose in doing His work through them here on earth. Even atheists or those just exploring their spirituality can find faith to be a powerful motivator.
Most important, if you are looking to put the passion and excitement back into your cancer registry work you will find that it does get better if you put a little thought into it. Explore these six areas of your life on a regular basis and you will likely improve your impression of the world around you and find yourself living a happier, healthier, more fulfilled life as a cancer registry leader.
TELL US: How do you put the BAAM! into your day? How do you help your coworkers or fellow cancer registrars to reconnect with their passion for this work?
http://www.RegistryMindset.com. Michele Webb CTR is, a nationally recognized, certified cancer registrar, committed to Cancer Registry leadership and professional education as a coach, mentor, motivational speaker, and author. You have permission to repost this article as long as you do not alter it in any way and give a link back and credit to the author on this website.
“The quest for perfection and certainty is one of the greatest stumbling blocks our profession faces. Too many learning leaders are paralyzed because they don’t want to make a decision without perfect information and without diligently addressing all the uncertainties and possible outcomes. My advice: “Just do it.”
OK, let’s back up a minute. Of course, you need some information. You need enough to make a good decision. So yes, gather the required intelligence, do some benchmarking, perhaps even hire a consultant to help. There comes a time, however, where a good leader will say “We now have enough information to make the decision and here is what we are going to do.” Could that decision be wrong? Of course. Will spending the next year gathering more data and hiring another consultant guarantee the decision will be right? No.
There are no guarantees in the learning field or in any field. Leaders always make decisions based on imperfect, incomplete and often contradictory information. Welcome to the real world! So make the decision and see what happens. You will learn from the implementation and the execution. Make adjustments as you go based on what you learn. The important thing is that you are moving ahead.
Although this issue confronts all leaders, it may be that learning leaders in particular struggle because many have not had the experience of running a business, where they were forced to make decisions under uncertainty and with incomplete information. Experience also means you will have been wrong before and yet lived to tell about it. The world did not end. You made adjustments and moved on. It really does get easier with experience.
So, next time you have to make a major decision, decide how much information is really needed to make a good one, and when you have it, make the decision. If you hear yourself saying “We are almost there” or “We need to study it just a little bit more” month after month, then you are probably procrastinating. Stop waiting for perfection and certainty – they do not exist. It is time to “just do it.””
(This post re-posted from Chief Learning Officer and was written by David Vance, published January 24, 2010). Registry Mindset wishes to thank the author and Chief Learning Officer for their great material and insight!
In 2010 sweeping changes were launched that are pushing cancer registrars to their limits and beyond. Undeniably it is the pace in which science and clinical medicine is changing that drives how cancer registrars need to work to keep pace and deliver the data and value to their healthcare teams. In a recent Journal of AHIMA article, Laura Vondenhueval, RHIT, CTR, said it best, “This is a massive change. It is a new way to look at how we are gathering our data.”
It is obvious that cancer registrars need to learn how to work in an environment where change is no longer the exception, but the norm. In the past we used to have long periods of stability with intermittent periods of change. Today, we need to shift our mindset and accept that we will now have almost constant change with intermittent periods of stability. Here are some common challenges cancer registrars face with constant change.
Challenge #1
Before the 2010 changes were introduced we thought that this was just a phase that healthcare was going through, and after a very brief period of adaptation, everything would revert to normal and we could go back to enjoying a long period of stability. Here’s a reality check, it’s not going to be that way any more because it’s not just a phase. Healthcare providers and standard-setters are expecting more from cancer registrars and are telling us that they are willing to make adjustments in their workforce if cancer registrars cannot change their thought processes or do their work differently. It’s not about workforce reductions, it is all about changing how we think about and do our work day to day.
Challenge #2
Today, when we do hit those infrequent moments of stability, we think that we have time to relax and enjoy the moment. In the past we focused on simply enduring the turbulence so that we could return to the comfort of stability. In order to succeed with today’s changes we must take advantage of the quiet, stable moments and use them as a “launching pad” to prepare for managing the next wave of change. During these moments of stability we should be thinking about what our healthcare teams and standard-setters will need from us in the short- and long-term future as well as what the new requirements might be. Look at the industry and investigate how to position yourself more competitively so you are prepared when the changes inevitably come.
Challenge #3
Some cancer registrars may have developed an attachment to stability and focused their energy on creating and sustaining it in the workplace. The hardest challenge of all will be to lose our attachments to stability. The cancer registrar needs to embrace change and harness its power and seek out new opportunities that change brings to us. Before 2010 we worked hard to get over change so we could relax; now we need to work hard at change so we can work hard at more change. Registrars who choose to play the role of the victim can ignore change and how to deal with it, but by the time they are in a position to do something about it they will have lost the opportunity to prepare for it, and likely their “edge” and career success as well.
So, what’s the solution?
First, make it OK to deal with change. Accept where we are and what we as cancer registrars need to deal with. Stop making judgments about change being necessary or unnecessary, good or bad, justified or not justified. Change does not have to control the reality of our situation or our ability to manage it or serve our teams.
Second, create a “safe” environment for yourself and other cancer registrars to deal with the change. Break the changes down into manageable chunks and begin to take action on small pieces of it. Start small and build from each successful step. Encourage and allow your staff and peers to take risks by coming up with new ideas and solutions to changing how we do our work. Provide a lot of encouragement and support to one another by building a solid support network and then by using it by tapping into its resources.
Third, if you, or some of your peers or co-workers tend to identify with the victim, set up some accountability and support for each other. Discuss the expectations and if necessary create workplace agreements and identify ways to interact and help one another so that each cancer registrar, whether they are local, regional, statewide or even nationally, can encourage you and other members of your network.
Fourth, begin a process of constant acknowledgement, support and challenge for cancer registrars. Be careful to not perpetuate the old paradigm of sitting back on your laurels during a stable period. Acknowledge people for managing the current change and encourage all to begin talking about and planning for new, incoming changes. When people get discouraged, provide support, acknowledge their success, and then present them with new challenges for growth.
Change is not new to cancer registrars, nor will it ever cease. Continual learning and enhancing the data that we collect to keep pace with medicine and science is driving the need for cancer registrars to develop new ways of thinking and doing their work. Periods of stability with intermittent change are now the old paradigm. Today, we must work hard to manage change in order to look ahead and be prepared for more change. Cancer Registrars cannot do this alone, they must develop a strong network of their peers for support, accountability and positive acknowledgement of their role in the fight against cancer.
IF YOU HAVE FOUND WAYS TO MANAGE THE 2010 CHANGES AND KEEP YOUR SANITY….POST A COMMENT BELOW. QUESTION: HOW CAN REGISTRARS HELP ONE ANOTHER THINK & DO DIFFERENTLY?
http://www.CancerRegistrar.com. Michele Webb is a nationally recognized, certified cancer registrar (CTR) committed to Cancer Registry leadership and professional development. She helps cancer registrars worldwide as a coach, mentor, educator, motivational speaker, and author. You have permission to repost this article as long as you do not alter it in any way, give credit to the author and link back to her website.
SEER released an update to the desktop version of Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual version 1.6.2 today. If you are a working cancer registrar or cancer registry student and have not already downloaded this update you may want to consider doing so right away.
This online manual contains the instructions and data collection rules for hematopoietic and lymphoid neoplasms that went into effect on January 1, 2010. Remember the older version we dubbed “the red book.” This online database replaces the “red book” and contains more information, including the MP/H rules.
When you download and install, don’t forget to sign up for email updates so that as new versions are released you are notified right away so you keep your references up-to-date. This is an incredibly valuable resource that every cancer registrar must have!
TELL US YOUR STORY … how have you used, or how has the SEER hematopoietic online database helped you? Scroll down and post a short comment and help another cancer registrar today.
http://www.RegistryMindset.com. Michele Webb is committed to cancer registry leadership and to making a difference in the lives of cancer registrars worldwide. She is a nationally recognized, certified cancer registrar (CTR), a motivational speaker, author and educator. You have permission to repost this article as long as you do not alter it in any way, give credit tot he author and link back to this article on this website.
Seasons Greetings everyone! As the year comes to a close we wanted to share with you how grateful we are for your time and attention and offer you a free gift. Look below at a short video and link to download your free gift!
One thing we know for sure today is that change and uncertainty happens daily. How we choose to react to uncertainty can either paralyze us with fear or thrust us into a world of new possibilities. In this article cancer registrars are given four ways to explore uncertainty in their life that will help them accept and accommodate change in order to bring about higher levels of growth and success and to develop agility and flexibility in the cancer registry.
We’ve created a video blog that compliments the complete article on this website. You can watch it here!
(Part Four of our series on “Agility Training for the Cancer Registrar”)
Much is said today in business, healthcare and Cancer Registry about change. In fact, one thing I know for sure is that we, as cancer registry professionals, are undergoing an unprecedented degree of change right now which will continue well into our future. Thinking about change today or projecting how it will impact our future can settle in on us like a dense fog and cause us to lose our bearings and sense of where we are. We may not be sure of which way to go when we reach a fork in the road because we can’t see the choices in front of us because of the fog. Uncertainty can paralyze us with fear or it can thrust us into a world of new possibilities.
Change brings chaos into our normally well-ordered lives and introduces levels of unpredictability and uncertainty that make us uncomfortable. Dealing with change is challenging, tiring and even threatening, but the flip side is that it provides the cancer registrar with tremendous opportunities for growth. Let’s look at how we can focus on accommodating the change instead of railing against it.
In the first article of our on developing agility in the cancer registry, we introduced embracing uncertainty as one way of becoming agile, or flexible in business. Agile cancer registrars will drive out uncertainty by developing working solutions and adjusting the registry’s operations in order to accommodate change. Dealing with uncertainty in a positive manner and being willing to accept things that are unknown or unpredictable are big parts of learning to be agile.
To help you face the challenges in a positive manner and to increase your agility in the cancer registry and healthcare business, here are four ways you can explore change:
Accept reality without fussing about the outcome. Face reality with no judgment. Think of the unknown as neutral rather than good or bad. Let go and detach from any outcome you cannot control. Keep your options open.
Explore the unknown. Ask yourself these questions:
What are all the things that are great about being a cancer registrar?
What is the worst that can happen?
What is the likelihood that the worse will happen?
If the worst were to happen, what do I need to do prepare?
Interrupt worry. The unknown can cause us to worry to the point of doing physical harm, but only if you let it. When worry starts to creep into your thoughts, interrupt it! Simply do not allow it to take hold of you. Here is how you can interrupt worry:
Get busy: occupy your body and your mind will follow.
Put it off: decide to enjoy today and maybe you’ll worry tomorrow – if it feels right.
Turn it over: write down your worry, put it in a box, and turn it over to a higher power.
Hum a tune: it is impossible to worry when you’re singing or humming, even if it is not out loud. Find a song that gives you strength. “A Beautiful Day” by India.Arie is a great one.
Trust yourself. You’ve probably faced change and challenges in the past. Reflect on those times and remind yourself how well you handled them, even though you may have been uncomfortable at the time. Trust in your abilities, thoughts and experience to take you through the transition.
None of us can be certain about tomorrow or the future of cancer registry. We can fret and fume about it, but no matter how much noise we make, we cannot control it. What we CAN do, each of us as cancer registry professionals, is make the most of each moment…each NOW….because that is really all we have. Only you can bring peace and acceptance of the unknown to you.
Accepting change and allowing uncertainty into our lives can lead us to a higher state of functioning as cancer registrars. Embracing uncertainty, then, is really just an engaging process in which we let go of control. Think of this as a spiraling UP in complexity, moving up the ladder of intellectual, emotional and professional growth. Engage your co-workers, peers and leaders in the process of embracing uncertainty. Don’t be afraid to network and ask for help and guidance where needed. By welcoming uncertainty and unpredictability into your life you will be expanding your horizons and developing agility in your cancer registry that will lead to great success and self-fulfillment!
WHAT DO YOU THINK? How are you accomodating change and uncertainty in your cancer registry and life? Send us your feedback or thoughts on this article and critic topic today.
http://www.RegistryMindset.com. Michele Webb, America’s Cancer Registry Coach, is a nationally recognized, certified cancer registrar (CTR). She cares passionately about helping cancer registrars around the world to grow personally and professionally and serves her community as a motivational speaker, author, and educator. You have permission to repost this article as long as you do not alter it in any way, give credit to the author and link back to her website.
(Part Three of Our Series on “Agility Training for the Cancer Registrar)
Assumptions make our lives easier. As creatures of habit we frequently rely on our assumptions and past experiences to drive our actions. Most of our day, with few exceptions, is driven by our unconscious assumptions and habits developed over time versus creative thinking and new conscious thought.
For example, when cooking over an open flame you automatically draw your hand back when you feel heat from the flame. This “stimulus-thought-response” chain of events relates to pain you previously felt from burning your hand. This automatic assumption serves you well and avoids a painful experience.
In business, however, this is often not the case. Cancer Registrars, for example, may use any number of assumptions, or statements of belief about their work, such as:
“That won’t work here.”
“I’ve tried that before.”
“We don’t get support for that here.”
“They just don’t listen to me.”
Brilliant, and successful, Cancer Registrars know that these assumptions can be challenged and take great pleasure in defying them. They welcome the opportunity to look within themselves, to create a new energy and develop new directions to solving problems or leading their Cancer Registry in a different direction.
Each of us has an inner reservoir of talent, ability, and intelligence. It is endless and readily available if we are willing to step out of our comfort zone to tap into these resources. Whatever you face, taking one step closer to success means you must trust your inner self, ignore criticism and judgment, and let go of your own resistance to doing something differently or believing that you can make a difference. Developing a new habit or behavior, based on what you know in your heart to be the right thing to do, is all the evidence you need to make your passion become reality. This mindset is what creates harmony and balance in life and business and determines your path between success and failure.
Here are six tips to help you challenge your assumptions:
Recognize that you, and everyone else, have assumptions about every situation.
Ask basic questions in order to discover and challenge those assumptions.
Compare the ground rules and assumptions to your situation or problem and then ask yourself, “What if we do the opposite of the norm?”
Pretend you are not a Cancer Registrar and ask yourself, “Why do we do it this way at all?”
Reduce the problem or situation to its most basic elements for understanding and creative problem solving.
Restate the problem in completely different terms.
It is up to you to decide what you would like to do to drive growth and success in your Cancer Registry. You must be willing to step outside of your comfort zone to challenge your assumptions and develop new behaviors to help you grow personally and professionally. By tapping into your inner resources you will develop a new mindset that is creative and in harmony with everyone you encounter.
What assumptions are you challenging today? How do you respond to “But we’ve always done it this way.”
http://www.RegistryMindset.com. Michele Webb, America’s Cancer Registry Coach, is a nationally recognized, certified cancer registrar (CTR). She cares passionately about helping cancer registrars around the world to grow personally and professionally and serves her community as a motivational speaker, author, and educator. You have permission to repost this article as long as you do not alter it in any way, give credit to the author and link back to her website.
(Part Two of Series “Agility Training for the Cancer Registrar)
Visualizing success, or turning dreams into reality, is a creative process that puts your focus and energies into looking ahead. Creative visualization is a technique that you can use to help you with this process. In the first part of our series on “Agility Training for Cancer Registrars,” we talked about visualizing success as part of meeting the challenges in life and business. In this session we will learn how to visualize success and turns dreams into reality!
To turn your dreams into reality and to be truly successful depends on several factors:
Having a specific goal,
Making sure that you really want to achieve that goal,
Having a clear mental picture of your goal,
Being motivated or having a strong desire or need to achieve the goal,
Developing the ability to disregard, or even walk away from negative thoughts or talk that take you away from that goal,
Showing confidence, faith and persevering until you achieve success.
Imaging having your own personal genie in a bottle to fulfill your every dream or desire. When you develop the techniques and begin to practice creative visualization you are tapping into your personal genie. Focusing on the end result, thinking and acting in a positive manner and not letting negativity (yours or anyone else’s) get in the way will empower you to continue on your journey.
Each morning I write out my “to do” list for the day on a 4×6 index card. On the right-hand side of the card I write my vision statement for my business. On the left-hand side I write down the most important things I need to do that day that will take me closer to my vision and goal. Then, I focus on the action steps and on completing the tasks that will help me reach my goal. By taking it one day at a time I know I will be successful. No one can deter me from this because I see my dream getting closer each and every day.
Discover what you need to do to visualize your dream and then, one day at a time, do something that takes you one step closer. Practice visualizing that success in your mind, focus on the positive, take action, even if only in small steps, and you will see your dreams come true!
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