Development of a Policy and Procedure Manual for the Surveillance and Epidemiology Unit, Cancer Care Nova Scotia

Abstract

The internship was completed at the Surveillance and Epidemiology Unit (SEU) at Cancer Care Nova Scotia (CCNS). The SEU is responsible for collecting and analyzing data on all diagnosed cases of cancer in Nova Scotia. This data is stored in the Nova Scotia Cancer Registry database which has been in existence since 1964. The main objective of the internship was to construct a Policy and Procedure Manual that provided a detailed overview of all core SEU processes. The internship work was performed from April 23 to August 10, 2007. The project involved documenting each policy and procedure in written format as well as presenting them graphically through flowcharts developed using Microsoft Visio. Information was obtained through reviewing existing documentation, staff meetings and observing work flow at the SEU. An objective of the project was to improve information and work flows wherever possible. One major problem identified by the author while analyzing the business processes at the SEU was that the current method of receiving pathology reports via letter mail from laboratories around the province is highly inefficient. A significant amount of time is spent opening the mail, sorting the reports for patient enrollment and filing the completed reports. Filing space is limited at the SEU and it is a challenge to find locations for new filing cabinets. Another problem with paper-based case ascertainment is that the SEU has to reply on transcriptionists to identify cancer cases and send copies of the pathology reports to the SEU. This method is subject to human error and cases could be missed which could potentially impact incidence rates. Case ascertainment would be much more efficient if the SEU adopted electronic pathology reporting or E-path, an IT solution that allows pathology reports to be submitted electronically to a cancer registry. The introduction of E-path at the SEU would eliminate time consuming tasks such as filing or data entry since the information would be digitized. In addition, E-path would allow case finding to be done automatically using an autocoding module and filtering logic. The internship was a valuable learning experience for the author. Developing a policy and procedure manual is a time-consuming but useful process that allows an organization to discover inefficiencies and identify areas for improvement.