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Standards development continues to focus the team at Cancer Care Nova Scotia

“A number of facjill carman sandrators impact how well a patient will do following treatment, but there is strong evidence indicating that a well run system is key to ensuring the best possible outcomes for patients,” said Dr. Carman Giacomantonio, Chief Medical Director, Cancer Care Nova Scotia. “Our work with district health authorities on developing and implementing clinical

L-R: CCNS Team Memebers Jill Petrella, Quality Manager, Carman Giacomantio, Chief Medical Director, Sandra Cook, Surgical Oncology Manager
standards of care is the foundation that will support a well run cancer system.”

The initial work of developing and refining the standards of care for rectal cancer in Nova Scotia continues to progress on schedule.

A draft document addressing treatment standards of rectal cancer care including, surgery, radiation therapy, chemotherapy, supportive care and long-term follow-up, will be shared with health professionals and administrators across the province in Fall 2012. They will be asked to comment on whether the draft standards are valid, reasonable, realistic and appropriate and if they will result in the best possible outcome or result for rectal cancer patients. Cancer patients and survivors will also have an opportunity to review and comment on the draft document.

Early in 2013 CCNS will incorporate feedback from the health community and cancer survivors, and provide the document to the Oversight Committee and the Department of Health and Wellness for review and approval in principle. The next step, engaging districts in an impact assessment, will occur over the winter months and will include identifying gaps in the standard, discussing challenges and system implications such as the best ways services can be organized to ensure patients receive the accepted standard of care.

Following the impact assessment, CCNS will work with districts to address the identified gaps and areas of concerns. The expected timeline for this work is Spring 2013. The proposed standard, together with considerations for implementation, should be ready to send to the Department of Health and Wellness for endorsement and approval by Fall 2013.

After receiving approval from Department of Health and Wellness, CCNS will re-engage stakeholders throughout the province and provide direction regarding implementation of the standards of care for rectal cancer management and monitoring and evaluation of the standard to determine if these efforts result in enhanced patient care, better outcomes and a more sustainable health care system for all Nova Scotians. This comprehensive approach to stakeholder engagement will be used in the development of all clinical standards

As work nears completion on draft standards for treating rectal cancer, a sub-committee of the working group has been struck to discuss and determine appropriate standards around diagnosis and referral of patients who arrive at their doctor’s office with possible symptoms of colon and/or rectal cancer. The draft report will be shared with the larger health community and cancer survivors for review prior to it being finalized and presented to Department of Health and Wellness.

Standards development has now expanded to include supportive care. This work will follow a similar process to the development of the treatment standards.  A decision has been made to adapt the Canadian Association of Psycho-social Oncology’s Pan-Canadian evidence-based standards to the Nova Scotia context.

The next step is to develop standards for colon cancer management. Unlike rectal cancer, colon cancer tends to be treated by a broader community. For this reason is being addressed separately.

“Developing and implementing clinical standards of care is a massive undertaking,” said Dr. Carman Giacomantonio. “The work completed to date by the Rectal Cancer Standards Working group is precedent setting and a tremendous accomplishment for the Nova Scotia cancer system. “In the past year our team of health professionals with expertise in rectal cancer together with cancer survivors have worked diligently to produce an evidence-based standard that provides the framework for a more effective, efficient and sustainable program of care for rectal cancer.”

We’ll keep you posted as our work on clinical standard development continues. In the meantime if you have questions, please contact Dr. Giacomantonio by phone at 902-473-6177 or by email at