Creating a Career Track for Cancer Registrars

J. Jackson-Thompson, MSPH, PhD Missouri Cancer Registry, University of Missouri, Columbia NCRA – April 2007

Missouri Cancer Registry A collaborative partnership between the Missouri Department of Health & Senior Services (DHSS) and the University of Missouri - Columbia (MU) Supported by a Cooperative Agreement between DHSS and the Centers for Disease Control and Prevention (CDC) and a Surveillance Contract between DHSS and MU

Acknowledgments For their assistance: Sue Vest, BS, CTR, MCR Project Manager Nancy Cole, BA, CTR, Asst. Project Mgr Graphics: Sharon El-Shoubasi For their hard work and support of MCR: Cancer registrars and other reporting facility staff

Objectives Briefly describe the Missouri Cancer Registry (MCR); Identify ways MCR deals with recruitment & retention, including developing a career track; and Summarize keys to success.

MCR Gold Celebration 2005

Overview of MCR History 1972 – voluntary data submissions 1984 – state mandate to report cancer 1995 – received NPCR funding 1999 – expanded law Data 50,000 cases processed 28,000 + unduplicated cases annually

Central Registry Challenges Meeting NPCR/NAACCR requirements Timeliness Completeness Accuracy Internal challenges Outdated hardware & software Non-standard data elements & layout Non-competitive salaries Too few staff

Meeting the Challenges Increase NPCR funding Upgrade hardware & buy appropriate software Hire more CTRs Rewrite job specs to reflect responsibilities Obtain permission to hire at top of pay scale Make working for MCR desirable Appoint Advisory Board Obtain case-sharing agreements

More Early Steps Improve relationships with reporting facilities From “There’s a law - our way or the highway” to “Partners for better patient outcomes” Provide service to reporting facilities Offer training for hospital registry staff Support hospital CTRs – talk to administrators Develop a constituency

Meet the Challenges … And what do you get? More Challenges!

Good and Bad…. Additional CTR positions funded by NPCR No state merit FTEs available Revise plan Strengthen existing external relationship Decrease state government – eliminate FTEs Outsource Operations! Overnight, MCR operations staff became University staff

Next Steps Impact of outsourcing: Greater flexibility in creating and filling positions More understanding of need to maintain competitive salaries, retain staff Support from University HR Obtained NAACCR certification Met most NPCR requirements

How? Flexible schedules for staff Adjust hours to meet MCR staff needs Added benefit – improved service to reporting facilities Allow telecommuting, working off-site Find a good CTR, don’t let distance/circumstances be an issue Set standards CTR or CTR-eligible to be cancer data coordinator If can’t find one, be creative – Health Program Assistant

Other Avenues Increase training opportunities Send all MCR staff to training of their choice Develop/improve training for hospital registrars Career development Pay professional association dues Encourage staff to take advantage of tuition reimbursement Restructure operations to meet registry & staff needs

Further Avenues Promote from within Annual salary increases Encourage staff to: Reach for the stars/achieve their dreams Submit abstracts to NAACCR/make presentations Get involved in research proposals Build a winning team

New Challenges Change from exempt to hourly for CTRs Hospital pay scales again outstripping MCR pay scales HR Misperception – MCR wanted to increase salaries to “steal” registrars from University hospitals

Solutions Create new 3-tiered career track for central registry staff!!! Recognize differences in duties between hospital and central registry staff Improve mechanisms to “grow our own” Acknowledge levels of expertise needed for different positions Provide growth opportunities for current staff

Career Tracks Central Registry Data Specialist Trainee CTR-eligible New CTR/new central registry CTR Central Registry Data Coordinator CTR w/no supervisory duties Central Registry Senior Data Coordinator Unit coordinators

Where are we now?

Success Stories HIM student Mother and daughter Health Program Assistant (Central Registry Data Specialist)

Keys to Success Patience – success doesn’t come overnight Strategic planning Flexibility Teamwork Hire the best qualified staff you can find Don’t be afraid to leave a position vacant or terminate an employee Know your staff, believe in your staff and try to meet their needs Competitive salaries/flexible hours Create career tracks Be supportive

Contact Information Jeannette Jackson-Thompson, MSPH, PhD Operations Director, Missouri Cancer Registry and Research Assistant Professor, Health Management & Informatics, University of Missouri-Columbia Phone: Toll-free for reporting facilities: MCR website:

Probably do not need all the pictures especially if you are short on time Maybe just say you wanted to show the pictures but did not have time