As described in the Optimal Resources for Cancer Care (2020 Standards), CoC Standards 5.3 (Sentinel Node Biopsy for Breast Cancer), 5.4 (Axillary Lymph Node Dissection for Breast Cancer), 5.5 (Wide Local Excision for Primary Cutaneous Melanoma), and 5.6 (Colon Resection) require operative reports to include specific elements and responses in synoptic format. For information on the timeline, compliance requirements, and the site visit process, please refer to the Timeline and Compliance Information page.
To integrate the required elements/responses in synoptic format into the operative report of record, programs can:
Create institutional templates that capture only the required CoC elements and response options in synoptic format:
- Institutional templates must include the required elements and response options in synoptic format as outlined in the Optimal Resources for Cancer Care (2020 Standards). Elements and response options must use the same wording as in the CoC standard.
- To meet synoptic formatting requirements, the operative report of record must list each required data element followed by its response (answer) in a "diagnostic parameter pair" format. Providing the required data elements and responses in prose format does not meet these requirements.
- All required elements and responses must be listed together in one location in the operative report of record.
- The required data elements and responses can appear in a separate synoptic portion that complements a traditional narrative report. However, the required elements and responses must be in the operative report of record. They cannot be a part of the brief operative note.
- Many electronic medical records (EMRs) can create such templates.
- The required elements and responses from the Optimal Resources for Cancer Care (2020 Standards) can be shared with your institutional IT team and with your EMR support team, as needed, to build a synoptic solution for your facility.
- There are no fees associated with use of the content in the manual.
- Since the content of the Optimal Resources for Cancer Care (2020 Standards) is copyright of the American College of Surgeons, we would appreciate where possible that you acknowledge the ACS copyright: Copyright © 2019 American College of Surgeons, 633 N. Saint Clair St., Chicago, IL 60611-3295. All rights reserved.
- Because the material is copyright protected, the material or tools built using this material must not be shared with commercial vendors or with other institutions.
Work with a third-party vendor to implement their solution:
- CoC-accredited cancer programs may opt to work with one of these third-party vendors to integrate their tool into the EMR.
- Working with these third-party vendors may involve an additional cost to programs.
Use the fillable PDF forms downloaded from the Standards Resource Library:
- The fillable PDF option for achieving compliance was offered as a stop-gap measure for programs unable to incorporate the synoptic elements/responses into their operative reports of record by the January 2023 deadline.
- Use of the fillable PDF forms for the synoptic requirements for CoC Standards 5.3-5.6 will no longer be compliant starting January 1, 2026.
- By January 1, 2026, programs must comply with the requirements of the standards for applicable cases and incorporate the required synoptic elements/responses into the operative report of record.
The Operative Standards Toolkit provides educational resources to support the implementation of these standards.
The above information applies to CoC institutions only. Non-CoC institutions should seek permission for use of ACS content. Please contact cssp@facs.org for information on copyright acknowledgement, permissions, or licensure. Questions about the requirements of the CoC Operative Standards or these implementation options should also be directed to cssp@facs.org.
