“At UPenn, I share responsibility for operations, quality,
cost negotiations with payors, and other related activities. In
several ways, my work with the Commission is a reflection of
the work I do at my home institution,” Dr. Shulman said.
eventually as its chair. Partly based on this work, ASCO
nominated him to be one of their two representatives
on the CoC. Dr. Shulman’s work in quality for ASCO
contributed to his selection as Chair of the CoC Quality
Integration Committee. Due to his success in that role,
he was nominated and elected as CoC Chair.
David P. Winchester, MD, FACS, Medical Director
for ACS Cancer Programs, noted the significance of
Dr. Shulman’s election: “Dr. Shulman was selected from
a large group of surgeons and other cancer professionals as the first medical oncologist in the history of the
CoC to serve in this important leadership role. Since
assuming this position in October 2016, Dr. Shulman
has demonstrated a broad knowledge of the workings of
a complex organization dedicated to the cancer patient.
His leadership crosses all disciplines related to cancer,”
Dr. Winchester said.
Beyond his extensive clinical and leadership background in cancer care, Dr. Shulman’s tenure as Chair
of the CoC’s Quality Integration Committee and his
prominent role in developing quality cancer infrastructure in low-resource settings around the world
are unique experiences that provide context for his
appointment and for the importance of developing,
maintaining, and advancing cancer care in the U.S.
Developing the CQIP report
In the modern health care landscape, “quality” is the
unifying watchword for physicians, patients, and health
care organizations. The College has a leading presence
in the area of surgical quality improvement through
several programs, such as the ACS National Surgical Quality Improvement Program and the Trauma
Quality Improvement Program. That commitment
to quality improvement also is apparent in the CoC
through its National Cancer Database (NCDB) and
Cancer Quality Improvement Program (CQIP).
CQIP is a product of the Quality Integration Com-
mittee, which Dr. Shulman chaired from 2013 to 2016.
The period during which he presided over the commit-
tee was significant, as the first CQIP report was released
in 2013 to the more than 1,500 CoC-accredited cancer
centers in the U.S. The cancer data in the CQIP 2013
report were far-reaching and novel in a report of this
size, providing short- and long-term quality and out-
comes data, which Dr. Shulman and the CoC maintain
are particularly useful when delivered directly to the
centers. “There’s a tremendous amount of data that
we thought needed to be codified and sent out to the
programs to say, ‘You need to look at all these data
and share them throughout your program and hospi-
tal,’” he said.
“We felt these data should be seen by the registrars
and the cancer committees of the individual hospitals,
but also by the leadership of the hospitals, including
the chief executive officer, chief financial officer, chief
operating officer, and so on. We put together a report
that focused on a number of quality metrics, including
the ones we routinely measure, and started increasing
that number,” Dr. Shulman said. “We looked at 30- and
90-day surgical mortality for six complex cancer sur-geries. We looked at both unadjusted and risk-adjusted
survival for a number of the more common cancers
and a number of other parameters, including insurance
status, miles traveled to the cancer center, and the time
from diagnosis to first treatment.” Disbursing these
data directly to the cancer centers and to all levels of
leadership allows for a level of standardized quality
control that previously would have been impossible.
And using these data is not only a suggestion—since
the first CQIP report was released, the requirements
for CoC reaccreditation have included bringing in hospital leadership to understand the data and providing
evidence that the organization is actively applying the
data in their treatment centers.
In developing the CQIP report, the Quality Integration Committee also worked to develop disease- and
condition-specific quality metrics and collaborated
with specialty organizations to be sure they harmonized with quality efforts from the CoC’s partners.
“For example, when we developed bladder cancer
quality metrics, we partnered with the American Urological Association; when we did melanoma metrics,
we partnered with the Society for Surgical Oncology;