Successfully Navigating Increased Demands with Fewer Resources

North Carolina Central Cancer Registry

In August 2007, the North Carolina Central Cancer Registry (NCCCR) migrated its database from Health Registry Network to Eureka, and that was just the beginning of a number of challenges. Database migration is never easy under the best of circumstances, but the clean-up from the prior system was enormous, with data submissions looming, a key manager retiring in December 2007, a quality audit by CDC's National Program of Cancer Registries (NPCR) scheduled in May 2008, and a shorter NPCR data submission deadline projected in 2008. Our success was possible due to NPCR and state funding support, as well as an agile staff, both in California and North Carolina, who always asked, "How can I help?"

After the December 2007–January 2008 submissions to the North American Association of Central Cancer Registries (NAACCR) and NPCR were completed successfully, our focus moved to database cleaning after migration, establishing new operational procedures, and preparing for the NPCR audit. Because our quality control (QC) manager retired in December, staff took on additional responsibilities—

• One QC staff member coordinated the audit preparations and communications.
• Another learned how to create state-specific edits for both vendors and North Carolina's instance of Eureka.
• A third took on additional training responsibilities for workshops.
• All QC staff devoted one day a week to clean up the database.

All staff contributed to developing new operational procedures for the database with limited supervision, but greatly increased communication. At no point did anyone say, "That's not my job!" In fact, most enjoyed learning and having new responsibilities. By May, the majority of the migration clean-up and audit were completed successfully!

In May 2008, we learned of the earlier deadline for the NPCR submission. In a similar fashion, everyone rallied to determine how best to meet the new deadline with fewer resources. The statistical staff provided innovative programming to target our highest-priority edits and consolidation activities, and the QC staff used Eureka's case management system to complete the work.

The challenge was great, but the registry enjoyed benefits as a result. The NCCCR now has a highly functioning database with input on important modifications as electronic reporting needs change; the collaboration with the California Central Cancer Registry has capitalized on their technical expertise and provided them with valuable feedback to enhance the system for other central registries.

All central cancer registries face increased demands and often diminishing resources. The NCCCR is no different, although the specific challenges may be. What worked was an empowered team who worked "smart," not just hard, and was ready to meet a new challenge.