Table 2. Process standards.

Standard 2.1	Diagnosis of rectal cancer confirmed by biopsy prior to treatment (target rate: 95%)
Standard 2.2	Patients must be registered into OSTRiCh database
Standard 2.3	Both systemic and local staging must be performed prior to definitive treatment. Systemic staging should consist of CT scan of the chest, abdomen, and pelvis. Local tumor staging should consist of MRI ± TRUS. Results of the MRI should be conveyed by a standardized synoptic reporting (target rate: 95%)
Standard 2.4	CEA level should be obtained prior to definitive treatment (target rate: 100%)
Standard 2.5	Individualized treatment planning discussion must occur at MDT prior to definitive treatment (target rate: 100%)
Standard 2.6	A Treatment Recommendation Summary (TRS) must be sent to the patient and referring or primary care physician prior to commencement of therapy (target rate: 100%)
Standard 2.7	Definitive treatment must begin within 30 days of patient's initial clinical evaluation at the institution (Target rate: 90%)
Standard 2.8	Standardized synoptic pathology report must be issued within 2 weeks of definitive surgical resection of the primary tumor. Tumor regression grade, budding, and growth border should be included in the report. (target rate: 90%)
Standard 2.9	Individualized treatment-outcome discussion must occur at MDT (target rate: 100%)
Standard 2.10	Adjuvant treatment (if selected) must begin within 6 weeks of definitive surgical resection of the primary tumor in uncomplicated cases (target rate: 75%)
Standard 2.11	Pretreatment staging, neoadjuvant therapy details, surgery details, pathology details, and adjuvant therapy details should be entered into database within 6 months of surgery (target rate:100%)
Standard 2.12	A Treatment Completion Summary and follow-up plan document must be sent to the patient and referring or primary care physician within 4 weeks of treatment completion (target rate: 100%)
Standard 2.13	The MDT must conduct an Annual Performance Review (target rate: 100%)
Standard 2.14	Molecular markers should be assessed when appropriate (target rate: 90%)

Abbreviations: CT, computed tomography; CEA, carcinoembryonic antigen; MDT, multidisciplinary team; MRI, magnetic resonance imaging; OSTRiCh, Optimizing Surgical Treatment of Rectal Cancer.