Skip to contents
In This Issue:
Ensuring the system works for the patient was one of the challenges of the Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) when it first formed.
The Gynecologic Oncology program is one of the DF/BWCC specialized centers turning the challenge into one of its greatest strengths, ensuring seamless, excellent care as patients navigate between two institutions and among many disciplines.
“It’s anxiety-provoking to have a potentially life-threatening disease and, at the same time, have to work through a confusing system,” Ross Berkowitz, MD, director of Gynecology and Gynecologic Oncology, said.
About a year and a half ago, all disciplines from BWH and DFCI involved in the care of gynecologic oncology patients began attending monthly operations meetings to discuss how to ensure continuity and responsiveness of care. Physicians, nurses and staff from social work services, pharmacy and patient scheduling participate.
“It’s a concerted effort to make sure all the elements come together,” said Berkowitz, who is leading the charge for community-building in Gynecologic Oncology with Ursula Matulonis, MD, and Akila Viswanathan, MD, MPH. “We want to be certain that everyone who is in contact with a patient—from the time the patient calls for an appointment right through all facets of inpatient and outpatient care—regularly meet to identify and solve problems.”
Detta Quigley-Lavoie, RN, nurse manager of CWN-7, said, “As nurses, we find these meetings invaluable. They provide a forum for us to share concerns, pose questions and offer valuable input.”
One improvement that stemmed from these discussions was assigning a physician assistant to work mainly on discharge planning, including communicating changes in medication to the patient’s primary care physician and notifying oncology nurses of consultations the patient is scheduling.
“For many of our patients, surgery is only the beginning of their care,” Berkowitz said. “We need to ensure that they experience no unnecessary delays in receiving treatment after surgery.”
Strong communication between inpatient and outpatient care providers is key. “Outpatient care providers at DFCI notify us in advance about upcoming patient admissions for chemotherapy,” Quigley-Lavoie said. “This allows us the opportunity to staff appropriately for optimal patient care.”
Berkowitz attributes much of the program’s success to a change in attitude among staff. “We’re not just a division,” he said. “We’re all part of a program that cares for women with gynecologic cancer. In everything we do for them, we are a community.”
New physicians and other staff hired by the DF/BWCC notice the community feeling immediately. When Gynecologic Oncology recruits fellows, for example, they also are interviewed by medical oncologists simply because the two divisions work so closely together. Similarly, the physician assistant assigned to discharge planning received training in radiation and medical oncology so she could understand what patients experience in the next part of their treatment. This way, she can answer patients’ questions about what to expect.
The Gynecologic Oncology program is one of 12 specialized centers in the DF/BWCC, all of which hold or will hold similar staff meetings by the end of September. Another way the DF/BWCC is helping patients access care is through the single call center. This number directly links all prospective patients on their first call to the appropriate new-patient coordinator.
Patients are noticing the efforts. Mary Barry, of Canton, has been a DF/BWCC patient since December, when she was diagnosed with breast cancer, and will begin receiving outpatient care at Faulkner Hospital’s new DF/BWCC clinic (see related story below). “I have found my care to be compassionate, competent and very focused on me as an individual,” she said. “Never once did I feel I was a faceless patient.”
Barry is among thousands of patients who receive care at the DF/BWCC, which continues to grow. Patient visit volume has increased on average 10 percent per year for the past four years.
“We are working to accommodate all of our patients by extending care to facilities beyond the Longwood Medical Area,” said Michael Zinner, MD, clinical director of the DF/BWCC. “The new location at Faulkner Hospital offers easier access to care for some of our patients, and we are looking into initiatives with other hospitals in community settings.”
The new DF/BWCC at Faulkner Hospital is scheduled to open to patients later this month and discussions are taking place regarding possible initiatives with South Shore Hospital in Weymouth and Milford Regional Medical Center.
Learn more about the DF/BWCC at its first community forum Friday, June 9, from 7:30 a.m. to 1:30 p.m. in the Cohn Courtyard. The event includes storyboard displays, entertainment, refreshments and prizes. A leadership grand rounds begins at 8 a.m. in the Bornstein Amphitheater.