New Patient-Centered Cancer Institute At Via Christi

Fri, July 01, 2011

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KMUW / Fletcher Powell

Though evidence of cancer treatment exists back to the days of ancient Egypt, the idea of treating the patient and not just the disease is still a relatively recent one.

Current trends are taking this a step further, streamlining treatment into single hospital units that are patient-centered and able to accommodate people at all stages of treatment.  KMUW’s Fletcher Powell took a look at one of these facilities, opening soon in Wichita.

Moser: This is our bone marrow transplant area. We’ve increased our rooms from four to six.

Patti Moser is giving a tour of the new Via Christi Cancer Institute. The 40,000-square-foot unit doesn’t open officially until July 7, but Moser, Via Christi’s administrative nursing director for oncology, is eager to show it off.

Moser: So we’ve got four rooms that are set up to be used in the future as an intensive care unit.

The Institute, found on the 7th floor of Via Christi on St. Francis, is the brainchild of Dr. Shekar Dakhil, president of the Cancer Center of Kansas and medical director of oncology services for Via Christi. And like a lot of things that cost $9 million dollars, it took a while for Dr. Dakhil to get it done.

Dakhil: Close to 1995, we start talking about how do we get one facility to take care of all cancer patients. And we start talking about a hospital within a hospital, rather than having an independent hospital. And so we start approaching all hospitals, from Via Christi to Wesley, to see if anyone has any interest in that concept. And it took, what, 15 years?

What Dr. Dakhil said about having a hospital within a hospital? This is an important part of his vision for the Institute. He rejected the idea of a stand-alone, specialty hospital, because he didn’t feel something like that could possibly offer everything a patient might need. Dakhil says it doesn’t serve anyone’s interests to make patients and doctors move throughout a decentralized hospital when everything they need could be collected in one place.

Dakhil: We have transplant units on the floor, we have surgical units—beds—on the floor, we have beds… it should be a one-stop shop. The patient who has cancer, where are you going? To the Cancer Institute! It shouldn’t be, if he gets transfusion he goes to the third floor, if he gets platelets he goes to the fifth floor, if he gets pre-op, he needs surgery, he goes up there, then they take him from there to the operating room… all these disjointed things, I think, they do not serve the patient well.

And listening to Dr. Dakhil, it becomes clear that there’s not much more important to him than helping patients to feel in control of their situations, and to help them avoid being overwhelmed by having to spend a lot of time in a lot of different places.

Dakhil: …the first important thing that the patient feels like this is an independent entity, and I gave them the example of, you know, QuikTrip, why is it successful? Because people get in and get out, quick. And we need to have something like that so that a patient doesn’t get completely lost in a big organization.

So when it came time to design the facility, Patti Moser says, this was the philosophy that informed many of their decisions. They conducted focus groups with patients and patients’ families to ask what was working well and what could be improved, which led to rooms in which the patient has total control, over the lighting, over the temperature, all from the patient’s own bed. As Moser says, the idea is to give people control over their surroundings, to make the hospital adjust to them, not the other way around.

Patient Room

Moser: And we talked to physicians along the way, particularly I met with physicians about the need for documentation space—so those little documentation alcoves that are there for physicians or other staff that are on every corner, those came from feedback from physicians, as well as the charting stations in the hallway.

These documentation and charting stations are one of the things Moser seems to be most proud of—small rooms tucked away where doctors can consult charts or dictate notes without raising the noise level in the unit. A major upgrade, Via Christi says, over the usual method of keeping charts in large, noisy metal compartments along the hallway walls.

And it does appear that Via Christi did what they could to incorporate the views of all their patients, not just the majority view. In designing their ambulatory infusion center—the place where patients go to receive chemotherapy, blood, and IV fluids—the hospital realized that some patients liked an open, communal area where they could chat with friends and family, while others preferred a private, walled-in unit. So they built both.

Ambulatory Infusion Center

Moser: But, you know, if you’re getting blood, you might be there for four to five hours. If you’re taking IV fluids, it could be anywhere from four to five hours, depending on how much you need. A lot of our patients felt like they could do either one, the community setting or the private setting. But if they didn’t feel well, they wanted the private setting. So that way they can choose.

But as focused as the unit seems to be on the comfort of patients, Dr. Dakhil says that it’s important to remember that they aren’t the only people who could be using the facilities for an extended period of time. In many cases, the patient’s family will be along as well, especially if they’re coming from, say, Dodge City or Liberal.

Dakhil: …because cancer is a family disease. It affects the kids, the grandkids, the siblings, everybody—they come in, spend time… in the hospital, you have an acute leukemic guy, he has kids, they come in, spend hours in the hospital. Having a place for them to stay, you know, I think it’s crucial.

To address this, the hospital did away with making family members sleep in clunky recliners, providing each room with a couch that quickly converts into a bed. They also have included separate sleeping rooms where people can go to nap for a few hours, and even a large home theater room where families can watch movies, all with the intent of retaining some level of comfort and normalcy for patients and their families.

Family Room

It seems reasonable to wonder why, after 15 years of work by Dr. Dakhil, Via Christi felt like now was the time to build this facility. Patti Moser points out that the entire hospital eventually plans to move to all-private rooms for patients, so the 40 private rooms in the Cancer Institute are serving as a test case, not to mention the fact that demand for cancer services in general is rising due to an aging population. For his part, Dr. Dakhil figures it probably also has something to do with good, old-fashioned competition.

Dakhil: I think the fact that Wesley has upgraded—that’s my personal opinion—has upgraded their facilities tremendously, they have private rooms pretty much everywhere, had put pressure on Via Christi to, I mean, patients are not gonna go just because of the good nursing care.

Dr. Dakhil is quick to say that Via Christi’s services have always been good—they operate in the same research base as the far more well known Mayo Clinic in Minnesota and MD Anderson Center in Houston, so they offer many of the same services—but he says the big problem has always been the facilities. Now, he’s hoping that has finally changed.

Dakhil: Via Christi has always had very good cancer services, from the nursing staff to the physicians to the administration, the commitment, etc., but they always had very lousy facilities. It’s like, someone has the best steak in town and lobster, but he serves it on a plastic plate. Now, you have the china and the silverware. Now, you can serve your steak and lobster and be proud of it. So that’s, I think, the difference.

This approach to patient care may not seem as groundbreaking as, say, the CyberKnife—although Via Christi wants everyone to know they have that, too—but if hospitals intend to pursue this direction of patient-centered treatment, Dr. Dakhil’s idea makes a certain amount of intuitive sense. It stands to reason that if people feel in control of their surroundings, they’re more likely to be comfortable, making the entire process easier for everyone involved. At least, that’s what Via Christi is counting on.