Women's centers can do more than offer place to birth babies
Women's centers can do more than offer place to birth babies
Oncology programs offer services to wide range of women
Moving beyond obstetrics and offering care to the total woman is essential for the long-term success of women's centers today. Some level of cancer-related care is a natural move for many centers, but how does a manager determine which services fit the center's goals, resources, and the overall organization's mission statement?
There are a variety of ways to offer oncology-related care, says Diane Bruno Himwich, MS, RN, national director of women's health for Phillips+Fenwick, a Scotts Valley, CA-based consulting firm that specializes in the development of women's health programs.
Both breast health and gynecological oncology programs are a natural fit for most women's centers, says Bruno Himwich. "There are different levels of complexities for each type of program, so the individual women's centers need to decide which is appropriate for their institution and their level of resources." (For description of different levels, see p. 123.)
A full range of oncology services from diagnostic to surgical and medical oncology is offered at Woman's Hospital in Baton Rouge, LA. "We started offering oncology services in 1993 and have built it over time to a comprehensive, well-respected program," says Jamie Haeuser, vice president of operations for Woman's Hospital. In addition to diagnostic services such a mammography and Pap smears, the hospital also offers stereotactic biopsy, surgical treatments, plastic surgery, chemotherapy, physical therapy, support groups, home health programs, and nutrition support. Radiation therapy is not offered at the hospital but is provided through a partnership with a local center.
A key to the oncology program's growth and respect in the community is a multidisciplinary, comprehensive breast pre-treatment conference that includes general surgeons, radiologists, and oncologists.
"The woman comes to the conference, and her physician presents her case," explains Haeuser. "The physicians discuss different options while the patient is present so that she can hear the opinions first-hand and ask questions."
Deciding to add oncology to a women's center mix means looking carefully at women's health and deciding where you want to be, Haeuser advises. Woman's Hospital was in the position of diagnosing the disease and sending women elsewhere for treatment.
"We had a real opportunity to develop a service that would be of value to our community," says Haeuser. Her community's aging population and the lack of nearby cancer centers made it feasible for the hospital to add oncology in such a comprehensive manner.
GYN procedures moved to outpatient
The impetus for positioning the Women's Unit at Wellstar-Kennestone Hospital as the place for women recovering from oncology-related surgery was the movement of most gynecological procedures to the outpatient arena, says Joyce G. McMurrain, RN, MSN, director of women's and infants' services at the Marietta, GA, facility.
McMurrain's five-story, 150,000-square-foot facility is connected by a corridor to the main hospital and contains a diagnostic center, a 40-bed mother-baby postpartum unit, and 21 birthing suites. There was no shortage of business for the diagnostic and obstetrics areas, but McMurrain still had a 20-bed medical/surgical unit to fill.
"We talked with GYN oncologists, breast surgeons, reconstructive plastic surgeons, and oncologists to see what they needed for their women patients," says McMurrain. "We emphasized our staff's focus on women and their needs. We also showed how we were able to provide more personal, empathetic care since we were women caring for women."
McMurrain's campaign was successful, and many surgeons now send their oncology surgery patients to the Women's Unit following surgery. Patients appreciate the special unit's amenities, such as makeup mirrors, hair dryers, and a bench seat that can double as a bed for a spouse or family member.
"We don't offer medical treatment such as chemotherapy because the cancer center is just across the street," says McMurrain.
Haeuser and McMurrain suggest that any women's center considering oncology evaluate the following four issues to make your decision:
1. What services are already in place?
Build on what you have. Can your breast center be expanded to handle stereotactic biopsy? Do you have a clinic area to offer Pap smears and physical exams?
How many GYN oncology cases are already diagnosed or treated in your facility?
2. Are you staffed appropriately?
Can your staff handle education, diagnostic, post-surgical, and medical care? Do you need to add or shift staff to meet your needs?
3. Do you have medical staff support?
Not only do you need support from GYN oncologists and reconstructive surgeons, but your OB/GYNs, primary care physicians, and general surgeons need to understand why you are pulling some services under the women's center umbrella.
4. What is available in the community?
There is no need to duplicate services, such as radiation therapy, if they are already convenient to your patients. If you plan to refer patients to other services, make sure the other provider has the same high standards as your program's and make sure the transfer of care is a seamless, easy process for the patient, says Haeuser.
Haeuser's most important piece of advice? "Make the move into oncology, because it is the right thing to do for women in your community, not because you see it strictly as a marketing move," Haeuser says. "Your ultimate goal should be to improve quality of care in the community."
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