A Decade of Excellence in Cancer Care
Monique Jean-Pierre, patient care assistant on Connors Center 7, cares for patient Margaret Gendron as she receives chemotherapy.
The DF/BWCC Vision: The Dana-Farber/Brigham and Women’s Cancer Center will provide excellent patient- and family-centered care. We will be an acknowledged world leader in the delivery of cancer care that is compassionate, safe, timely, efficient, equitable and seamless across all disciplines and sites of care.
When Patti Smith-Allen, BSN, RN, tells people she’s a nurse in Oncology, a silence often follows. “Some people think it’s a sad or difficult place to work,” she said. But Smith-Allen tells them that because of the Dana-Farber/Brigham and Women’s Cancer Center, cancer patients have hope.
“We can do things here that can’t be done anywhere else because of who we are,” said Smith-Allen, who has been at BWH for 30 years. “I’m very proud to be a nurse here.”
In 1997, the Dana-Farber Cancer Institute and BWH began a vanguard partnership to push innovation in prevention, diagnosis and treatment of cancer further and faster than ever before. For these 10 years, patients have received the benefits of this partnership in care.
On Feb. 15, 1997, the first 13 patients were moved from Dana-Farber to BWH. Since then, all inpatient cancer care for adults is delivered at BWH and most outpatient care at DFCI.
Elvi Rigby, RN, then nurse manager of BWH Hematology/Oncology and Bone Marrow Transplant, praised the merger, calling it the beginning of a new era in oncology care. “We have been given an opportunity to create a model of care that will set the standard for not only Boston and the country, but for the whole world,” she said at the ceremonial ribbon-cutting. “It is the passion for our patients that has united us, that forged collaboration out of competition, creating a synergy that is boundless. We can be proud of the legacy we are creating in honor of the very courageous and special patients that continually inspire us to press on.”
That’s just what physicians, nurses and staff of the DF/BWCC have done over the last decade. The two institutions have worked to complement and coordinate medical oncology, surgical oncology, nursing, pharmacy, psychiatry, pain and palliative care, infusion, radiation oncology, transfusion, nutrition and other cancer support services.
A New Identity
Prior to the 1997 merger, oncology patients at BWH were combined on a floor with General Medicine patients. Nurses had the choice to stay with General Medicine or specialize in Oncology.
“Before the merger, Brigham nurses practiced oncology nursing along with many other specialties, and we were good at it,” Smith-Allen said. “But after the merge, we became ‘oncology nurses,’ and we are now excellent at it.”
For those who chose Oncology, the decision was easy. “I wouldn’t practice any other kind of nursing,” Judy Rumble, BSN, RN, now a NIC on 4C, said. “We are able to offer so much hope to our patients and really connect with them and their families.”
The merge itself wasn’t so easy. Combining nurses from two institutes, each with different computer systems, policies and protocols, resulted in something of a culture clash.
Rumble remembered the Saturday that the Dana-Farber nurses began at BWH. “It was a little tense at the time,” she recalled. “We each had a different way of doing things.”
But staff were able to work through differences, knowing the newly-formed center would strengthen care. The creation of uniform policies and procedures and the collaboration among staff eventually gave way to a unified cancer center.
Putting Patients First
Because the DFCI nurses had always specialized in oncology, they were a great resource and example for the BWH nurses just beginning to call themselves oncology nurses.
“I learned a lot from the Dana-Farber nurses,” Smith-Allen said. “They took a step back from everything else going on and really took the time to connect with each patient.”
That kind of attention led to better outcomes and more trust and comfort among patients and families and clinicians.
Another strength DFCI brought was the Patient and Family Advisory Council, a concept brand new to BWH. The council formed in 1998 to enhance communication and collaboration and improve care.
“Families know firsthand the internal challenges involved in having cancer or seeing a loved one struggle with it, and they understand the compassionate response that’s needed,” said Elizabeth Tracey, RN, who was involved with the committee.
Involving patients in care has been one of the hallmarks of the DF/BWCC since its opening. Earlier this year, Oncology nurses teamed up with a patient to produce an educational video on preventing patient falls. Shooting the video from the patient’s perspective was instrumental in conveying how to reduce falls.
A Blend of Talents, Expertise
“Input from Dana-Farber’s clinical experts combined with that of our Brigham experts was magnificent,” Rumble said. “Great advancements in care have happened because of this collaboration.”
Medical research, for example, has made huge strides in treating the disease. “I remember 24 years ago when patients with acute myelogenous leukemia didn’t have any hope at all,” she said. “Today, they do because of the phenomenal research that has been done.”
Nursing research has also blossomed during this time extending nurses’ knowledge regarding family involvement, end of life decision making, pain management and decision support.
Continuing to Improve
Since its opening, the center has honed in on some of the challenges of navigating two institutions. Last year, the DF/BWCC established one toll-free number for potential patients and families, as well as referring physicians, to inquire about services or request an appointment. In 2005, the center hired two patient navigators to reduce disparities in health care by assisting women who have not pursued follow-up treatment.
Today, the DF/BWCC continues its quest to make every aspect of a patient’s cancer treatment better.
“That name, the Dana-Farber/Brigham and Women’s Cancer Center, is big,” Rumble said. “I’m proud to be part of it.”