Published: Apr. 13, 2012
Updated: Apr. 13, 2012
One of the first patients ever to step inside the new Duke Cancer Center was there long before opening day.
Back in October 2011, 80-year-old Laurence DeCarolis donned hard hat, orange vest, and safety glasses to be escorted across a muddy courtyard bustling with heavy equipment to the building-in-progress. DeCarolis, a leukemia survivor, and his wife, Elizabeth -- both longtime volunteers with Duke’s Cancer Patient Support Program -- had been invited to take part in a walk-through test of the facility’s wayfinding signage.
Along with other volunteers, they navigated their way to five sample appointment locations following temporary paper signs, and then offered feedback to help make sure the permanent signage would clearly direct patients to their destinations.
The navigation test was one of many times during the multiyear planning and construction process that patients, faculty, staff, and volunteers pitched in to make this new building the best possible environment for delivering and receiving cancer care. And the team effort toward that shared goal has produced a place that’s truly remarkable, says DeCarolis.
“You walk in and just say, ‘Oh boy.’ The initial reaction is one of awe, with that fantastic atrium. And then as you come in you see all the special touches, like the host stations with complimentary beverages and snacks and the wonderful resource room and the lounge areas where you can look out into natural light. You can tell that so much thought has gone in to making patients comfortable.”
The Duke Cancer Center has in fact required years of thoughtful planning and concerted effort. The idea of creating a dedicated cancer center at Duke began taking shape in the mid-2000s, when it became clear that existing facilities were neither designed for the way cancer care was evolving nor sufficient to meet the growing demand for services.
Not only is the Duke Cancer Institute (DCI) currently serving more than 50,000 patients a year, forecasts project a 15.3 percent increase in new cancer cases in North Carolina between 2010 and 2015 -- and a 22.4 percent increase in the greater Triangle region that is Duke’s home base.
Far beyond simply adding space to accommodate more patients, though, “We saw a real opportunity to create an environment that would dramatically improve the patient experience,” says Kevin Sowers, MSN, RN, president of Duke University Hospital.
“Our providers have always put the patients first, but older facilities didn’t always support that -- they were more sterile environments designed primarily for clinical efficiency. The new cancer center is designed from the ground up with the patient in mind.”
In fact, patients -- including DeCarolis and many others -- helped inform the design, providing input in early focus groups that was complemented with extensive research and additional suggestions from caregiver teams. “We really wanted to listen to what people found challenging and what we could do to make the whole experience better for them,” says DCI administrator Carolyn Carpenter.
For example, in the old space, family members often overflowed from crowded waiting rooms into the hallway. Research showed that patients brought an average of 3.5 friends or family members with them, so the new building was designed with ample, living-room-like waiting areas.
For the 120 patients who receive chemotherapy each day, the new facility offers options of cubicles for privacy, a bright communal space for chatting, or even receiving treatment on the rooftop terrace on pleasant days. And healing spaces such as a quiet room for meditation are complemented by practical amenities like a boutique, a pharmacy, an educational resource center, and a café serving healthy foods -- reflecting the focus on whole-person care.
“The new cancer center is a wonderful, beautiful environment in which to deliver the very best cancer care,” says William J. Fulkerson Jr., MD, executive vice president of Duke University Health System. “Caring for our patients, their loved ones, and each other -- that’s what it’s all about.”
Beyond providing a comfortable and welcoming environment, the Duke Cancer Center will also enhance the leading-edge care Duke Cancer Institute is known for, says DCI executive director Michael B. Kastan, MD, PhD.
One important change is that the facility brings together almost all cancer clinical services on the main medical campus, meaning that patients no longer have to travel to far-flung locations to see multiple specialists. Instead, most of the DCI’s 100-plus board-certified physicians and 500 clinical staff will come together in multidisciplinary teams organized by disease type -- so that patients will have access to a full range of expertise in one convenient setting.
“It’s one-stop care delivery,” says Kastan. “The providers’ visits are all coordinated and everyone comes to the patient, which not only makes for a better patient experience but better medical care, because communication and efficiency are enhanced by the subspecialists being in close proximity. We’re also building survivorship services around that multidisciplinary care -- activities like social work, nutritional counseling, all the things we do to help the patient thrive during and after their treatment will be much easier to deliver with this kind of geography.”
The expanded space provides an opportunity to enhance these kinds of services, adds Carpenter.
“With space organized around disease groups, we can accommodate additional staff to enhance the depth of specialized care we offer. We haven’t historically had a dietician especially for breast and ovarian cancer, for example, but now there will be one embedded on the floor where those services are located. We’ll have genetic counselors, new-patient coordinators, family and marriage therapists, and pharmacists dedicated to focusing on specific patient populations, whether it’s prostate cancer or head and neck cancer. We want to give patients easy access to a total range of expertise.”
The new facility is also designed to bolster clinical research -- a key differentiator for the Duke Cancer Institute, which currently conducts around 700 clinical trials of investigational new cancer therapies and treatment approaches at any given time.
While these trials can provide patients with treatment options they will find nowhere else, it wasn’t always easy in the past for trial coordinators to find private space to discuss enrollment opportunities with patients. The new facility not only includes dedicated private rooms for these consultations, but will actually make clinical investigation itself easier, says Kastan.
“Many clinical protocols are multidisciplinary in nature, with surgery, imaging, and chemotherapy components. Having those specialists together in one setting, along with dedicated nurses who are in tune with every aspect of the treatment protocols, will make it easier to conduct complex trials.”
In such ways, he adds, the building supports the overarching vision for the DCI, which was created in 2010 under the leadership of Duke chancellor for health affairs Victor J. Dzau, MD, to accelerate the translation of research discoveries into improved patient care.
“This is going to be a sea change in patients’ experience,” Kastan says. “The opening of this new facility, combined with the creation of the DCI, will enable multidisciplinary teamwork, facilitate the clinical research enterprise, and make care more effective, efficient, and patient-friendly. It’s really making cancer care what it should be -- an endeavor where everything starts and ends with the patient in mind.”
The following slideshow offers a brief glimpse into what you can expect when you visit the Duke Cancer Center.