A new oncology leadership group has taken shape at the Palo Alto Medical Foundation, uniting several medical and surgical specialties under one umbrella. PAMF specialists in medical oncology, radiation oncology, surgery, palliative care and gastroenterology are located throughout the Bay Area, but now these physicians and staff come together once a month to learn best practices from one another. This new effort streamlines communication and processes to increase effectiveness while also providing more personalized care to our cancer patients.
“Our goal is to create a system that delivers timely, innovative, high-quality care with a human touch,” says Natalia Colocci, M.D., department chair of medical oncology for the Palo Alto Foundation Medical Group. “For instance, we aim to build a cancer navigation system that ensures a patient will hear from a team member within 24 hours of receiving a diagnosis—a tremendous feat that will greatly benefit patients.”
Cancer navigators help patients interface with medical oncologists, radiation oncologists and the surgical team at the time of diagnosis. “I think of our service as a kind of concierge medicine,” Dr. Colocci says. “Cancer navigators are an integral component of that experience, becoming a partner to patients so they don’t feel lost during this traumatic time. This is happening in some areas at PAMF, but we want to make it the experience at every clinic.”
Bridging Gaps to Create Solutions
Before this dedicated, hardworking group came together, there wasn’t a forum for uniting physicians, infusion nurses, medical assistants, palliative care specialists, pharmacists and patient service representatives. Sometimes these team members never met one another. Now they can truly communicate, better understand gaps in existing processes and brainstorm solutions.
“Personally, it has been a huge learning experience to see the myriad aspects of caring for cancer patients and to learn how decisions are made after diagnosis and throughout treatment,” Dr. Colocci says. “We are communicating much more effectively, and everyone is more engaged.”
For example, the team recently reviewed the journey of early-stage breast cancer patients from diagnosis through the completion of treatment. They took three days to thoroughly understand each step patients go through, which revealed seven areas in which the processes varied significantly from one clinic to the next. The streamlining of these systems forms the framework for future improvements.
On specific area the group addressed was how physicians and staff across departments had been documenting chemotherapy regimens and timing of treatment. “It turns out each medical oncologist captured this on patient electronic health records in a different way,” Dr. Colocci says. “This team has now created one standard—same words, same font, same position in the health record—that all physicians will use, which will eliminate confusion for all parties.” The team hopes to apply what they learned through this endeavor to caring for patients with other types of cancer.
Embracing the Whole Patient
As more cancer patients are being diagnosed at earlier stages of the disease, more are surviving, either in remission or with a cure. The unfortunate reality is that some of these patients face greater odds of developing another form of cancer, making it especially important to include palliative care specialists on the cancer team. “Research has proven the importance of palliative care for cancer patients,” Dr. Colocci says. “People who receive it in addition to standard therapies feel better during treatment and also live longer.”
PAMF is developing additional education to emphasize the importance of providing palliative care earlier, rather than waiting until a patient becomes extremely sick. The goal is to teach physicians and patients that palliative care does not mean other kinds of care stop. “It will be a continuous process to better integrate palliative care into our treatment regimen,” Dr. Colocci notes. “It will be a big value for our patients.”
Elevating the Level of Care
Generous donors throughout the community have helped PAMF continue to improve the level of cancer care available. These gifts have enabled PAMF to implement state-of-the-art diagnosis and treatment technologies such as digital breast tomosynthesis and brachytherapy, as well as open new clinics like the Paul L. Locatelli Center for Cancer Care in Sunnyvale. PAMF physicians are deeply grateful for this powerful community partnership.
Philanthropy can help us achieve our dreams, such as navigation for every cancer patient,” Dr. Colocci says. “It also enables us to expand upon the ideas that are more difficult to implement within a tight operational budget.”
Already, the personal touch in PAMF’s cancer care is unmatched in our community, but Dr. Colocci and her team want to set the standard even higher. She has a broad vision for the next few years to provide navigation for all breast cancer patients—and possibly all cancer patients. She hopes to add full-time social workers and dietitians at all sites and hire more staff and physicians to relieve work-related stress and burnout. Dr. Colocci would also like to expand clinical trials to all PAMF cancer care sites and create a survivorship program that is consistent across the system.
The ultimate goal of Dr. Colocci and her team is to improve a patient’s experience throughout their healthcare journey. “Our patients are not treated like just another number,” she says. “Their care is personalized, and they have 24/7 online access to their doctor through My Health Online—in the spirit of concierge medicine.”
Dr. Colocci is already feeling the impact of these efforts. “I recently sent a birthday email to a patient who responded, ‘Wow! I’ve never had a physician wish me happy birthday,’” she says. “That made our relationship feel more powerful and fulfilling, because after surviving cancer, getting to the next birthday assumes a whole new meaning. Being able to add that personal note while providing outstanding care is what makes us tick.”