A more perfect union
Breast Cancer Program leads the way in integrating services at DFCI, BWH
By Rob Levy
Illustration by David Cutler
Two institutions with a single adult cancer service — that is the theme of the Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC), the joint oncology program launched last year by Dana-Farber Cancer Institute and its next-door neighbor, Brigham and Women's Hospital (BWH).
It's a partnership designed for effi- ciency that began in 1997, when DFCI moved its adult inpatient beds to BWH, which in turn transferred its outpatient hematology/oncology units to Dana-Farber. The new joint oncology program aims to smooth the remaining "seams" between the services, giving patients a sense of being treated within a single organization, with a unified care team and group of clinical facilities. And the Breast Cancer Program is leading the way.
The integration represents a major undertaking for programs that, though closely allied, have sometimes seemed to patients like separate operations. When the transition is complete a year from now, the Breast Cancer Program will be a model for how to bring the best of Dana-Farber and Brigham and Women's together for patients.
"Patients will feel fewer 'bumps' when they move from one institution to the other for care," says Eric Winer, MD, director of the Breast Oncology Center at DFCI. "If a patient moves from the inpatient to the outpatient setting, or vice versa, the transition will be seamless."
The integration promises to simplify access to breast cancer care and make the entire system more sensible and easier to navigate. "Breast cancer patients will have one number to call to register or make an appointment," Dr. Winer remarks. "If a patient needs to page a physician, she won't have to think, 'Is my doctor a Dana-Farber doctor or a Brigham and Women's doctor, and which number do I need to call for that hospital's paging service?'"
Allies united
In the coming months, staff will be working to unify the programs' computer systems, paging and telephone systems, scheduling procedures, and reporting responsibilities. Among the biggest challenges will be finding ways to blend the institutions' organizational cultures.
Ross Berkowitz, MD, director of Gynecologic Oncology Services at Brigham and Women's Hospital and Dana-Farber, says, "Although each institution has its own identity, they share a set of core values—a commitment to delivering the highest level of care, providing the best training for young clinicians, and conducting research to advance the treatment of disease."
The Breast Cancer Program has hired a project manager to oversee the integration of the DFCI and BWH services. J. Dirk Iglehart, MD, director of the Women's Cancers Program at DFCIand chief of Surgical Oncology at BWH explains, "Integration is absolutely critical for our patients, and we'll be working closely with them to ensure that clinical services come together in a way that best supports their needs."
