Major Remake Pays Off for the Cancer Program at Washington Hospital Center

PHILADELPHIA--The strategy of the Washington Hospital Center (WHC)cancer program for surviving managed care has been to enthusiasticallyembrace change, said Kenneth Samet, president of WHC, at the annualmeeting of the Association of Cancer Executives (ACE).

Before 1990, the program was diffuse, with services scatteredthroughout the facility. Technology was outdated, and the programfocused on inpatient services. It lacked a strong community imageand had minimal market share.

That changed with the development of the first strategic planthat made the cancer care program a "center of excellence,"not just on paper but with a capital investment of $18 millionfor a 60,000 square foot facility and equipment.

Other changes included the recruitment of "magnet" physiciansin targeted service lines, establishment of an integrated homecare program, major public affairs and marketing initiatives,including aggressive pursuit of managed care and carve-out contracts,and expansion of clinical research.

In April, 1992, the program opened with a new facility and a newname, the Washington Cancer Institute at the WHC. It now featuresa multidiscipli-nary, integrated approach to comprehensive cancercare, whereby patients can receive all necessary treatment, consultations,and support services at one site.

To help it survive as a tertiary site, WHC's cancer program hasbecome the hub for OncoPlex, a regional network of medical oncologists,hospitals, and radiation centers stretching into neighboring Marylandand Northern Virginia. The sites are closely linked, Mr. Sametsaid. "You can't have multiple sites if they feel like multiplesites to the patient."

The results of the WHC cancer program efforts have been dramatic,he noted. Inpatient discharges have held fairly steady for thepast decade while, at other hospitals, oncology inpatient admissionshave dropped by an average of 30% over the past 5 years as morecare has shifted to the outpatient and home care settings. Outpatientregistrations at WHC have gone from 16,800 in 1986, to 28,716in 1994 and 34,501 in 1996 (projected).