Inside Duke Medicine

Glimpse into the future: Animations show how the projects will change the Med Center campus

Transformative cancer center and hospital expansion to become reality

Historic expansion will increase capacity to meet demand and enhance nationally recognized training and research programs

After several years of strategic planning, and the successful achievement of state regulatory approvals, Duke Medicine has initiated the construction of major new facilities at the Duke University Medical Center.

These new buildings – a comprehensive Cancer Center and a major expansion of Duke University Hospital’s critical care and surgery platforms (which will include state-of-the-art imaging facilities) to be called Duke Medicine Pavilion – represent Duke’s commitment to continuing to meet the needs of patients in North Carolina and further enhance our teaching and research missions.

“The decision to go forward with this project was ultimately driven by what we see as a fundamental responsibility to patients throughout North Carolina to increase our ability to meet the demand for the kind of evidence-based, quality care that Duke is known for,” said Victor J. Dzau, M.D., chancellor for health affairs and CEO of the Duke University Health System. “We are already near, or at, capacity at Duke University Hospital and there is an acute need for more space in which to provide treatment to patients, facilitate important research activities and train the next generation of medical leaders.”

That decision, said Dzau, was subjected to exhaustive analyses of projected patient need, financial feasibility and commitment to employees by the DUHS Board of Directors, Duke University Board of Trustees, School of Medicine faculty, Duke Medicine employees, and leaders throughout Duke Medicine. Furthermore, plans related to the new facilities were shared and discussed with a variety of community groups, community leaders and elected officials.

“The unanimous conclusion was that this project is necessary and consistent with our commitment to the people of North Carolina,” he said.

The global economic and financial crisis demanded that DUHS examine – and re-examine – every element of this project in great detail, said Dzau. He and the health system senior management team are confident that efficient financial management over the last several years, as well as the positive financial performance within DUHS that has been driven by outstanding employee work and dedication, have put DUHS in a position to move forward with the expansion project.

This plan was subjected to extensive scenario planning exercises that included some of the worst-case possibilities that could emerge from the current federal healthcare reform discussions. In each case it was determined that the new Cancer Center and hospital expansion would benefit the citizens of North Carolina and that DUHS could manage through the various scenarios.

Construction will begin in mid-2010 with the Cancer Center, a seven-story, 267,000-square-foot facility that will consolidate outpatient cancer services from around the medical center into a single, multidisciplinary center. The new building, targeted to open in 2012, will connect to the existing Morris Cancer Clinic.

“Duke is already a nationally and internationally recognized leader in the treatment and research of various cancers, and the creation of this multidisciplinary focal point for clinical care and clinical research programs will allow us to more comprehensively and efficiently meet the expected increase in demand for the care provided by our faculty and staff,” said William J. Fulkerson Jr., M.D., senior vice president for clinical affairs.

The Health System’s investment in a new Cancer Center is critically important, as projections currently call for double-digit increases in cancer rates in the Triangle, and throughout the state, over the next five years. The new facility is also expected to result in new synergies in treatment and research advances as a result of bringing together – in one space – the many specialty areas involved in cancer care and research.

“Duke is fortunate to have many nationally respected leaders in various areas of cancer care and research, and I believe we have only scratched the surface in terms of how this collective expertise can be tapped in order to design better studies and more fully interpret resulting data,” said P. Kelly Marcom, M.D., breast oncologist at Duke.

Marcom and his fellow researchers, including colleagues at the Duke Institute for Genome Sciences and Policy (IGSP), are pioneering an approach to breast cancer treatment that is hoped will ultimately personalize chemotherapy strategies for each individual patient based on the genetic composition of a patient’s tumor.

“The new Cancer Center will better facilitate how we educate patients about participation in clinical trials and, for those who elect to participate, provide a convenient, patient-friendly venue in which they can receive care and follow up,” said Marcom.

The architects and engineers who have designed the Cancer Center have listened to needs identified by patients, physicians, nurses and others. Their design for the building is rigorously patient-centered, with attention having been given to the physical and emotional needs of cancer patients.

Linking the Cancer Center to the existing bed towers of Duke University Hospital will be the Duke Medicine Pavilion, an eight-story 580,000-square-foot addition to DUH that will greatly expand DUH’s critical care and surgical capacity and house a large high-tech centralized medical imaging center.

The Duke Medicine Pavilion, expected to begin construction in late 2010 or early 2011, is targeted to begin receiving patients in 2013. This facility will include 16 new operating suites that will feature state-of-the-art surgical technology, including intraoperative MRI and CT imaging scanners. It will also include the creation of 160 much-needed new state-of-the-art intensive care and intermediate care beds.

Both the Cancer Center and Duke Medicine Pavilion, once completed, also will serve as high-tech training grounds for the nearly 900 residents and fellows who train in Duke’s graduate medical education program – one of the largest in the country.

Even prior to completion, the new buildings will have a more immediate local and regional impact. The more than $700 million in estimated project costs will translate to a significant positive boost to the Durham, Triangle and North Carolina economies. Project managers estimate that as many as 1,500 highly skilled construction workers may be needed during the approximately five-year construction phase. Ultimately, the project will provide an additional 1,000 permanent provider and staff jobs.

However, it is critically important that this expansion project be viewed as something substantially more important than just the construction of new buildings.
“It is first and always about people,” said Duke University Hospital CEO Kevin Sowers, MSN, R.N., FAAN. “Most importantly, it’s about the patients we will serve there, the people who will work in these facilities, and how these buildings will help them do the excellent work they do every day.”