Inside Duke Medicine

Sequencing plan tests systems, work flow, patient care

Though the first patients will enter the new Cancer Center facility on Feb. 27, the full opening will be sequenced over a period of three weeks to ensure that key systems, processes and the building itself are fully functional from staff work flow and patient-care perspectives.

Though the first patients will enter the new Cancer Center facility on Feb. 27, the full opening will be sequenced over a period of three weeks to ensure that key systems, processes and the building itself are fully functional from staff work flow and patient-care perspectives.

“If we determine there’s an issue in one area of the new building, we can go check to see if it also exists in another area,” said Tracy Gosselin, RN, MSN, assistant vice president and associate chief nursing officer, Oncology Services. “And with the building not full, we will be able sooner rather than later to minimize and correct risks that potentially could arise. Making changes on a scale of 100 or 200 patients in a clinic is a lot easier than changing for a scale of 700-plus patients in an entire facility.”

In the interim, some patients will continue to be seen for some services in the Morris Cancer Clinics. Wayfinding “ambassadors” will be deployed, especially during the first two transition weeks, to help patients and families navigate back and forth between the Cancer Center and Morris.

The sequence of moves begins the weekend of Feb. 24 with radiation oncology, sarcoma, brain tumor, prostate, hematologic malignancies, radiology and laboratory. Moves over the weekend of March 3 include the oncology treatment center, followed on the weekend of March 10 by breast, gynecologic, gastrointestinal,thoracic, sarcoma, melanoma and genitourinary services. The final service, mammography, moves in May.

“That’s when we turn off the lights and all the practitioners move into the Cancer Center building,” Jan Tabor, administrative director for Oncology Services, said of the final weekend.

The sequencing plan was carefully developed to mitigate unforeseen issues by testing systems and procedures, such as the central lab and registration; making sure supplies are delivered; and ensuring that staff is familiar with the building.

A particular challenge is moving physicians and nurses in a way that allows the Cancer Center to open, but maintains necessary staffing levels in services that remain in Morris for the time being.

“It’s like chess,” Tabor said. “Which pieces should move first? We think we have a really good plan in place.”

Meanwhile, on-site orientation and training begins Feb. 1 for faculty and staff who will work in the Cancer Center.

That includes a facility-wide orientation, with topics such as fire safety and emergency management that are applicable to every floor, along with unit-specific orientation about new processes, equipment and protocols for specific departments. Clinical leadership will manage the orientation schedule for their staff and coordinate with providers and other staff what dates and times will work for their orientation.

Attending the orientation sessions is important for everyone, and relates directly to the key Duke University Health System values of teamwork and excellence, Gosselin said.

“You don’t want to be the only one who doesn’t go to training and then on Day One you are not able to help your team members or provide excellent care to patients,” she said. “That means knowing where things are, knowing your way around, knowing what’s in the building, understanding what to do if an emergency should happen.”

Staff will be divided into three groups for orientation and training: Front line clinical staff, providers and support services.

Though many employees have faced a unit renovation, bringing the Cancer Center online is in another category entirely. But they are ready for the challenge, said Pam Edwards, Ed.D., MSN, RN-BC, FABC, CNE, associate chief nursing officer, Education.

“This is a huge move, but these people really know how to do their jobs, know how to work as a team caring for patients and families. The critical issue for them in moving into a new space will be managing the new patient flow,” Edwards said. “Through our orientation and training program, we want to provide them with everything they need so that on Day One, Patient One they know what to do.”