As milestones go, it's a tall one. Perched on a ridge and reaching seven stories into the sky, the Seattle Cancer Care Alliance's new outpatient clinic is the most visible sign of the Alliance's progress.
But completion of the building - it will open to patients Monday, Jan. 29 - is not the first, last, or even most important step for the Alliance, said Executive Director Dr. Fred Appelbaum, who also directs the Hutchinson Center's Clinical Research Division and heads the Medical Oncology Program at the University of Washington.
"It is a milestone in that it is the culmination of an enormous amount of work," Appelbaum said. "But opening the facility does not eliminate cancer."
What will eliminate cancer is teamwork, dedication and breakthrough research. And making important contributions to that research - while simultaneously providing superior patient care - is what the Alliance is all about.
State of the art
"Our goal is to provide state-of-the-art care while at the same time moving the state of the art forward," said Norm Hubbard, chief operating officer of the Alliance.
But with three renowned institutions combining their strengths, not beyond reach.
"The Alliance is going to be one of the jewels of Seattle because it is bringing together the powerhouses of clinical care and research at Fred Hutch, the University of Washington and Children's Hospital and Regional Medical Center," said Dr. Marc Stewart, medical director of the Alliance.
The three founding institutions announced formation of the Alliance in October 1998. The idea was to develop a joint patient-care system that would expand two critical missions: offering the latest treatments to more cancer patients while providing clinical researchers at the parent institutions an enhanced setting in which to pursue their work.
It was a powerful vision - so powerful that even though all the details were not clear, people could sense that what ultimately emerged would justify the enormous effort that has taken place.
"I liken it to driving into Seattle in the morning on a foggy day," Hubbard said. "You know there's a wonderful city out there, but you can't see it. Then bits and pieces gradually come into view."
During the last two years - and with tremendous, hard work by hundreds of people - the concept of the Alliance crystallized into concrete form, first with the opening of a pediatric inpatient unit at Children's in July 1999 and adult units at the UW in mid-2000. Now comes the outpatient clinic.
"It's a spectacular, state-of-the art facility where nearly every aspect of the treatment of cancer and blood disorders has been designed to maximize patient safety and convenience," Stewart said.
Located on the southeast corner of the Hutchinson Center Day Campus, the clinic is the Alliance's "front door," Hubbard said. Behind that door are the combined resources of the Alliance - not only at the clinic, but also at the oncology programs at Children's and UW Medical Center.
"The Seattle Cancer Care Alliance is about bringing together the strengths of each of the organizations to make something better than what we already have," said Lisa Brandenburg, UWMC associate administrator and administrator for oncology services.
That's saying a lot. After all, each institution already shines brightly on its own. The Hutch is internationally known for its laboratory science and its clinical focus on blood cancers. The UW is recognized for its research and the breadth of its oncology programs. Children's is known for its pediatric care and research.
Even so, "We were not fulfilling all the potential that exists," Appelbaum said. "I think the Alliance gives us the opportunity to have a greater impact."
How? By leveraging key assets from each institution to create a comprehensive oncology center capable of advancing the research and treatment of all forms of cancer.
"I think we are right on the cusp of major opportunities," said Susan Heath, patient care administrator and nursing executive at Children's.
The biggest opportunity is to significantly increase the percentage of patients on research protocols in the region. Not only will that give more patients access to the latest treatments, Brandenburg said, it also will help researchers answer questions about how to eliminate cancer more quickly - objectives that speak directly to why the Alliance was created.
For example, the Hutch has extensive experience with clinical trials but a narrow patient base restricted mostly to transplant cases. On the other hand, the UW and Children's have broad patient populations but are not as focused on trials. Alone, each is limited, but by collaborating via the Alliance, the goal of conducting many clinical trials with diverse patient populations can be reached.
What's more, as the Alliance matures, efforts will be made to form collaborations and share new treatments with hospitals and physicians throughout the region, Hubbard said.
Another opportunity is to strengthen collaborations among the Alliance partners. The successful openings of the adult and pediatric inpatient units prove that the Alliance is traveling the right path, Heath and Brandenburg said.
"Already what we're seeing is an incredible opportunity to look at all of our systems and take the best from each of them," Brandenburg said.
Heath calls that process "sharing intellectual energy."
As logical as it all sounds, change is never easy, Appelbaum noted. With Alliance staffers from the founding institutions preparing to leave their old employers and move into the new clinic building, the ongoing process of melding policies and personnel will reach a new peak.
Besides assembling numerous outpatient services in one place, the building will become a physical focal point for a more structured form of collaboration than the three institutions previously practiced.
Given the depth of institutional pride within the three parent organizations, it's a delicate transition, but one that must occur if the Alliance is to harness its full potential, Appelbaum said.
"It's our goal to diminish any barriers and develop a sense of mutual trust and mutual respect where collaboration can occur," he said. "At the same time, I don't want the Alliance to get in the way of the institutions maintaining their sense of identity."
From Heath's perspective, both of Appelbaum's wishes are coming true. She said staff from the various institutions are learning each other's strengths and vulnerabilities to form effective teams. Meanwhile, Heath said, patients and their families continue to recognize and respond to the reputations of the institutions behind the Alliance.
First place to call
In the long run, Hubbard hopes the Alliance will be the first place people in the Pacific Northwest call if they or someone they know has cancer - either for their entire course of treatment, a specific intervention or a second opinion. "We want to be the center of excellence for cancer care," he said.
Along the way, however, it's important that the community remembers who the Alliance really is, Appelbaum said.
"I still want them to think of the Hutch and the University of Washington and Children's," he said. "The Alliance won't diminish the reputations of the three institutions. Rather, it will reflect the best of each institution."
[Brad Broberg is a contributing writer for the Hutchinson Center.]