The Seattle Cancer Care Alliance (SCCA) has come a long way since Fred Hutchinson Cancer Research Center, UW Medicine and Children's Hospital and Regional Medical Center united in 1998 to form an integrated care system for cancer patients. It was a bold move, but ultimately a successful one as seven years later the SCCA is in the black, on the map and out of room.
Given the SCCA's goal of becoming a world-class cancer center, running out of space would be a big problem except for one thing. It was anticipated. From the day the SCCA opened its outpatient clinic on the Fred Hutchinson campus in January 2001, the clock was ticking on expectations that the clinic would need to grow. Now, with completion of a new strategic plan, that time has arrived.
"We knew from the start that we would need to expand and the clinic building was planned with that prospect in mind," said Norm Hubbard, the SCCA's chief operating officer.
Work will begin in June on a new Women's Center, which will occupy 12,000 square feet of unfinished shell space on the clinic's third floor. In July, construction will begin on a six-story addition to the clinic. The 55,000-square-foot addition will rise immediately adjacent to the south side of the existing building, where a temporary metal facade was installed in anticipation of expansion. When the addition nears completion, workers will tear away the facade to turn the two structures into one.
With patient volumes growing by an average of 8 percent a year, it was only a matter of time before the SCCA maxed out the outpatient clinic, which supports inpatient units at Children's and UW Medicine and serves as the organization's headquarters. "Ever since we opened, we've been growing and adding people," Hubbard said. "First, we moved into some smaller vacant spaces left after the initial construction and then we began moving staff out of the building into the Aloha building and into space at 1144 Eastlake. Now, we face running out of space to see more patients."
The upside to the SCCA's growing pains is that with them has come financial health. "We achieved our financial goals sooner than expected — we became profitable in 2002 — and have been in the black ever since," Hubbard said. Plus the SCCA is becoming more widely known, he said. "It gives me a great feeling to hear more and more positive comments from people in the community who've had a friend or relative cared for here," Hubbard said.
Even so, all of that alone probably wouldn't warrant expansion of the clinic at this time. Driving the expansion is the SCCA's goal to become a world-class cancer center. "Our mission is to be a world leader — not to hope to be or strive to be or try to be, but to actually be a world leader," said Madeline Buelt, chief nurse executive at the SCCA.
That commitment was reaffirmed with completion of a new SCCA strategic plan. "We opened inpatient units at Children's and the UW Medical Center, built the SCCA clinic building, achieved financial stability and then the question became where do we go from here?" Hubbard said. "What does it really mean to be world class?"
Already regarded as world leaders in both patient care and clinical research related to leukemia, lymphoma and other blood cancers, the SCCA's parent organizations decided they needed to take their solid-tumor programs (e.g., breast cancer, lung cancer) to the same level if they wanted to create a truly world-class institution.
At that point, the SCCA approached the Cancer Consortium about working together on their respective strategic plans, Buelt said. The Cancer Consortium involves the same three institutions as the SCCA — Fred Hutchinson, UW Medicine and Children's — but maintains a different focus. Funded by a joint core grant from the National Cancer Institute, the Cancer Consortium is dedicated to building superior oncology clinical-research programs.
The SCCA and the Cancer Consortium were made for each other. To become a world-class cancer center, the SCCA needs to build stronger solid-tumor programs, which can only happen if it provides patients with greater access to clinical-research studies. To conduct world-class clinical research, the Cancer Consortium needs greater access to larger numbers of solid-tumor patients. With so much to gain from each other, it only made sense for the SCCA and Cancer Consortium to collaborate on their strategic plans, Buelt said.
They ultimately agreed to target five categories of solid tumors with the greatest potential for clinical and research growth. The five priority categories are breast, gynecology, prostate, lung and gastro-intestinal. "It was vital that the consortium be involved in setting the priorities because clinical research is one the key things that distinguishes a world-class cancer center," Hubbard said.
Expanding the SCCA clinic will enable the solid-tumor programs to add the physicians, staff and services necessary to bring the new strategic plan to life. Right now, the SCCA's general oncology outpatient services are concentrated on the clinic's fourth floor. That will change with construction of the new Women's Center as the breast and gynecology programs will move out of the fourth floor and into the new center on the third floor. "Not only will the move leave more room on the fourth floor for other solid-tumor programs, it will create a nucleus on the third floor for a one-stop array of women's services," said Cheryl Wyman, director of the Women's Center.
Scheduled to open in October 2005, the Women's Center will house the breast and gynecology programs, mammography and breast imaging, the Wellness Clinic and the Breast and Ovarian Cancer Prevention Clinic. Physicians, staff and patients have all been involved in the planning, Wyman said. "I think people are really excited about the Women's Center," she said. "It's really brought people together."
If all goes well, the clinic's six-story addition will be completed in March 2006. The addition will sit atop the clinic's existing first floor and mirror its full seven-story height. The SCCA has recently received final design approval from the city of Seattle, said Cecilia Larson, planning project manager for the SCCA.
The expansion will add nearly 10,000 square feet each to floors two through seven of the clinic. The expanded floors will allow space to be built out flexibly and incrementally to accommodate the additional clinical and administrative space required by future growth.
Although the expansion won't be complete for at least 15 months, the SCCA already has started recruiting additional research physicians, said Dr. Marc Stewart, medical director. In addition, a consultant is helping the SCCA improve the operations of the existing clinics even before the availability of additional space.
As the SCCA grows, the goal is to offer new treatment options that currently may not be available in the community. "We don't want to give the impression to other health-care providers in the area that we're directly competing for patients," Stewart said. "What we are interested in is increasing the number of patients in the region who are participating in clinical-research studies, particularly in general oncology."
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