Delivering the best possible cancer care

As chief medical officer, Tom Purcell, MD, MBA, is the clinical leader of Fred Hutch Cancer Center. In this role, Purcell eats, sleeps and breathes the importance of quality care in determining patient experience and outcomes. “When I wake up in the morning, my main goal is to improve our ability to deliver the best cancer care available,” he said.

Purcell is overseeing an organization-wide initiative to improve the delivery of care, with the goal of expanding operations to create capacity for more patients in the community who need access to the expertise of a National Cancer Institute-designated comprehensive cancer center like Fred Hutch. Patient satisfaction at Fred Hutch is at an all-time high — ranked in the top tenth percentile for U.S. cancer centers, according to Vizient, which rates academic medical centers — but Purcell believes there is always room for improvement. In this Q&A, he shares details about the initiative’s key focus areas: patient access, clinical care model and capacity.

What is the goal for patient access and scheduling?

We want our patients, especially new patients, to be able to get on the schedule easily, within 48 to 72 hours. When a patient is diagnosed with cancer, they want to see a specialist as soon as possible. We are reshuffling how we do our new patient appointments and restructuring how the clinics run in terms of teams and pods to better support APPs (advanced practice providers) and physicians so we can see more new patients. Having said that, it’s challenging because it involves significant changes in most of the clinical areas of Fred Hutch.     

You mentioned that Fred Hutch is transitioning how it cares for patients after their treatment wraps up. What can patients and providers expect?

We also need to improve how we follow up with patients and how we handle cancer survivorship. We need a better way to manage those patients who have completed their treatment. There is a model of having a survivorship group embedded within each disease type where a subset of providers would do survivorship visits and take over the care of those patients not actively in treatment. We have hired a medical director of Adult Medical Survivorship, Dr. Vidhya Nair, who started July 1. We also hired Theresa Wittenberg, PA-C, MS, to serve in the role of APP Survivorship Senior Manager. She will be Dr. Nair’s partner in leading survivorship across different disease groups.  

Another way we’re evolving relates to how we deliver care. What is the goal in terms of creating more of a team-based approach?

We are looking to team up doctors and APPs to work together on groups of patients at the clinic at the same time, so we are reshuffling how teams come together in pods, supported by nurses and pharmacy. Shuffling responsibilities is complicated with a ton of change management, and it is affecting people’s daily jobs. We have to do this carefully.

How is Fred Hutch planning to increase the number of patients seen?

We have grown substantially since I got here four years ago, which has put pressure on areas where there are bottlenecks. We need to evaluate current capacity in all areas. As part of that, I work with departments at the University of Washington School of Medicine to team up and to integrate how we care for patients.

What kind of plans are there for the Blood and Marrow Transplant program?

The transplant program and immunotherapy are two areas of worldwide expertise for Fred Hutch. Caring for these patients is more involved than caring for non-transplant patients. We want to optimize their care model as well as address capacity bottlenecks and other constraints. We will become more efficient and grow because our mission requires it. Financial headwinds are looming, and there are changes in our research funding, so there is an increased burden on our clinicians to help support our mission.

You’ve described a lot of changes, and change can be hard. How do you get people on board with the vision?

Getting people to do things I can’t directly control is about 3/4 of my job. As a leader, I have to work with creating relationships and developing trust to move things forward. These changes represent a cultural shift, but the goal is to improve the way we deliver care more efficiently and to more people.