December 14, 2017

Head and Neck Oncologists Provide New Model of Care at Taussig Cancer Center

A Q&A with the Head of Surgical Oncology

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When Cleveland Clinic’s new Taussig Cancer Center opened in March 2017, it introduced an innovative model of patient-centric cancer care.

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  • Almost all services for cancer patients — from radiation to infusion to yoga classes to wig fitting — are housed in one building.
  • Clinical exam areas are designated by cancer discipline. For example, all head and neck cancer caregivers and patients are in one area.
  • Patients have private rooms while caregivers rotate to them.
  • Surgeons, oncologists, radiologists, palliative care providers, nurses and other members of multidisciplinary cancer teams collaborate right outside patient rooms, in shared workspaces.

At first, the model didn’t seem more efficient for physicians, admits Brian Burkey, MD, Head of Surgical Oncology at Cleveland Clinic’s Head and Neck Institute.

“Patients used to come to us,” Dr. Burkey says. “The new center positions us to provide care differently and allows us to think differently about care.”

Just how differently? Dr. Burkey explains in this Q&A.

How has care changed for head and neck cancer patients?

Dr. Burkey: Planning the new Taussig Cancer Center was in the works for years. Our No. 1 priority was to make it patient-centered — a one-stop shop for cancer care. And that’s what we’ve achieved. Except for major operations requiring general anesthesia, patients have all cancer services at the center — including imaging and pre- and post-op visits.

Patients see all of their doctors together instead of running from one floor to the next or taking a shuttle from one building to another. They sit in one room and see their doctors back to back to back.

Medical and radiation oncology live in the cancer center. Surgery still lives elsewhere, but a head and neck surgeon is always on site. We rotate.

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Besides improving patient convenience, has the new center changed how treatment is administered?

Dr. Burkey: Yes, the new center is helping speed care decisions as well as interventions.

Before the new building opened, I might get a call about a PET scan showing something in a patient’s neck. We’d schedule a surgical consult. Now I get tapped on the shoulder so we can look at the scan together and, if needed, prepare for a biopsy right then. We often can do ultrasound-guided biopsies and open biopsies there instead of in the general OR, which can save weeks of waiting.

Or, let’s say a patient is referred to me for surgery, but I think they’re better suited for chemotherapy or radiation. Instead of advising them to make an oncology appointment, I can walk across the hall, talk to a medical or radiation oncologist, and have them see the patient immediately. That happens at least once a week!

What has improved for head and neck cancer caregivers?

Dr. Burkey: Our head and neck team is more tightly knit now that medical oncology, radiation oncology and surgery all share the same workspace. Working in close proximity is a benefit — especially with communication.

Maybe a medical oncologist will be talking about a tongue cancer patient, and I mention that the case reminds me of another I just saw. Maybe that inspires someone else to do a study. And maybe a resident who has been listening in wants to get involved with the study. We used to have conversations like that in our weekly tumor boards or quarterly research meetings. Now we have them continuously.

How was the head and neck team involved in designing the new center?

Dr. Burkey: We literally designed our exam rooms from scratch. We incorporated new video systems for endoscopies and ENT-designed patient chairs.

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Personnel-wise, we added a head and neck patient navigator. Every morning, we have a team huddle to review patient cases and talk about who needs to be seen sooner or moved up in the OR. What used to require lots of time, emails and phone calls between doctors, nurses and admins now takes 10 minutes with all of us standing there.

Only a portion of my practice is cancer, so I only have one clinic day per week at Taussig Cancer Center. But if it were up to me, I’d be there every day. It’s such a great environment to work in.

Dr. Burkey is Vice Chairman and Section Head of the Section of Head and Neck Surgery and Oncology at the Cleveland Clinic Head and Neck Institute. He also serves as Medical Director of the Center for Consumer Health Information.

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