Unity Health Care and Sibley Memorial Hospital recently formalized their joint establishment of a cancer care clinic within Unity's Parkside Health Center in Ward 7. Vincent A. Keane, president and CEO of Unity Health Care, signs paperwork during a recent press conference as Dr. Hasan Zia, interim president and CEO of Sibley Memorial Hospital, looks on. Standing behind them, from left, are Sibley/Unity nurse navigator Ruth Williams, Ward 7 DC Council member Vincent Gray, Deputy Mayor for Health and Human Services Wayne Turnage and Sibley/Unity nurse navigator Florence Odubayo.(Photo courtesy of Unity Health Care)

Unity Health Care, Sibley Hospital partner on new cancer care clinic to fill service gaps on DC’s east end

By Candace Y.A. Montague On Aug 12, 2019 Last updated Aug 19, 2019

A new collaboration between Unity Health Care and Sibley Memorial Hospital is bringing much-needed cancer care closer to residents in wards 7 and 8 — a response to calls from community members, health educators, and advocates for more specialty services east of the river.

The two health care providers signed an agreement June 28 formalizing and announcing their joint establishment of a cancer care clinic within Unity’s Parkside Health Center on Kenilworth Avenue NE in Ward 7. The new clinic began seeing patients in March.

The only cancer clinic previously operating east of the river was located inside United Medical Center on Southern Avenue SE in Ward 8. At the end of June, that clinic — which was staffed by Sibley — shut down, continuing an erosion of specialty services available at the Ward 8 hospital that began with the 2017 closure of its obstetrics unit. The closure has made the new cancer care clinic all the more significant.

It’s a prime time for Sibley Memorial to expand its services beyond its Loughboro Road NW campus in Ward 3, according to Elisabeth Carrino-Tamasi, assistant director for oncology and the Center for Patient and Family Services at the Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital.

“We understand that there’s a real gap in services in wards 7 and 8, and our plan was always to expand our reach into those wards,” she said in an interview. “This seemed like the perfect opportunity with Unity being the largest health care provider in the District.”

The clinic’s medical staff will have two key personnel: a nurse navigator and a nurse practitioner. The nurse navigator will conduct specialized assessments, coordinate access to care, obtain medical records if necessary, and screen patients to identify barriers to care. Patient navigation has been touted by the American Cancer Society as a helpful service for patients.

The clinic’s nurse practitioner will be on site to provide urgent care so patients can avoid unnecessary emergency room visits, as well as medical services to help reduce their need to travel across town for symptom management. The nurse practitioner will also manage medication related to cancer care. As of now, the two are at the clinic all day Monday and Wednesday.

The new cancer care clinic at Unity Health Care’s Parkside Health Center is staffed by a nurse navigator and a nurse practitioner. The wraparound services are aimed at alleviating barriers to care and avoiding gaps in care. (Photo courtesy of Unity Health Care)

Carrino-Tamasi says that having both types of nursing care located in the same place reduces wait times, which is crucial to patient outcomes. “What the data show is that residents in wards 7 and 8 have the highest mortality rates. Also, they are affected by higher rates of later-stage cancer. And that makes quality and quick access to care imperative.”

Sibley will provide wraparound services to alleviate many barriers to care, including the cost of transportation in some cases. “Once that navigator does the screening and assessment, we will bring that patient to Sibley for their consultation with a specialist and create their treatment plan,” Carrino-Tomasi explained. “When we get them here, the navigator has connections to social workers, other navigators, nutritionists, palliative care and others. We will make recommendations and identify barriers.”

Tracy Harrison, Unity Health’s vice president for business development, innovation and population health, explains how the navigator acts as a safety net. “When a patient is diagnosed with a gynecological or prostate cancer, we can do a warm handoff where we can walk them over to the patient navigator. They will take them and they will walk them through the entire process. They will literally close the circle and the gaps in care.”

Gary Stephenson, Sibley’s senior director of media relations and public affairs, explained that referrals will help connect Unity patients with Sibley’s services. “Navigators provide expert assistance with the psychological, social, spiritual, emotional and practical needs of the patients and family members.”

Although the clinic will assist all of Unity’s cancer patients, the initial focus will be on patients with gynecological and prostate cancers. Carrino-Tamasi points out that a shortage of specialists factored into the decision to concentrate on gynecological cancer care. “There are very few gynecologic oncology specialists in the District. The defined intake and assessment process that we’ve established for GYN cancers, coupled with the navigation and wraparound support services provided at the Johns Hopkins Cancer Care Clinic located at Unity, creates direct and timely access to gynecologic oncology specialists.”

The Kimmel Cancer Center located on Sibley’s campus is open to all Unity Health Care patients who have a cancer diagnosis, including those with breast cancer.

Unity Health Care’s gynecological and prostate cancer patients will have access to a multi-disciplinary cancer consultation clinic at Sibley that expedites the treatment planning process into a single day rather than multiple consultation appointments on different days. This process aims to reduce emotional distress and travel costs, and reduce missed work days for patients.

The DC Department of Health’s latest report lists the top four cancers in the District in 2012 as breast, prostate, lung and colorectal — a finding reiterated in more recent data from the U.S. Centers for Disease Control and Prevention, According to the 2016 data, for every 100,000 people in the District, 123.3 women were diagnosed with breast cancer, 28 with uterine cancer, nine with ovarian cancer, and eight with cervical cancer. Among DC men, there were 117 new diagnoses of prostate cancer that year per 100,000 people.

Carrino-Tamasi explained that the clinic will follow the model of place-based health care. Place-based systems of care take responsibility for providing care for all people living within a select geographical boundary. The model is designed to generate partnerships between health and community resources that address the social determinants of health and to also provide convenient and culturally sensitive health care. Place-based care is gaining popularity as examples demonstrate that concentrating resources within smaller communities can create a healthier environment.

Harrison believes partnerships that come from place-based care benefit residents. “I feel very passionate about [the partnership] because I really feel like the service that our patients in wards 7 and 8 need and want to have, they just don’t know how to access,” she explains. “Unity has a strategic plan for providing comprehensive care in the area whenever possible. So we are really looking to partner whenever and wherever we can to provide complete comprehensive care.”.

The Sibley Memorial Cancer Clinic at Unity Parkside will accept patient referrals regardless of whether a person is covered by health insurance. Sibley accepts all major commercial insurance and managed care organization (MCO) plans, Medicare and DC Medicaid. Patients can start receiving navigation services as soon as the Unity team receives an oncology referral from their primary care physician.