Breast cancer patients at Parkland hospital currently cram into a 7,500 square foot facility, not much more than a portable building that is not easily accessible. Multiple appointments at multiple locations are required for diagnostics, treatment, imaging, and other services. Many of the patients who seek care at Parkland have additional hurdles to care, such as transportation and childcare.
Patients change into gowns and put their belongings in a plastic bag where they wait in a room with other patients, and carry the bag from room to room for mammography and consultation. If patients don’t speak English, translation services are in person only three days a week, and a video interpretation service is used when translators aren’t available. Twenty percent of Dallas County patients receive their breast cancer treatment this way.
For the staff, things aren’t much better. The staff room is also the storage room, the room where incarcerated patients wait away from the others, and the yoga and relaxation room for patients.
But at the Moody Center for Breast Health, set to open in 2021, many of these problems will be solved, offering top of the line treatment that is both convenient and accessible. “We wanted to create something where it’s easy for them to get there, and it provides a little bit of hope. If they were to have a bad diagnosis, they’re more likely to come back. And it makes it easier for them to come back,” Meredith Brelo, a vice president at HKS, which designed the new center.
The new facility, which was built with $40 million in fundraising, brings medical oncology, surgical oncology, plastic surgery, infusion, imaging, physical therapy, and more under one roof, making the visits much more convenient. The new center is just across the DART line from Parkland hospital, making it more accessible to the patients who need it most. The facility is 40,000 square feet, with multiple exam rooms, semi-private waiting areas, and a patient flow that allows for convenient and comprehensive care. It is built to care for three times the number of patients the clinic sees typically. There will be lockers for patients’ belongings, a sub-waiting room that is somewhat private, all equipped with calming design to offer comfort to patients going through difficult diagnoses.
The new center’s welcoming design and convenience are meant to make sure patients return for follow-up care after their initial diagnosis. This is important for the patient’s care and is more efficient for the health system as a whole. One study said that missed appointments cost the US health system $150 billion a year. Cancer, especially, is less expensive the earlier it is treated. When breast cancer is detected early, the five-year survival rate is 99 percent, according to the American Cancer Society. This also avoids expensive and invasive treatment further down the line.
“In designing this facility, we took into consideration the challenges that folks have. The idea of this facility was to look at the challenges and determine what we could do to make sure they received appropriate care,” says Dr. Philip Evans, professor of radiology and chief of the breast imaging division, and the medical mind behind the center. “Of all the people in the world who need to have one-stop shopping, it’s the people who come to the Parkland Breast Center.”
The center also provides for men and transgender patients who have breast cancer, making sure that patients are given the privacy they need. In November, a new childcare center at Parkland will open up, allowing parents and caregivers an opportunity to get treatment without arranging for alternate care, a significant obstacle to care for many. The team was tasked with answering tough questions about patients dealing with cancer. “How can we bring dignity to these women and the staff?” Pinto-Alexander says. “How do we evoke trust and confidence that it is okay for a woman to come here and have a first-rate examination?”
One way to improve care was to design collaboration into the building. Instead of having the typical nurse station and offices, teaming rooms were created in the clinic to allow clinicians to have multidisciplinary discussions about patients. “They have a better opportunity to kind of collaborate, as opposed to working in these silos that they do when they have all these disparate clinics,” Brelo says.
The new facility is designed to better fit the staff’s needs, who will have their own space. “We’re designing for the staff to provide a moment of respite because they’re so important, says Ana Pinto-Alexander, director of health interiors and principal at HKS. “We have always known that the staff is the key. But right now, we have a special empathy, love, and gratitude for them.”
Design for the building began in 2017, so adjustments had to be made as the pandemic took hold. Patient flow, cleaning and sanitization, furniture layout, and social distancing had to be considered in a post-COVID-19 world. Touchless bathrooms, removing air dryers, adding hand sanitizing stations, patient flow organization, and other modifications had to be made after construction began.
The clinic will address the structural inequalities in Dallas County, providing improved, efficient care. “We’re closing the gap for people who have long times between appointments and treatment,” Evans says. “We want to make sure our needy patients are getting the treatment when they need it.”