Over the past several years, Florida Hospital has been working to expand their Digestive Health program throughout Central Florida and redefining the healthcare delivery model for treating colorectal cancer. John Monson, MD, was brought on to lead the charge of what would become a much bigger project, one not only focused on overall digestive health but also the patient experience. Committed to changing the paradigm of colorectal cancer care, which had long been an area of healthcare that has lagged behind in the U.S., Florida Hospital began aggressive recruitment of surgeons and teams to expand their world renowned programs and bring services to the patients in their communities. The goal was to offer a patient-centric experience, providing expert care close to home. Now, the Digestive Health program has expanded in size and scope, providing comprehensive colorectal services across an extensive geographical area.
The Digestive Health program is a collaboration of Florida Hospital specialists including gastroenterologists, pancreatic surgeons, liver surgeons and colorectal surgeons focused on coordination of care. The growth of the Digestive Health program, led by Dr. Monson, included implementing changes in the colorectal surgery program to accommodate the needs of patients at multiple locations. This change further streamlined the clinical practice and expanded the clinical footprint throughout Central Florida.
According to the American Cancer Society more than 140,000 new cases of colon and rectal cancers will be diagnosed in 2018. Colorectal cancer is expected to cause more than 50,000 deaths making it the second leading cause of cancer-related deaths among men and women combined. While the death rate has been dropping for decades, due in part to screenings and early diagnosis, there has been a disparity among colorectal cancer survival based on a person’s zip code and the access they have to life saving screenings and specialists.
“It has been referred to as the zip code lottery,” says Monson.” Where a person lives directly translates into outcomes.”
GROWTH AND EXPANSION
Florida Hospital has made enormous investments in bricks and mortar, technology and equipment to further the focus on colorectal surgery and digestive issues and bring services to the patients, rather than requiring them to travel for care. Additional colorectal surgeons were brought on to staff existing and new clinics throughout Florida Hospital campuses. The colorectal surgery practice is now comprised of nine surgeons, with services added to Florida Hospital campuses in Celebration and Kissimmee. Surgeons were also added to existing teams in Altamonte Springs and in East Orlando. A new clinic was built on the main Orlando campus and there are future plans for growth in Apopka, Winter Garden and Florida Hospital Memorial on the Space Coast.
The response from the community and campuses has been very positive.
“For patients, whose natural home base is Celebration or Kissimmee, they are very happy,” says Monson. “These hospitals are now served by a well recognized colorectal group with an international reputation for quality. There is consistent, 24/7 coverage for these patients. In turn, the number of patients needing to be transferred to the main Orlando campus has now dramatically decreased.”
Committed to pioneering how healthcare is delivered, Florida Hospital also built a brand new research facility on the Orlando campus dedicated solely to health services research. The Surgical Healthcare Outcomes Consortium (SHOC) includes a new suite of research offices and staff all dedicated to the care delivery project as well as innovative trials available in both technology and treatment options.
“This was the first facility of its type,” explains Monson “We recognized that it was extremely critical that we examine the way we deliver care to patients. What drives successes in clinical care, what drives obstacles, why is there such a spectacular level of diversity of care provided to people around this country?” The Surgical Healthcare Outcomes Consortium was established to allow us to understand the delivery of care and best value of care for our patients.”
Research looks at everything from managing electronic medical records, to geographical challenges, to getting doctors and hospitals to talk to one another.
EDUCATION AND ACCREDITATION
Expanding the educational portfolio has also been critical for the Florida Hospital teams as they continue to build a model that will last for decades to come.
“We have expanded our fellowship program, bringing two additional fellows on this year and in 2019,” says Monson. “This year we will have five fellows, which is a significant expansion.”
The program continues to offer training and education courses. Last year Florida Hospital hosted the inaugural Orlando Colorectal Congress, a three-day event featuring national and international faculty.
Monson believes that Florida Hospital is the perfect location to investigate issues and implement new ideas.
“My research over the last 17 years has been focused on analyzing delivery of care, developing new treatments with clinical trials,” says Monson. “This colorectal group has always been very active from a research and education standpoint and is one of the most productive colorectal groups in the state of Florida and in the entire Florida Hospital system.”
Recently the Institute has completed the inspection process by the Commission on Cancer to be approved by the National Accreditation Program for Rectal Cancer (NAPRC). This accreditation resulting from the collaboration between the Digestive Health program and Cancer Institute would be the first in Florida and a unique step forward for the care of patients.
Monson recognizes that implementing new ideas to benefit the patient care experience, especially in a system such as Florida Hospital, which has its origins in private practice, is a big project. But, with population growth and the demand for highly specialized practices Florida Hospital is well poised to meet those needs and continue to grow the Digestive Health program by laying the foundation in education, training and research.
“It’s important to look at examples of best practices around the world when redefining healthcare delivery programs,” says Monson. “No one has the patent on excellence across the board, but by partnering with national consortiums, we will continue to build on the training and research that we have access to here in the Florida Hospital system and we will make great strides in the delivery of care for our patients.”
Monson knows this success depends on a group of people focused on the broader, balcony level view of healthcare. And, he believes that from the overseas observers and the fellows that come to Florida Hospital for the specialized training, to the new surgeons joining the team, and research outcomes, Florida Hospital is well positioned to change the way healthcare is provided for patients in need of digestive health and colorectal cancer specialists.
“It’s a major revamp of colorectal cancer care,” says Monson. “Where physicians, surgeons and clinicians work it all out for patients in one package for a bespoke and personalized approach – and now in multiple locations, for the convenience of the patient.”
By Katie Dagenais