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Onsite primary care 11 Aggressive breast cancer study
ChristianaCare’s Helen F. Graham Cancer Center & Research Institute among first in nation to offer primary care onsite to cancer patients
Jennifer Newman was prepared for the challenges of her cancer diagnosis but losing her primary care provider (PCP) at the same time was not something she planned on.
“When you are fighting cancer and you find out you don’t have a doctor anymore for everything else, it is overwhelming,” Newman said. “I spent hours calling around to various primary care practices without finding a doctor in my network who was accepting new patients.”
The Helen F. Graham Cancer Center & Research Institute at ChristianaCare is among the first cancer programs in the nation to offer patients undergoing cancer treatment the opportunity to see a PCP onsite if they don’t already have one of their own.
When Newman started treatment with her oncologist at the Graham Cancer Center, she was able to get a referral to the Primary Care Practice right there in the building. “Besides cancer, I have a number of other health concerns that need continued monitoring,” Newman said. “Being able to go to one place for all the care I need has been a godsend.” The new Primary Care Practice builds on the success of the Oncology Express Unit, a pilot program at the Graham Cancer Center offering urgent care to cancer patients in distress during treatment.
Unique among cancer centers
“Our ability to offer primary care services to our patients who need them alongside a multidisciplinary roster of cancer services all under one roof is highly unique among major cancer centers,” said Nicholas J. Petrelli, M.D., Bank of America endowed medical director at the Graham Cancer Center. “By adding a primary care provider onsite, we are taking a somewhat novel approach to providing both the latest cancer treatments but also care designed to improve our patients’ long-term health.” Cancer diagnoses often happen unexpectedly, in a specialist’s office or in the Emergency Department, and more than half of patients diagnosed with cancer have other co-morbid conditions, including heart disease, high blood pressure, high cholesterol and diabetes.
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Sometimes cancer treatment can make these chronic medical problems even worse, so it is important for patients to continue to see a PCP during cancer treatment. This relationship particularly can be important for timely intervention when health issues arise that could otherwise lead to unnecessary urgent care or Emergency Department visits. Before opening the Primary Care Practice, planners conducted an informal survey among cancer patients at the Graham Cancer Center. “We found that as many as 15 percent of our patients did not have their own primary care provider,” said Cancer Program Clinical Director Cindy Waddington, MSN, RN, AOCN. Since the practice opened in January 2021, patient feedback indicates that percentage may be even higher.
“Having a PCP onsite at the Graham Cancer Center working closely with the entire cancer care team will help insure that essential patient care beyond cancer treatment is not delayed,” Waddington said. Patients are referred to the practice by their oncologists for any non-cancer health concerns. “Our focus is providing care for the whole person by addressing patients’ other medical needs during cancer treatment and by promoting healthy living for the long term,” said Family Nurse Practitioner Debra Delaney, RN, MSN, ACNS-BC, FNP-BC, who provides primary care services at Graham Cancer Center.
Managing routine care
Delaney helps patients manage their chronic medical conditions, monitoring labs, refilling prescriptions and coordinating and communicating about any referrals they many need. So far 157 patients have been referred to her care.
Her 20 plus years of experience at ChristianaCare includes 12 years as an advance practice nurse taking care of adult and pediatric patients in trauma and acute care settings. She has a keen interest in cancer care delivery and works closely with cancer care providers at the Graham Cancer Center, including members of each patient’s multidisciplinary disease site clinic team.
When patients complete active treatment, Delaney connects them with another PCP if they would like to continue to receive primary care at ChristianaCare.
Jennifer Newman
Promote healthy living
“We promote healthy living both during and after cancer,” Delaney said. “When their cancer treatment is completed, we can help our patients transition to other practices where their primary care needs will be met.”
Delaney also takes time listen to her patients' concerns and challenges as they go through cancer treatment and uses her contacts in the community to connect patients with any resources they may need.
Patients like Newman are enthusiastic with praise for Delaney’s support and attention to their health concerns as they move through cancer treatment.
“What I love about Debra is that she really cares about her patients,” Newman said.
“Everything and everyone has been so friendly and welcoming. I am so grateful for this program, and the care I have received for the past nine months.” The Primary Care Practice sees patients by referral five days a week. Appointments with the nurse practitioner are available Mondays through Wednesdays and Fridays from 8 a.m. to noon and on Thursdays from 11 a.m. to 3 p.m. The practice is located in the Oncology Express Unit on the first floor of the Graham Cancer Center in the West Pavilion.
