WOONSOCKET -- The quality of care offered at Landmark Medical Center, a 214-bed community hospital, can't be measured by its physical size, hospital officials say.
Especially, not now.
The hospital is ambitiously revamping procedures, undergoing major renovations in joint ventures with well-established health-care organizations and raising the patient-service bar. It recently opened a cardiac care center in collaboration with Beth Israel Deaconess Medical Center, streamlined its emergency room services, and yesterday, administrators announced the creation of a new $6.1-million cancer center at the hospital.
Hospital officials say a 12,000-square-foot cancer center with state-of-the-art technology will be built adjacent to the main hospital building on Cass Avenue. Landmark's cancer center, in partnership with the Lahey Clinic, based in Burlington, Mass., which will provide oversight, and with Radiation Therapy Services Inc., is expected to open its doors in early summer 2003. Treatment will be administered by oncology physicians originally based at Massachusetts General Hospital in Boston.
The center's Certificate of Need application was approved this month by the state Department of Health and the Health Services Council. Yesterday morning, a groundbreaking ceremony drew U.S. Sen. Jack Reed, U.S. Rep. Patrick J. Kennedy, and several other politicians and medical officials to the hospital's grounds to laud the effort.
Gary J. Gaube, president and chief executive officer of Landmark, said the new cancer center, three years in the making, should be "a godsend" to people in the region, where, he said, there is a far higher rate of cancer than other areas.
"The cancer rates in Northern Rhode Island are about 29 percent higher than the U.S. average," said Gaube. "The rates here are about 8 percent higher than the Rhode Island average."
Given the area's large elderly population and taking into consideration the fact that many older residents' worked in the unhealthy environment of the mills, the higher cancer rates should not be unexpected, Gaube said. "The need for the cancer center is here -- dramatically so -- and we'll serve the people of this region far better than they have had in the past."
Another city health-care administrator agreed, praising Landmark's newest addition.
"It's not every community hospital that will take on a project of this magnitude and deliver this quality of care to the community," said Maria Montanaro, chief executive officer of Thundermist Health Associates in Woonsocket.
Montanaro, a cancer survivor, said that too often, sick people in the Blackstone Valley region "have had to settle for care that's less than the best" and that traveling any distance for the best treatment is exhausting both physically and emotionally when you're in the throes of the disease.
Years ago, when she was undergoing cancer treatment, Montanaro related that she could "never, ever have endured the commute to Boston" for radiation therapy. "Even a trip to Providence can be prohibitive for [cancer patients] in this area."
Currently, there are no full-service cancer treatment centers between Providence and Worcester, Gaube said. "We're going to fill that gap."
Generally, people diagnosed with cancer get radiation treatments, the most common treatment for cancer patients, for about a month and a half with an average of roughly 20 treatments.
Chemotherapy and radiation treatments take a heavy toll on patients, family members and caregivers alike, Gaube said. With this in mind, the hospital will offer van service from patients' homes to the new center, allowing patients to receive care without having to stay in the hospital overnight.
The cancer center will feature "focused beam" radiation and other services not available before locally. Most radiation is delivered in an older, less-precise technique called "broad beam," according to hospital officials.
"Broad-beam radiation can damage surrounding healthy tissue, among other problems," Gaube said. "The focused beam of radiation therapy that the center will have allows a stronger and more accurate dose directly at the tumor."
For small community hospitals such as Landmark, medical officials say, it's increasingly important to ally with a larger health-care system, so the hospital can work favorably with managed-care contracts, at the same time that the hospital is enhancing clinical services and lowering costs.
In 2000, the Lahey Clinic signed the agreement with Landmark to provide treatment services when the cancer center opened its doors. Then, plans called for a much larger center -- nearly 50,000 square feet -- that would have cost roughly double the current $6.1 million center.
"Due to financial problems we ran into two years ago, we had to reconfigure our plans, and along the way, we discovered a more creative way of starting the cancer center," Gaube said.
Lahey, which has facilities north and northwest of Boston, also provides services to medical practices in dozens of communities in eastern Massachusetts.
Cancer treatment is a big, competitive business, and comprehensive care centers to treat the disease are becoming more prevalent nationally because it can keep them afloat, medical officials say. Cancer is the second-biggest killer nationally, after heart disease.
So, although the new center should be a boon for Landmark financially, patient-friendly care at the community hospital will still be priority number one, Gaube said.
"Our patients are never just a number; they are known by their doctors and nurses by their names. Because we are so small, we stress treating the whole person. You don't get lost in the crowd around here," Gaube said.
The general contractor awarded the job of building the cancer center is Cranston-based O. Ahlborg & Sons Inc. The architechtural firm is New England Medical Design.
Other improvements include the hospital's emergency department, which has recently been reorganized with the introduction of upgraded equipment and an Express Care wing so patients with minor problems are treated more quickly and more comfortably.
"It wasn't very efficient before," said Dr. Walter Simmons, the ER's assistant medical director who worked with director Dr. Emilio Belaval to reduce bottlenecks. "When the staff was really busy with patients that had serious, acute problems, other patients had to wait sometimes for up to three hours with nothing really being done for them. That's a disservice, and not uncommon in larger hospitals."
Now, with the introduction of the fast-track service, all patients get their requisite lab work, such as blood tests, attended to immediately, Simmons said. Lab equipment is located near the ER, increasing medical personnel's ability to track patient care.
Wait times have been reduced to approximately 45 minutes, Simmons said. "Our goal is get it down to 30 minutes," he added.
The system is working, according to long-term hospital staff.
"When we're not bogged down, it really does help to keep a work flow going," said 24-year Landmark veteran nurse Sheila Iacone.
