Beyond Chemo: Supportive Care at City of Hope

March 15, 2017 | by Samantha Bonar

Matthew Loscalzo Matthew J. Loscalzo, L.C.S.W.

With a focus on healing the whole person, City of Hope takes supportive care for cancer patients just as seriously as their medical treatment.

The Department of Supportive Care Medicine, a tightly knit unit that includes physicians, advanced practice nurses, clinical social workers and chaplains, works together to help patients with serious illness face complex challenges related to physical, spiritual and emotional stress.

Patient-centered Treatment

The hub of supportive care is the Sheri & Les Biller Patient and Family Resource Center, but spokes include mental health professionals in psychology and psychiatry, child life specialists, Positive Image CenterSM cosmetologists, patient navigators, health educators and nutritionists.

It’s one of the largest such supportive care teams in the world and the first of its kind in the country.

The Department of Supportive Care Medicine at City of Hope is unique because there is a Department of Supportive Care Medicine,” said Matthew J. Loscalzo, L.C.S.W., executive director of the department and administrative director of the Biller Patient and Family Resource Center. “It is the first fully integrated, fully interdisciplinary supportive care program in the country. All of the supportive care services are integrated into one department with one chair and one executive director. This is highly unusual.

The reason such a setup is important, he said, “is not only do you have the efficiencies of the departments talking with each other under one roof, but also you have the opportunity to create a program that is patient- and family-centered from day one. That concept is revolutionary, evolutionary and entirely disruptive.

“Our vision for the department is to be the best program for supportive care medicine in the world,” he said. “And you cannot be the best supportive care medicine department in the world if you don’t have your values stated, and our values are very clear: Everything we do is from the perspective of the patients and their families, not the professionals.”

Interactive Care

When a new patient comes into the center for the first time, before they even see a physician, they are given a touchscreen with a program called SupportScreen that asks them questions about pain, anxiety, insomnia, finances, transportation, substance abuse in the home, how their spouse is coping and more. City of Hope was the first hospital in the country to develop such a touchscreen program; it has now licensed it to five other hospitals.

“As they fill this out, we are educating them about typical problems that cancer patients have, as well as destigmatizing them,” Loscalzo explained. Then, “in real time, an email goes to the appropriate professional” who can help them with their concerns. In this way, Loscalzo said, the patients drive the clinical visit. “That’s pretty unique,” he said.

“The way you do right by patients and families is through support screening to know what the patient’s values are and to base the treatment on that open and honest communication,” he added.

‘Powerful, Meaningful’ Goals

Just as important, the supportive care team assists with navigating common health care decisions, such as advance health care planning and documenting goals for cancer care through all its stages. The team also ensures that these documented discussions are communicated to the whole hospital system to ensure that all treatments offered match the patients’ goals and values.

For example, an intensive care unit program has families of very ill patients fill out a touchscreen about what they need, and it’s sent to their team of physicians, nurses and social workers. A meeting is set up to go over goals of care. “It’s very powerful, very meaningful,” said Loscalzo, the Liliane Elkins Endowed Professor in Supportive Care Programs.

Personalized Programs

In addition, the resource center has three paid staff who do nothing but put together highly personalized programs based on more than 27,000 SupportScreen surveys of patients and families, as well as input from three advisory committees made up of patients and families.

Some of the services offered include guidance about benefits, patient navigation assistance, access to nutritionists, clinical social workers, psychiatrists, psychologists and chaplains, cancer and bereavement support groups, art, massage and music therapy, and cosmetology services including wigs, scarves and makeup tips.

A patient resources coordinator takes care of the practical details such as financial assistance, transportation to appointments, health care referrals, support groups and childcare.

“We need all of your energy to be focused on getting healthy,” Loscalzo said.

Treating the Whole Family

In addition to services for pediatric cancer patients, “We’re one of the few places in the world who actually has a child life worker who focuses on the children of cancer patients. That is rare,” Loscalzo said.

The center also offers a gender-specific couples-counseling program. “No one else in the country has this,” Loscalzo said.

In the end, “We want to focus on the strengths of people,” Loscalzo said. “We don’t want to focus on what is lost. We want to focus on what is left. We see the whole person. We want to make this a growth experience. That’s what makes us very different.”

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