Focused care: hospital specialty centers from bariatric to orthopedic.

• Author: Held, Shari
• Position: HOSPITALS

ACROSS INDIANA hospitals are developing specialty centers to provide the focused care for conditions ranging from cancer and headaches to organ transplants and brain surgery. By combining specialized staff, new technology and patient support services in a single location, these centers are meeting the needs of a growing number of patients.

Clarian Neuroscience Methodist and Indiana University Hospitals, Indianapolis

"Having sub-specialty expertise is what makes neuroscience centers stand out," says Dr. Gerald Szkotnicki, director of neuroscience for Clarian Health. "Our physicians are known nationally and internationally for their work on pituitary tumors doing different surgical approaches to that particular type of tumor ... We have often operated on inoperable tumors with positive results, because of the confidence and recent and highly specialized training of some of our physicians. They know they can get into a certain part of the brain like no one else can."

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Few centers have the latest technology that Clarian Neuroscience offers, such as the Polstar, an intraoperative MRI that allows surgeons to view changes in the patient's brain or Spine while the surgery is in progress. In its next phase of development, the center plans to add imaging equipment that will produce live images in the operating room that are as good as in any diagnostic center. Clarian Neuroscience also has an in terventional neuroradiology suite for surgery performed using special miniaturized tools.

"It is minimally invasive brain surgery using the vascular system to access the brain," Szkotnicki says. "There's a huge shortage of such specialists, so we are lucky to have two of the nation's top specialists in neurovascular work. We are happy to have that service available, and it's available 24/7 for emergencies."

Neurotrauma is a strong part of the neuroscience program and multiple specialists need to he available in "short order," but a full range of services are available for advanced elective surgery.

Szkotnicki also credits the highly trained and experienced staff of neuroscience nurses and other support staff with being the foundation of a neuroscience center.

Methodist Hospital will be the anchor site for Clarian's neuroscience center, and will provide the high-end, neuroscience diagnostic and interventional services.

Colorectal Cancer Center, St. Francis Hospital and Health Centers, indianapolisarea

More than 100 patients have come through the Colorectal Cancer Center since it opened last July. Dedicated to the prevention, diagnosis and treatment of colorectal cancer, the third leading cause of cancer deaths in Indiana, the center features the latest technology, such as megavoltage cone beam imaging for more precise targeting of tumors, and it has piloted selective internal radiation therapy for colon cancer that has spread to the liver. Patients can participate in 100 clinical research trials though St. Francis Cancer Research Foundation.

A multidisciplinary team of more than 25 physicians discuss every case that comes through the center, a virtual center that encompasses several St. Francis campuses, for a more coordinated approach to care. A unique feature of the center is the nurse navigator, who schedules appointments, testing and acts as a liaison between the patients and all the doctors. Having one point of contact makes the process easier for patients.

"What the center does is allow for improved communication," says Michael Morelli, M.D., medical director of the Colorectal Cancer Center. "It allows physicians with different expertise to work together, and it allows the nurse navigator to tie all that together to offer patients a more positive...