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Cancer Center gets green light to move ahead

STORY BY MEG LAUGHLIN (Week of November 28, 2013)
Photo: Board Chairman Tom Spackman votes yes to the building of the cancer center.

Indian River Medical Center is now moving full-speed ahead with preparations for a $48-million, Duke-affiliated Cancer Center following a 6-to-1 vote in favor of proceeding by Hospital District trustees.

The approval marked a dramatic turnaround by District trustees, who only a couple of weeks ago seemed to favor holding off on launching the ambitious Cancer Center project until the hospital had successfully fixed a variety of operational problems and staunched the current flow of red ink.

What turned the tide for the majority of District trustees was a promise from hospital board chairman Tom Segura that the hospital would hire an independent consultant to evaluate hospital operations from the top down and report back to the District.

“Issues with the hospital need to be addressed and I was heartened that they will be with the top-down evaluation,” said District trustee Trevor Smith, who with three other District trustees had previously been hesitant to approve the Cancer Center.

Along with financial concerns, the operational issue that has drawn the most attention in recent months was the average wait time of almost six hours for people coming to the hospital emergency room.

In response, the emergency room management team and most of the emergency room doctors have been terminated as of this Sunday, and a new physicians group will take over with a goal of cutting the time it will take for a decision on admitting or discharging patients to 180 minutes.

The green-light for the Cancer Center also followed pledges by Segura that the medical center would hire a new chief operating officer in early 2014 to fill a position vacated four months ago, and would tie top executives’ salaries to financial and operational performance. Segura also said that the money for the Cancer Center would “come exclusively from donor dollars” and not cut into the existing hospital’s operational budget.

The offerings by Segura convinced six of seven District trustees to endorse the Cancer Center.

 “We will do everything we can to fulfill our commitment to the taxpayers and the community,” said Segura. “We need a broader and deeper cancer program, which will come from a full-time director and our strategic partner, Duke.”

Groundbreaking for the Cancer Center Pavilion will take place in 2014.  Completion of the Cancer Center and renovations of the operating suites and inpatient oncology wing is slated for 2015.

“With these improvements, more patients and their families will be able to stay close to home to receive the very latest in cancer diagnostics and treatment,” said Jeffrey Susi, hospital CEO. “And, for those who need to leave the area for second opinions or very specialized services not available locally, our Cancer Care Coordination team will assist them in finding the best centers of excellence in the nation and help coordinate their care.”

After the Cancer Center was put on hold in October, hospital senior leadership held meetings at some of the island’s most prestigious communities, assuring donors that all was well, and it was time to proceed with the Cancer Center. Repeatedly, they said if the Cancer Center continued to be delayed, fundraising momentum could fall by the wayside and donors would back out.

Their efforts inside and outside of the hospital influenced three of the seven District trustees to support proceeding with the Cancer Center. But four trustees remained hesitant right up until Thursday’s meeting. 

To shift the vote, Segura met with them one-on-one last week, sweetening the pot with the offering of the independent operational consultant. 

At Thursday’s monthly meeting, before the vote took place, Segura repeated these promises and said that the Duke heart program at the hospital proved that “we could put together something from scratch and make it great.”

“Next is cancer,” he said.

District trustee Mike Weiss, the only trustee to vote against proceeding immediately, asked why the existing cancer program wasn’t enough. Segura replied that the new program and building would “bring breadth and depth” to the hospital’s cancer care.

While he felt “blessed by the philanthropy” in Vero Beach that would fund the center, Weiss said he still worried about losing money.

Trustee Trevor Smith, who had consistently questioned the hospital’s changing numbers, complimented the “generosity of the benefactors which has been extraordinary,” but said that it concerned him that “the hospital is taking on an awful lot right now” and that he hears “from a number of people that we have to do something about the hospital.”

But, ultimately, the changes promised by Segura convinced Smith, along with District trustees Tom Spackman and Burton Lee to vote for building the Cancer Center.  

Hospital District attorney Jennifer Peshke read a statement from Lee, a retired senior physician from Sloan-Kettering in New York, who was vacationing in the Bahamas.

In these times of “financial uncertainty,” he advised going slowly with the Cancer Center because “we don’t have the funds to underwrite it.” But, nevertheless, he voted for it, along with Spackman and Smith and the three District trustees already supporting it.

After the applause, someone in the audience congratulated Segura on being successful.

“It’s not me,” he said. “It’s a success for the community.”