Comprehensive Care at the Ourisman Center:
New Initiatives Promote Breast Health Without the Stress

The Betty Lou Ourisman Breast Health Center at Lombardi has been designed to make breast health care as easy and comfortable as possible, offering the physical examination and imaging services of health care professionals who exclusively subspecialize in the breast. Devoted solely to breast health care, these doctors, nurses and technologists – working within steps of each other – afford seamless, confident, accurate medical management.

More than this, the Ourisman Center strives to take the stress out of managing breast health, providing patients with services that make life just a little bit easier. One of the Center’s goals is to increase women’s access to breast health care. “We often have high risk patients who want more follow-up in their care,” said Shawna Willey, MD, Medical Director of the Ourisman Center. “The independent practice of the nurse practitioners allows us to provide this within the context of Lombardi, which also includes access to surgeons and medical oncologists, as needed.”

In March of 2006, the Center began offering a new clinical service to their patients. Minna Manalo, MSN, CRNP, and Theresa Harrington MSN, CRNP, Ourisman’s nurse practitioners (NPs), started their own practices seeing patients independently.

These new practices compliment Ourisman’s screening services and the clinical breast care program. The Center offers the physical examination and imaging services of health care professionals who exclusively sub-specialize in the breast. With their new practices, Minna and Terri have expanded the clinical breast care program from one to three primary providers.

“As nurse practitioners, we bring a different perspective to medical care. We have a focus on education and instruction, not just the disease,” said Terri. “It's a more holistic approach.”

NPs are registered nurses with advanced academic and clinical experience, enabling them to diagnose and manage many common and chronic illnesses, either independently or as part of a health care team. Both NPs at Ourisman are certified breast health specialists and are available to treat patients both pre- and post-surgery, patients with benign breast conditions, and patients at high risk of breast cancer.

Minna and Terri continue to work as part of the Ourisman health care team with the breast surgeons and Robert Warren, MD, Co-Director of the Ourisman Breast Health Center and an attending physician in the clinical breast care program. “We provide continuity of care,” explained Minna. “If Dr. Willey is not available to see a patient, I often am. In the clinical breast care program with Dr. Warren, we work together to achieve excellent patient care.”

Another important part of the Center is the services provided by the breast surgeons. Many women visit Ourisman for procedures including biopsies, lumpectomies, and mastectomies. One recent addition to this service, now celebrating its one year birthday, is the patient navigator program. 

“I was sitting in the surgical waiting area in my booties and hospital gown, wondering where I was supposed to go, when my patient navigator introduced herself,” said Anne Holman, who was at Lombardi on February 17th, 2006 for diagnostic surgery with Dr. Willey. Doctors had just discovered a 5 millimeter tumor in Anne’s breast, and Dr. Willey was concerned it may have spread to her lymph nodes.

“They told me I had to go to nuclear medicine,” Anne said. “And I had no idea where that was. But here came my little angel in disguise – my patient navigator.” Her navigator handed her a Ritz Carlton spa robe to wear and took her to all of her pre-surgery appointments throughout the hospital, staying with Anne until it was time for surgery.

“It made such a difference,” she continued. “You feel so lost, even if you have your family with you. You feel like a little pebble on the beach. And this patient navigator comes and says, ‘This is where you are, and this is where you’re going.’ Then she brings you back again so you don’t have to drop little grains of rice along the way. It’s a wonderful program.”

In 2004, Dr. Willey and Minna brought together a committee of staff members and patients who would design the program.  Joining the staff in July of 2005, Program Manager Nancy Muzeck developed and implemented the final program by fleshing out the initial plans, and doing significant research on other Centers’ programs. 

Plans for the program were initiated in late 2004 thanks to a grant from the Polo Pink Pony Fund and a generous personal gift from Ralph and Ricky Lauren. It operates as a partnership between the Lombardi’s Nina Hyde Center for Breast Cancer Research and the Ourisman Center.

By December of that year, Georgetown University Hospital (GUH) volunteer navigators were assisting their first patients. In December 2006 the program expanded from patients seeing Dr. Willey to patients seeing all four breast surgeons.

Julie Aaron was one of the members of the initial committee which planned the program. As a patient – she had just completed her post-operative visit with Dr. Willey – and as a member of the GUH staff for 29 years, Julie knew her way around the system.

“The benefit of this program is the additional support it provides to the patient and their family and friends,” she said. “I think that in some ways we are enabling them to have more control over the situation because when we’re walking and waiting with them, we can provide answers to some of their questions, like whether their husband or friend can come with them to the appointments.”

Julie is quick to add that navigators are not there as a medical resource. Navigators refer any medical questions to the patients’ doctors and nurses. But they are available to assist with additional care services that may be needed. For example, each navigator begins with a brief needs assessment survey, which helps the navigator identify what kind of educational materials and referrals to other resources a patient needs.

One of the first parts of the program that Dr. Willey organized was working with the Ritz Carlton to provide robes to patients for their hospital stay. Each breast surgery patient receives one of the famous robes, which navigators say has had an incredible impact on the comfort-level of women walking through the hospital.

All of the patient navigators who participate in the program are volunteers. Some, like Moira Hilscher and Valerie Trabosh, are Georgetown University students. Both women are interested in careers in medicine and searched for a volunteer opportunity in the Hospital that allowed them to have interactions with the patients.

“The patients are so surprised and excited by a person who cares for them. I will continue volunteering with Ourisman for as long as I am at Georgetown,” said Valerie, a 4th year PhD student in the department of biochemistry.

On the other hand, Moira is a pre-med undergraduate student. Her experience volunteering in the Ourisman center has made her want to pursue a career in medicine even more. “We are helping people in their greatest need,” she explained.

Other navigators, like Carol Wells, want to work in a hospital setting, but are not exactly sure how they can help. Carol is a retired law firm administrator who signed up for the GUH volunteer program, run by Sara Kish, the director of Volunteer Services. Sara places volunteers in different parts of the hospital, including inpatient and outpatient areas, as well as office settings. For the navigator program she looks for volunteers who can meet the early morning schedule of surgery patients and people who can work well with patients one-on-one. She placed Carol in the navigator program when it began a year ago.

“Patients just appreciate having someone there with them and it makes me feel great when I can do that for people,” Carol said.