Jordan Report

King Hussein Cancer Center expansion to house state-of-the-art facilities?

King Hussein Cancer Center in Amman, one of the region’s leading cancer hospitals, is in the process of expanding its facilities to accommodate the high demand for its sought after services. Middle East Health speaks to Dr Asem Mansour, the CEO and Director General of KHCC, about the expansion, what new facilities it will house and the challenges they have faced.

Middle East Health: KHCC is expanding with the construction of two new tower blocks. When are they due to be completed and operational?

Dr Asem Mansour: The new towers are seen to be fully operational by early 2017, after the completion of all needed construction work, equipment installation and testing.

Middle East Health: Why was it decided to expand the cancer centre?

Dr Asem Mansour: Based on the last Cancer Incidence Report, Jordan had an average of 132 cancer cases for every 100,000 population. For KHCC, this translates into approximately 60-70% of patients being treated at the centre, between 70% national and 30% international patients. This means that the centre is actually working on full capacity all year round. KHCC receives around 3,800 new cases annually and has to reject many due to full capacity, so the need for the expansion emerged. The capacity needs to be more than double the current capacity to meet the patients’ treatment needs for now and 10 years ahead.

Middle East Health: I understand the expansion will provide 84,000 sq. m. of new space and will be three times bigger than the current area of the centre. How tall will these towers be and what will they house?

Dr Asem Mansour: The in-patient tower will consist of 12 functional floors and the out-patient tower will consist of 9 functional floors. The in-patient tower will have capacity to take 182 patients and the tower is being equipped with state-of-the-art medical equipment for diagnostic and therapeutic purposes along with six operating theatres that have the latest technologies. As for the out-patient tower, it will house an endoscopy and bronchoscopy unit, an education and training centre, general oncology clinics as well as dentistry, audiology and speech therapy clinics. Additionally, it will house a women’s centre, which is a comprehensive floor that consists not only of breast clinics, but also a Breast Imaging Unit which includes ultrasound and mammography services. Moreover, and since we have a holistic approach, we don’t only focus on the medical side, but also provide psychosocial and spiritual support as well, in addition to a beauty salon. The tower also includes Bone Marrow Transplant (BMT) clinics for adults and paediatrics along with an Applied Genomics lab. In addition, the KHCC will establish a healing garden within its premises in line with the centre’s initiative to provide a comprehensive care experience for patients. The garden will be built with the highest safety measures to insure a secure space for kids to play with one another. It also serves as a safe haven for kids, their families and KHCC staff to interact and host a variety of outdoor activities such as summer camps, storytelling and more.

Middle East Health: Will you be taking more foreign patients following the expansion?

Dr Asem Mansour: The centre currently receives around 1000 international patients annually, and we expect the number to increase, considering the high quality care available at KHCC and the increase in the success rates for the majority of cases. Because of this, many patients prefer to choose KHCC as their destination for cancer care, and with the expansion, it will become possible to accommodate more foreign patients.

Middle East Heatlh Will you be moving some departments across to the new towers or will they mostly house completely new departments?

Dr Asem Mansour: Some departments will be moved across and completely new departments will be established, so it is a mixture of both. As it was highlighted earlier, one of the towers will be dedicated for clinics, as the current out-patient building will no longer exist. Also, the diagnostic radiology and radiation therapy will be among the departments that will be moved across the bridge.

Middle East Health: Which new specialties / departments will you be introducing?

Dr Asem Mansour: The new facilities will feature a cutting-edge Cell Therapy and Applied Genomics Floor, including the first public cord-blood bank in Jordan, and state-ofthe- art stem cell labs. Having a national public cord-blood bank with a capacity of 10,000 units collected from Jordanians enhances the chances of finding matching cord-blood units. Moreover, among the new services that will be available at the towers is a Brain Suite, which will offer state-of-the-art intraoperative navigation techniques accompanied with functional magnetic resonance imaging (fMRI), which will improve precision during neurosurgery.

Middle East Health: Moving across to the new towers will pose some major challenges – could you tell us about some of the challenges you expect and how you plan to resolve them?

Dr Asem Mansour: One of the most importantchallenges that we are facing right now is determining the opening date for the new tower considering that there have been delays on the part of the contractor. This has become very challenging as we have to start the employment cycle for most positions at least 6 months prior to opening. In case of unanticipated delays, there would be significant financial loss to the centre if we hired all the needed staff. Conversely, delaying staff and equipment beyond the handover date, would also cause significant revenue losses to the centre. Another challenge that the new towers pose will be the duplication of some of our services such as radiology, radiation oncology, pharmacy and operating theatres. When services are provided in more than one location, quality assurance becomes more difficult. Therefore, the new building contains some new systems, such as an advanced nurse call system and pneumatic tube system, which will assist in maintaining quality assurance. Moreover, patients may develop a certain preference for wanting to be treated in the “new” building when schedules of certain resources may mean that patients will have to go to the “old” building. KHCC now has a “campus” composed of multiple buildings, facilities and locations, which will be challenging for departments such as maintenance and security.

Middle East Heatlh: One of the floors in one of the towers will be for gene therapy. What exactly will you be offering here – as I understand much of gene therapy is still in an experimental stage?

Dr Asem Mansour: The establishment of a Cell Therapy and Applied Genomics (CTAG) Department will enable KHCC to deliver personalized medicine through cellular therapeutic and genomics-based technologies to Jordan and countries throughout the MENA region. The scope of service of this facility which will be hosted on the 9th floor of the out-patient building and includes the following:

1. Cell Therapy (which includes stem cell processing lab, Cryobiology and cryopreservation facility as well as cord blood bank).
2. Genomics / Molecular genetic pathology (which includes Molecular Oncology, Molecular Infectious Disease, Transplant Immunology, Histocompatibility and Genetic Counselling services).
3. Cytogenetic (Karyotyping, Molecular Cytogenetic and Fluoresce in Situ Hybridization (FISH)).
4. Flow cytometry.

The Cell Therapy division will host a Good Manufacturing Practices (GMP) facility with rooms versatile enough to be used for cell therapy, gene therapy and immunotherapy. All therapeutics modalities offered in this facility will follow approved standard of care protocols. Furthermore, the infrastructure will enable us to conduct clinical trials in this field that are approved by the Institutional Review Board (IRB).

Middle East Health: What new / advanced devices will you be installing in the new towers? And how will they benefit diagnosis and treatment?

Dr Asem Mansour: As a leading oncology centre, KHCC continues to build upon its technology infrastructure and introduce new technologies that allow effective diagnosis and enhance treatment options. A new service to be introduced is intraoperative neurosurgery; in which magnetic resonance images of the patient’s brain are taken during the operation allowing the neurosurgeon to locate the tumour and observe the progress as it is removed. Additionally, a new state-of-the-art linear accelerator, equipped with the latest technologies, will be installed in the new Radiation Oncology Department. This will increase treatment benefits as radiation beams target tumours with a much higher precision. A set of advanced and automated genomics lab equipment will also be added to the premises of the new department of Cell Therapy and Applied Genomics. The high precision of this equipment will minimize human error and expedite the testing process. The expansion will house six new operating theatres with state-of-theart medical furnishing and videoconferencing, image-sharing, and control integration capabilities.

Middle East Health: One of the towers will have patient rooms – each room with only one bed. Why have you decided to take this route in having only single-bed patient rooms? I understand it will enhance privacy, in what other ways will they benefit the patient?

Dr. Asem Mansour: We have always had private rooms even in the old hospital. We have three main reasons for opting to design single-bed rooms: isolation of immunecompromised patients such as BMT and leukaemia patients, social reasons as in the case of paediatric patients who typically have a companion sleeping with them in the hospital. In such instances a 2-bed patient room becomes too crowded and really does not give any privacy for the patient or the companion, and lastly many patients are demanding single occupancy rooms and are willing to upgrade whatever room class their insurance is covering to a private room. So all in all these rooms will have major impact on patient experience.

Artist's impressions of th interiors of the new towers at KHCC

Middle East Health: The single rooms will presumably be more expensive. Who will cover the extra cost?

Dr Asem Mansour: This will be a mix of insurers and out-of-pocket expenditure based on the need for such private rooms.

Middle East Health: Can you tell us more about the Khalid Shoman Center for Education and Training? Who is Khalid Shoman? What training will be offered and to whom?

Dr Asem Mansour: The late Khalid Shoman was one of KHCC’s most generous donors. His donations helped in improving the health services available at the centre through the establishment of the Nuclear Medicine Department. In appreciation of his donations, the education centre was named: The Khalid Shoman Center for Education and Training. This centre will establish a Training Academy within its premises. The aim of the academy is to train healthcare providers and improve their knowledge and skills in order to enhance their competencies and improve the safety of their practice. Since KHCC believes in the continuous professional development of its employees, it was decided that the best approach will be through providing them with different courses and programs and other educational activities to enrich their knowledge and skills in their field of practice. These training programs include: Nursing Oncology, Respiratory Care training, Clinical Pharmacy and Medical Physics. These training programs have been accredited by the American Nursing Credentialing Center (ANCC).

Middle East Health: Can you tell me a bit about the tissue bank and the research that will be carried out here?

Dr Asem Mansour: The tissue bank, or rather a bio repository, is a section that collects various specimens from cancer patients that are left over after routine diagnosis is carried out. These specimens may be tissue or blood. Specimens are collected fresh frozen or as paraffin embedded tissue blocks. The idea is to create a collection of various types of cancers that can be used later on by researchers in order to come up with further understanding of the mechanisms of cancer occurrence and find new therapies.

Middle East Health: KHCC is highly regarded in the region. Will this expansion enhance its recognition as a centre of excellence and as referral centre?

Dr Asem Mansour: KHCC is the only healthcare institution in the Arab world and the sixth in the world to receive disease-specific accreditation from the Joint Commission International (JCI) for its Oncology Program. The centre is also recognized by a spectrum of international, regional, and national accreditation bodies including the College of American Pathologists (CAP), the Healthcare Accreditation Council (HCAC) and others. The centre is currently serving patients in Jordan and the Middle East region, and there are continuous referrals to the centre based on its excellent reputation and continuous work to improve the quality of care; through the utilization of a system of key performance indicators to monitor performance in different areas, and emphasizing patient safety and satisfaction. However, and as highlighted above, the full occupancy rate was an obstacle in regards to meeting the rising demands, and this has caused satisfaction rates to be slightly below the target of 90%. Therefore, the expansion will surely solve this problem and we will be able to accommodate more patients and accept more referrals.

Date of upload: 16th Jul 2016

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