As the severity of the COVID-19 pandemic became apparent at the start of last year, more and more patients began staying away from hospitals for fear of contracting the virus.
This, however, was especially dangerous for patients with cancer, as they needed to closely follow a regular treatment regime – which could only be provided by the appropriate medical institutions – in order to keep their condition under check.
But what if these patients had the option of receiving their treatment at a separate facility instead? And what if that facility was at a holiday resort?
This was exactly what ARC Hospitals, located in the tropical holiday destination of Cebu in the Philippines, offered to their oncology patients during the pandemic.
Instead of their hospitals, ARC allowed their oncology patients to receive chemotherapy infusion treatments at the neighbouring Bluewater Resorts. It was a service that began when the first wave of COVID-19 cases hit the country around February last year, and lasted all the way till July, when the number of cases began to subside.
Offering a sense of comfort and assurance
For patients battling cancer, the COVID-19 virus naturally adds another layer to their fears and uncertainties. Providing them with treatment away from the hospital setting therefore “offers them a sense of comfort and trust that they will be safe,” explained Dr Alex Alegrado, Medical Director of ARC Hospitals. Being segregated from other patients at the main hospital also gave oncology patients the assurance to return regularly for their treatments.
The satellite clinic at the resort offered consultations as well as chemotherapy infusion treatment, in which chemotherapy medication is administered intravenously. The treatment sessions saw patients sited either in the resort rooms, or around the open-air area next to the resort pool, thus providing the sort of relaxing environment – which aids in recovery – that cannot be found in the hospital setting.
The move also relieved capacity pressure at the main hospital, and offered some nurses who were fearful about the risk of infection an alternative work site.
Behind the scenes
For any hospital, setting up a satellite facility that meets infection control and clinical requirements on short notice is no easy feat. This was especially so for ARC Hospitals, given that they were then barely just over a year old.
Nonetheless, ARC Hospitals, which celebrated its second anniversary in September 2020, made certain they had stringent processes in place at the facility to combat the threat of COVID-19.
Firstly, proper COVID-19 testing and screening procedures were set to ensure the safety of patients and staff at the resort. Dr Alegrado noted that COVID tests were conducted on all patients each time they arrived. Patients would then have to wait for their results in a separate holding room, and could only enter the facility once they were given the all-clear. Another aspect of the facility that ARC had to give due consideration was medical waste management, as they had to find ways of transporting the medical waste generated at the resort back to the main hospital for proper disposal.
Then, there was the installation of supporting infrastructure, such as the facility’s information system, which they had to link to the main hospital, as well as the setting up of all the necessary medical devices and equipment.
Staff management was also a key area of focus for ARC Hospitals. Nurses assigned to the resort facility were told not report to the main hospital, so as to prevent the possibility of cross-infections. Training was also conducted to orientate staff to the new work environment. This included resort housekeepers, who needed to learn cleaning and disinfecting procedures that were befitting of a medical facility.
“There were many things that went on behind the scenes, and there were a lot of back and forth discussions and trainings,” Dr Alegrado recalled. “For me, the learning point was that even though we were a young hospital, if you have the motivation and the drive to help the community, you can accomplish things you never imagined could be done. We saw that the processes we developed not only worked, but also improved the quality of care for our patients.”
Ensuring quality of care
ARC Hospitals’ initiative to open their satellite clinic at a resort was well-received by their patients. Mrs Luz Filipinas S. San Pedro, a patient of ARC Hospitals, said: “This was a great way to segregate the cancer patients to a safer, more relaxing, and convenient place. Being at the resort made me feel like I was on vacation, while the medical staff was very professional and accommodating. The experience greatly improved my holistic well-being.”
While both staff and patients alike have reacted positively to the resort facility, Dr Alegrado remained conscious of the need to reduce patients’ exposure to potential infections.
“I try to make sure that I adopt a regimen that is still the standard of care, but given in prolonged intervals – for example, every three weeks, rather than weekly,” he said.
The satellite facility was eventually closed in July 2020, when COVID-19 cases began to fall, and patients were gradually directed back to the main hospital. By the time the second wave hit the country in February 2021, the hospital had updated and strengthened its COVID-19 protocols – they are now able to fully accommodate both COVID-19 and regular patients safely at its main hospital.
Dr Alegrado, though, is keen to pursue the concept of medical treatments in a resort setting – perhaps in the form of a wellness and rehabilitation facility for cancer patients in the future.
Looking back on the journey the hospital has taken over the past year, Dr Alegrado said he recognised there were many lessons the hospital had learnt; one of which was the need, as healthcare providers, to innovate in care delivery. “The care for cancer patients never stops. So, we have to find ways to be able to cater to their needs, and improve their healing process in the most innovative way. By doing so, we are doing good to our patients, and improving their care and quality of life.”