Recently, City of Hope began a new chapter by opening the City of Hope Orange County Lennar Foundation Cancer Center (Irvine, Calif.) and acquiring Cancer Treatment Centers of America (CTCA), which added treatment facilities in Atlanta, Chicago and Phoenix. City of Hope is now one of the largest cancer research and treatment organizations in the nation.
With its reputation for providing high-quality cancer care and the latest life-saving treatments, City of Hope’s designated Comprehensive Cancer Center has been recognized with the highest ranking possible — a rating of “Exceptional” from the NCI — and is ranked by US News & World Report as one of the nation’s top 10 “Best Hospitals” for Cancer.
Now, City of Hope is extending its industry-leading innovation and proven standards across its expanding clinical network to deliver optimal cancer care to even more patients, families and communities nationwide.
To learn more about City of Hope’s evolution, its current focus and the organization’s plans for the future, Becker’s Hospital Review spoke with Vijay Trisal, MD, surgical oncologist and chief medical officer at City of Hope.
Dr. Trisal joined City of Hope in 2001 as a fellow in surgical oncology. Over the past 22 years, his roles and responsibilities have included conducting basic scientific research, developing City of Hope’s community network, helping lead implementation of the organization’s Epic EHR, overseeing the quality of care that City of Hope delivers, and having oversight of its graduate medical education.
Compassion and excellence
City of Hope was founded with one purpose, Dr. Trisal said: “To help people who are faced with life-threatening diseases and to take care of those patients.” He said City of Hope’s steadfast work in the field of oncology has led to the development of processes and expertise that result in the best outcomes for patients. But what really differentiates City of Hope is the compassionate care the organization consistently delivers to those who are most in need. This may be when a person is challenged with a particularly difficult diagnosis or is in a long battle with a disease and has already exhausted several lines of treatment and is in need of an innovative approach. “That is what we are geared toward,” Dr. Trisal said.
Surveys of patients who have received care at City of Hope bear this out. These surveys show that patients feel that they’ve been the recipients of special levels of compassion at City of Hope compared to other providers.
Transformation and growth amid disruption
Despite the many challenges presented by the COVID-19 pandemic, City of Hope continued to grow during this time. The number of physicians recruited to join City of Hope has doubled over the past few years to more than 600 cancer-focused physicians, and the number of surgeries increased dramatically.
Also, City of Hope acquired the Translational Genomics Research Institute (TGen), a leader in applying genomic analysis to diagnostics and therapeutics for cancer and other diseases, helping make precision medicine a reality for patients. TGen enables City of Hope to sequence the genome of a tumor and the germline of a patient. That information is used to identify tumor mutations and then create targets for those mutations, which may result in using an off-the-shelf drug or manufacturing a drug, such as a monoclonal antibody or a targeted therapy.
Together, TGen and City of Hope are transforming the diagnosis, treatment and prevention of cancer and other life-threatening diseases. While TGen is a research-focused organization, this collaboration is accelerating new discoveries and enables City of Hope to use precision medicine in the clinic when treating patients.
From regional to national — carving a path to reach more patients
In addition to its main campus just north of Los Angeles, City of Hope has expanded to more than 30 community practices in Southern California. In 2019, City of Hope announced plans to invest $1 billion to build a comprehensive cancer campus in Orange County, which opened in 2022.
That same year, the opportunity arose to partner with and acquire CTCA, a leading cancer-focused organization with hospitals in Atlanta, Chicago and Phoenix. CTCA already had a national patient care network and shared a similar compassionate, patient-centric culture with City of Hope. This acquisition dramatically expanded City of Hope’s geographic footprint and increased care capacity to over 134,000 patients treated in 2022.
As part of this transformation, Dr. Trisal emphasized, “The promise to patients is that no matter what door they come in from, they will get excellent care.
Operating as “One City of Hope”
For the first year that CTCA was under the City of Hope umbrella, the locations in Atlanta, Chicago and Phoenix continued to operate under the CTCA brand. During this time, those locations went through various legal and administrative processes to begin functioning as nonprofit organizations.
Also during this time, City of Hope broadly extended its wealth of knowledge, expertise and know-how to all locations with the objective to achieve care delivery that is consistent, integrated and of the highest quality. This required a systemwide HER integration, which is scheduled for completion in 2023, care standardization and increasing connections between CTCA and City of Hope clinicians through joint tumor boards.
Today, CTCA is integrated with City of Hope as part of “One City of Hope.” This is far more than a rebrand; it is one cohesive and collaborative organization. “We aim to have no daylight between what City of Hope does in Duarte or in Chicago or Atlanta or Phoenix,” Dr. Trisal said. “Our objective is to deliver consistent care at each site.”
An important area in which City of Hope has extended its expertise to benefit patients at the organization’s newest locations is in the diagnosis and treatment of complex cancer cases. Dr. Trisal explained that in addition to standard oncology services that City of Hope offers throughout its clinical network, patient cases are being presented at joint tumor boards, where national experts provide education and insights on complex cases, such as unique carcinomas, sarcomas and genetic mutations, to provide the best care across all locations. Through these joint tumor boards, City of Hope physicians can tap into the knowledge and extensive experience of specialists and subspecialists throughout the system to collaboratively come up with the best diagnosis and treatment option for each patient. “We are applying these learnings in Phoenix, Atlanta and Chicago,” Dr. Trisal said. “That is directly benefiting patients.”
Another benefit of working as one, collaborative organization — “One City of Hope” — is working toward extending participation in the organization’s many clinical trials to benefit even more patients across more geographies.
A relentless focus on quality
City of Hope recognizes that the concept of quality does not have one narrow meaning. For many patients, quality means how quickly they can be seen and how quickly they can get to treatment. According to Dr. Trisal, quality also relates to making the correct diagnosis, treating patients with the most appropriate therapeutic approach and delivering care in a holistic, deeply patient-centered way that humanizes the care experience and reduces treatment-related toxicities. Because of the importance of quality, City of Hope has spent extensive time defining what matters and how to measure it.
To assess the organization’s level of quality and to constantly improve the care that is delivered, City of Hope has developed what it calls “7 x 7 quality metrics.” These are seven metrics that measure in-patient quality and seven separate metrics for outpatient quality. Metrics include areas such as patient experience, infection, complications, pressure ulcers, readmissions and end-of-life care.
The next 100 years
Dr. Trisal said City of Hope will continue to focus on delivering excellent, compassionate care. The organization will also work to expand access to care by providing treatments to even more patients, increasing participation in clinical trials and continuing to accelerate development of innovative treatments. They are also recruiting more physicians and adding operating room capacity to be able to take care of even more patients.
City of Hope will continue to be recognized as one of America’s leading cancer research and treatment organizations, delivering unprecedented patient-centric care, training the next generation of elite scientists and clinicians and engaging in innovative, leading-edge research and clinical trials.
During the past few years, City of Hope has expanded its research capabilities into precision medicine through its affiliation with TGen and extended its reach through its acquisition of CTCA. These initiatives give City of Hope the ability to provide even better treatments to more patients across more geographies. City of Hope’s enhanced national system will positively impact more patient lives by connecting people to the innovation and expertise available at a comprehensive cancer center.
In the last century, City of Hope built a reputation as a world leader in the research and treatment of cancer and other serious diseases. As the organization continues to advance care and extend its reach, this legacy is poised to continue another hundred years.
