With more than 50 years of experience navigating Crohn’s disease under his belt, Charles Moses is no stranger to change. Beginning in his teenage years, Moses, a 73-year old retired teacher from Millville, New Jersey, was treated for ulcers, colitis, and seemingly “anything but Crohn.’s.” A misread X-ray even led his primary doctor to mistakenly inform him he had cancer. After finally getting the correct diagnosis and realizing that he needed more advanced care to manage this chronic inflammatory bowel disease, Moses made the switch from his local specialists to the gastroenterology (GI) team at Penn Presbyterian Medical Center (PPMC). Over the past 30 years, he has undergone bowel resections, infusion therapies, and other treatments, and he has watched longtime members of his care team retire. But amidst all of the changes, he noted, “The quality of care has remained the same. That’s what’s important.”
This spring, it wasn’t just Moses who experienced another transition, but his providers and fellow patients too. After three years of planning, PPMC successfully moved the division out of the hospital and across the street. The all-new Penn Digestive and Liver Health Center is located on the 11th floor of Penn Medicine University City (PMUC), an advanced treatment and outpatient facility on the PPMC campus. This ambulatory surgical facility aims to provide convenient access to both clinic visits and outpatient procedures for patients with a range of GI conditions, and particularly those living in West Philadelphia.
“This is one of the most complicated projects I’ve ever worked on,” said Greta Gilbode, MBA, associate executive director of Service Line Operations. The multidisciplinary team had to “work through mechanical issues, COVID-19, and capital delays, but everyone remained focused on our patients and on the finish line.”
Following a ribbon-cutting ceremony that marked the culmination of the project and the beginning of a new chapter of GI care, the center opened its doors on April 1, 2021.
Refreshed and Ready for Remarkable Care
Though the pandemic temporarily stalled the project, it also underscored the importance of the move. The original unit was located in the Wright-Saunders building, the oldest part of PPMC’s campus, and it was time to upgrade. Not only had the GI division outgrown the space through increased volume and expanded services, but it quickly became clear that the small unit wasn’t built to effectively accommodate social distancing. Now, the expanded, 11,515-square foot Penn Digestive and Liver Health Center sets up the team for success beyond COVID-19.
The center boasts a clinic space with a second triage area to cut wait times and 12 spacious exam rooms full of natural light. The four procedure rooms are double the size of the previous rooms, and they feature enhanced video equipment that allows for improved detection of abnormalities. All GI patients are now directed to the center for regular office visits, and many can schedule their colonoscopies and endoscopies there too. Patients on dialysis, requiring more extensive testing, or with comorbidities like severe sleep apnea or high BMIs will continue to get procedures done on the main hospital campus.
“It like we’ve entered the 21st century. It’s beautiful, it’s clean, and it just feels good,” said Lori Fowler-Gagliardi, BSN, RN, MBA, CNOR, clinical director of Perioperative Services. “Our facility now matches the level of expert care that we’re providing, and it’s also a better work environment. We put so much time into this move, and I’m so proud to be able to offer the experience that our patients and staff deserve.”
New Look, Same Familial Feel
Afi Peele’s biggest worry about the relocation wasn’t related to integrating new tech or planning the logistics of moving day, but whether it would be possible to preserve the sense of community that had become a cornerstone of the unit. Fortunately, the practice manager’s concerns quickly abated as she watched the GI and endoscopy staff build stronger relationships, embrace the new space and take steps to improve it further, and welcome patients with even more enthusiasm and care.
“Because we have always been a smaller team, the staff and providers treat each other like family — and we want our patients to feel like they’re part of the family too,” Peele said. “When patients come in, they often aren’t feeling good; they’re dealing with abdominal pain, nausea, diarrhea, all kinds of things. Our goal is to provide a great experience from the moment they’re greeted at the front desk. By talking to them about their lives, we make sure they feel listened to and cared about.”
For Moses, “the old location was certainly comfortable because it was familiar. I went through a lot there. But it’s not about the office — it’s about the people,” he said.
He cites nurse Michelle Grainger, LPN, as a prime example. “I’ve known Michelle since I first came to Penn Presbyterian. At one point, they were giving me Remicade [infusions], and she’d sit and talk to me for hours,” he said. “The nurses, doctors, intake staff — everyone is just wonderful. I can’t stress enough how important it is that every person I have seen makes you feel comfortable, even on the worst days.”
Between the patient representation on the center’s Patient Safety and Quality Improvement Committee and the team’s demonstrated commitment to building a supportive space where all patients feel seen and valued, it’s clear that the experiences of patients like Moses will remain the division’s top priority as they identify opportunities for advancement.
Growing a Comprehensive, Community-Focused Center
“It's like we've entered the 21st century. It's beautiful, it's clean, and it just feels good.”“Outgrowing our existing space limited our ability to grow the practice,” said
James D. Lewis, MD, MSCE, chief of Gastroenterology at PPMC.“ Moving into this new, larger facility has given us an opportunity to build our current programs and to expand in new directions. I’d love to increase our capacity to support patients managing upper gastrointestinal disorders, esophageal disorders, and liver disease, as well as patients who need advanced therapeutic and endoscopic procedures.”
Additionally, a major component of the center’s mission is to increase capacity for — and access to — colorectal screenings, particularly for higher-risk Black community members living in West Philadelphia. According to the American Cancer Society, colorectal cancer is now the second deadliest cancer in the nation, and it disproportionately threatens Black Americans. Black patients are 20 percent more likely to be diagnosed with colorectal cancer and 40 percent more likely to die from the disease when compared to white patients. With convenient access to early screenings at the Penn Digestive and Liver Health Center and to advanced GI surgical and oncological interventions in the hospital, community members can get all of the care they need in one place.
As they recruit more providers, communicate with local primary care offices about referral opportunities, and work to automate the call system so patients can self-schedule their procedures, the GI team is confident that they will be able to effectively connect their neighbors with the care that they need.
“It’s all about access. If more of the community has more access to preventative care, we hope to identify fewer people with late-stage GI cancers and diseases,” Gilbode said. “But if you come in for a routine screening at PMUC, and we identify a suspicious polyp that ends up being cancerous, Penn Presbyterian can provide all of the services you need. We’re the community hospital for West Philadelphia, and we’re here for you.”