After she was diagnosed with stage 2 triple-negative breast cancer in December 2022, Michelle Cleave found herself practically living at VHC Health.
First it was weekly chemotherapy treatments for six months, then surgery (a lumpectomy to remove the tumor) and then radiation every weekday for three weeks.
“It was very intense,” says Cleave, who lives in Washington, D.C., but sees physicians at the Arlington hospital. “It was a hassle just in that I had to remember which building each provider was in. My oncologist was in one building, my breast surgeon was in another building, the cancer center was in a different part of a different building. I got my steps in; I guess that was a benefit. But sometimes, especially when you’re tired and you’re going through treatment, that could be tricky.”
Today, Cleave is cancer-free. The hospital has also made dramatic improvements to its layout for patients like Cleave whose care involves multiple treatments and specialists.
VHC Health’s Charlotte Stump Benjamin Center for Women’s Health, which opened on the fifth floor of its Outpatient Pavilion in October 2023, houses doctors and nurses in a range of women’s health specialties in one place.
Now, when Cleave returns for check-ups such as mammograms and breast MRIs, she goes to one building. “I would say 90% of my stuff is at the new facility,” she says.
Designed by women for women, the center represents a new model for care that hospital officials say they intend to apply to other areas. Consolidating specialists in one location improves patient care by speeding the time to treatment when problems arise, explains Kelly Orzechowski, an obstetrician/gynecologist and Chief of Women’s Health Services at VHC Health.
For example, many patients get orders for a mammogram from their OB/GYN. “The result may come back to [the OB/GYN], and we can get somebody into breast health literally the same day” if the images show an abnormality, Orzechowski says. “It’s the difference between us being all in close proximity and able to communicate vs. having to call or email and then [not hear back until] the next day because you couldn’t get a hold of anyone.”
The redesign came by way of an advisory group spearheaded by Orzechowski along with internist Christina Malekiana, plastic surgeon Marilyn Nguyen, breast surgeon Molly Sebastian, and OB/GYNs Alexis Light and Lynsey Owen. They spent several months discussing the concept before approaching hospital president Christopher Lane in September 2022. The initiative did not follow any existing model; rather, it emerged organically from the collective insights and concerns of the physicians involved.
The doctors had two main requests, Orzechowski says: “One space where we could all be in close proximity to each other” and a restructuring of the women’s health hierarchy so that all related disciplines fell under the same division.
For instance, Orzechowski’s specialty—maternal and fetal medicine—was previously overseen by a medical subspecialties team, while breast health fell under the jurisdiction of the surgical team. As a result, these specialties had different physician leaders and were located in different parts of the hospital. “Reorganizing our org chart would allow the women’s health subspecialties to be under one division” and on one floor of the pavilion, she says.
Today the Women’s Center is home to 25 physicians’ offices and 59 patient exam rooms, providing care in a range of disciplines including obstetrics and gynecology, maternal and fetal medicine, breast surgery, urogynecology and gynecology oncology, as well as a dedicated Menopause Center.
Built on a collaborative model in which care and decision-making are shared equally among physicians, the Menopause Center is open to patients three days a week. Doctors treat conditions such as hot flashes, sleep problems, weight gain, thinning hair and memory problems, all of which are associated with menopause.
“Clinically, what makes the most sense for a patient is to come off the elevator, be greeted by our front desk staff, and then they come to a clinical area. Our administrative area is in the back, where we can all communicate with each other,” says Orzechowski, referring not only to her practice’s staff, but also other providers.
As an example, she mentions an obstetrician who stopped by her office for a face-to-face conversation about a patient Orzechowski had seen the day before. “You can communicate through a chat message in the [electronic medical record], or through patient notes, but it’s not the same as actually having that two-way communication in real time,” she says. “The patient gets a lot better care because we all know each other and we’re literally right down the hall from each other.”
For patients, convenience is another major benefit. Orzechowski says she helped one patient schedule her obstetric and neonatal medicine appointments back-to-back at neighboring offices for the remainder of her pregnancy so she could make one trip each time. “The highest-risk patients are here twice a week in [their] last month, so being able to do that all on one floor makes a difference,” she says. “It’s women working for women.”
Even upgrades that seem minor have a big impact, adds Sharon Brickhouse Martin, vice president of health services integration at VHC Health. The new exam room layouts are one example: Physicians asked that stirrups on exam tables not face the door, and they added hooks and mirrors to the back of the door. “It sounds trivial, but it’s not when you’re the patient,” Brickhouse Martin says. “This group [of physicians] sat down and talked about stuff like, ‘We need a basket so people don’t have to put their bag on the floor.’”
Cleave says the redesign makes a big difference psychologically for patients facing serious medical challenges. “The old facility was old. It was dark. A lot of the areas didn’t have many windows,” she says. “There’s just so much light in this new building. You’re there for the medical side of things, but just being able to see daylight makes such a difference.”
In the 18 months since it opened, the women’s center has become one of the hospital’s most sought-after care facilities, Brickhouse Martin says. VHC Health is now looking to open two “mini hubs” in Tysons (slated to open at the end of the year) and Kingstowne (to debut in 2026).
The hospital is also applying the model to other specialties. The recently opened VHC Health Physicians Digestive Center near the Mosaic District in Fairfax co-locates urology, colorectal surgery and bariatric surgery.
Meanwhile, Orzechowski says the women’s center is looking to offer “hoteling space” to gastroenterologists, cardiologists and other specialists who focus on treating women. When office space is available, even for half a day each week, they could set up clinics focusing on women’s heart health and GI issues.
The differentiation is important because symptoms of heart and gastrointestinal disease often present differently in women compared to men. For instance, a woman having a heart attack may report vague symptoms such as fatigue, nausea, or jaw and neck discomfort, rather than the classic chest pain so often felt by men.
“Recognizing these differences is critical to ensuring women receive timely, accurate care—because women are not just smaller men. Their bodies and experiences demand thoughtful, individualized attention,” Orzechowski says. “If you have providers who understand the things that are unique to women’s physiology—different hormones, different stages of life and [symptoms] that can present differently—[it leads to improvements] in the type of the care they get and the experience they have.”