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2012

A Model for Continuity of Care

July 20, 2012
Cancer dtl

(from left to right) Pediatric neuro-oncology director Ken Cohen, nurse manager Lisa Fratino, and pediatric oncology director Donald Small were among the early planners.

Peds oncology magazine 2012

The trio today in the open and naturally-lit two-story infusion suite in Bloomberg Children's Center.

For children with cancer, continuity of care is essential. That was the response of Pediatric Oncology Director Donald Small and his staff when asked years ago for input on the design of their unit in The Charlotte R. Bloomberg Children’s Center. So rather than just build an inpatient unit, why not add an adjacent pediatric oncology outpatient component?

“From the point of view of our patients and their families, as well as our physicians, fellows, nurses and other staff, the improvement in continuity of care would be tremendous,” Small said at the time.
The powers that be listened and connected the two units in the new Bloomberg Children’s Center. That means rather than taking a ten-minute walk across campus to check on a recently discharged patient in
the outpatient clinic, staff now only have to walk down a hallway.

“Perhaps someone on the outpatient side did not know what the patient’s condition was like on the inpatient side, whether the patient is better, worse or the same as when they were discharged,” Small
says. “Now the inpatient team can easily help out with that evaluation by running over quickly to the outpatient clinic to see the patient and consult with staff.”

The arrangement improves physician learning, too, Small explains. After discharge, fellows have a greater ability to see their own patients and how the patient’s particular type of childhood cancer is responding to treatment. The adjacency, adds pediatric oncologist Ken Cohen, also means seamless movement of patients between inpatient and outpatient units, with the potential for reducing a hospital length of stay.

“For the patient waiting to be admitted, we can start inpatient chemotherapy here in the outpatient infusion area and then move the patient down the hall when the room is ready,” says Cohen. “You don’t have to wait for the patient to get to the floor to do those kinds of things, which can mean the difference
between an extra night in the hospital. For our patients, who are repetitively hospitalized, any night not in the hospital is a good night.”

Other features in pediatric oncology include larger and all-private inpatient rooms and more-accessible treatment rooms. The outpatient side features an open and naturally lit two-story infusion room, and more exam rooms to speed up patient flow and reduce wait times. Also, all of the nurses are specially trained in caring for children with cancer. 

“We’re the only unit in the area with a dedicated nursing staff who only take care of cancer patients,” Small says. 

He adds that pediatric oncology continues its policy of seeing patients the same day as their call. 

“Pediatricians may worry about how to get their patient into the Hopkins system, but that’s something they don’t have to worry about,” Small says. “If they call the HAL line, my office, the outpatient clinic or inpatient unit, we will get them to the right place and see them that day.” 

For more information: Division of Pediatric Oncology