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Children's Hospital clinics overcome challenges

With more than 30 clinics on four floors under her direction, Rosemarie Battaglia, R.N., knows a thing or two about challenges.
As the manager of Children’s Services Ambulatory Care at MUSC, Battaglia oversees 32 primary and specialty care clinics, including infectious disease, neurology, orthopaedics, pediatric developmental, endocrinology, genetics, hematology/oncology, day services, pulmonary, urology, rheumatology, adolescent medicine, gastroenterology, orthopedics, neurosurgery, primary care, pediatric transplant, surgery, pediatric forensics, sickle cell, Down syndrome, spina bifida, sweat-testing, neonatal intensive care unit graduates, international adoption, pediatric phlebotomy, and lactation.
All are located in Rutledge Tower where Battaglia recently gained much needed space on an additional floor. With a rapidly expanding patient base, Children’s Services Ambulatory Care is keeping pace, averaging 7 percent growth during the last year. In July, the group added nine new providers including two nephrologists, two surgeons, two physician assistants, a urologist, rheumatologist, and nurse practitioner; all specializing in pediatric care.
To meet the increasingly complex needs of patients, the staff recently changed its care delivery model by aligning staff into more effective care teams.
“Coordinating the staff into teams of RNs, LPNs and PCTs [patient care technician] allows for better care coordination, and allows them to understand our patients on a different level,” said Battaglia. “It also provides consistency of staff and continuous care for patients, and helps nurses get more familiar with what doctors want so they can better guide and instruct the family.”
In a setting where clinics share space—often as many as three or four in one location at a time—the focus on high quality care, and the coordination of that care, is crucial.
 “Patients want the best care, but they also want to move through their clinic visit quickly,” explained Battaglia.
Her greatest challenge—the sharing of space—is also a great opportunity.
“We are definitely forced to use the space efficiently,” she said. “The upside of sharing space is the one-stop- shop advantage of localized care. Having all the clinics here in Rutledge Tower means kids with multiple needs can visit multiple clinics all in one day,” said Battaglia.
It easily integrates care for primary and specialized pediatric needs. Doctors work side-by-side and often simply walk down the hall for a consult.
Because MUSC is a teaching institution, patients also gain the benefits of residency training and evidence-based practices.
“That translates into more people looking more closely at data collection and assessment, which helps with diagnosis and care planning. This is such an advantage for our patients and their parents,” said Battaglia.
 It might mean your visit takes longer, she said, but it also means you have more experts looking and thinking about your care and solutions to your health problems.
“Working with residents also helps our nurses stay up-to-date on the latest treatments and care, and encourages staff to think outside the box on how to best care for patients,” Battaglia said.

Editor's note: The article was reprinted with permission from the October issue of the Children’s Hospital newsletter, Kids Connection. Visit


Friday, Oct. 31, 2008

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