Aimed at Quicker Admissions, Patient Comfort, Lower Costs
Patient Discharge Unit Under Construction
Imagine you're a patient entering
Duke Hospital, and your doctor
instructed you to be here at 11 a.m. to be
admitted.
You show up on time and you are
processed promptly for admission. But
you have to wait because the bed you
were to occupy has not been vacated by
the out-going patient.
Jody's mother noticed early that her
son seemed a bit slow. He didn't learn to
walk or talk as soon as he should have.
When Jody was five his kindergarten
teacher noticed it, too. Jody was clumsy
and slow to learn, and he was always
disrupting the class.
At the teacher's suggestion, Jody's
parents brought him to the
Developmental Evaluation Clinic at Duke.
The clinic works with any child who is
delayed in his physical or mental
development, from mentally retarded
children to those with cerebral palsy,
learning problems or behavioral
difficulties.
Jody went in for a day and a half of
testing by a team that included a
pediatrician, psychologist, social worker,
nurse, speech therapist, physical
therapist, special education teacher and
child development specialist.
Consultants in audiology, neurology,
psychiatry and pastoral counseling were
also available if needed.
Jody was found to be borderline to
mildly retarded. The center staff
recommended that he repeat
kindergarten, this time in a more
structured and formal setting. His family
was counseled on how to handle his
behavior problems at home.
At the end of the second year of
kindergarten, Jody was brought back to
the center for another evaluation. The
Ftaff recommended that he start first
grade and be given special tutoring.
The center staff will continue to
follow Jody's progress, helping his
parents and teachers to understand and
work with him more effectively.
"Our task is to find out exactly what
his abilities are and to help the family
work with him and maximize these
abilities," said Dr. Ann Alexander, a
pediatrician and director of the clinic.
The clinic is administered by Duke and
is one of 11 funded by the Maternal and
Child Health section of the state Division
of Health Services. It is intended
primarily to serve Orange, Durham,
Chatham, Person, Granville and Vance
counties, but the clinic sees children from
all over the state.
Families pay for the clinic service on a
sliding scale depending on their incomes.
No one is turned away because he can't
pay.
When the clinic first opened in 1965 it
operated only two days a week in the
pediatric clinic here. The clinic now
occupies modern facilities in the Civitan
So you wait, and the wait stretches
into the afternoon and evening,
sometimes as long as 10 hours or more.
By the time you are taken to your
room (perhaps missing the evening meal
because of the late hour), your mood is
far less pleasant that it was at 11 o'clock
that morning.
Over the past several months, Duke
Building, and since this summer it has
been operating four days a week.
Three days a week are devoted to
seeing patients, and the fourth day is
spent in home visits and contacts with
other agencies.
"Our function is basically evaluation,"
said Dr. Drew Edwards, a clinical
psychologist and assistant director of the
clinic. "If there is any other agency
available to handle the treatment, we
refer the child there. But sometimes if
there are no services available where the
child lives, then our people do get
involved in some treatment.
"For instance, our child development
specialist has been helping a Rocky
Mount family toilet train their retarded
child so that she would be accepted at a
local day care center for the retarded," he
said.
One Wednesday a month the clinic
staff drives to Oxford to work with
children from Granville and Vance
counties. This also gives the staff a chance
to work with local health clinic nurses
and social service workers.
The clinic staff has also held
workshops for teachers and other people
in the community on how to look for
developmental difficulties in children and
how to refer children to the appropriate
agencies.
has taken some major steps aimed at
getting incoming patients admitted and
settled comfortably on the ward as
promptly as possible.
This week work began on a Duke
Hospital Discharge Unit which will
further aid the prompt-admission
concept.
Construction of a Discharge Unit was
The clinic can now handle two or
three new children a week in the
program. The target age is birth to 10
years, with priority given to children
under seven, although the clinic can take
persons up to 21 years of age.
"We handle a majority of pre-school
age children," Dr. Alexander said. "We
are seeing greater numbers of children
three years and under as parents become
aware that there are facilities available for
assessing the development of young
children." -YVONNE BASKIN
The University's Epoch Campaign is
only four months old, yet good progress
has already been made toward achieving
the three-year goal of $162 million. To
date over $31 million dollars has been
pledged.
More than half of the funds sought
during the campaign are to be used to
increase Duke's endowment—increased
endowment to support professorships,
scholarships and research. Three of the
proposed by the Committee on Patient
Services and Personnel Relations
(sometimes called the Quail Roost
Committee because the committee was
organized formally during a meeting at
the Quail Roost Conference Center last
February). Dr. Richard Kramer, a
neurosurgeon, chairs the committee.
The Discharge Unit will be built in
what has been an eating lounge area
across from the Auxiliary Snack Bar on
the first floor.
Persons purchasing food and beverages
at the snack bar will be instructed that
they can find seating in the cafeteria or
the cafeteria annex. Consumption of food
and beverages is, of course, not permitted
in the main lobby.
A wall separating the eating area from
the adjacent vending machine area will be
removed, and the Discharge Unit will
occupy the entire section.
Vending machines, including those
from the Carousel Room in the hospital
basement, will be moved to the cafeteria
annex where they will be centralized and
be more accessible to patients, visitors
and employes.
The Discharge Unit will be an enclosed
ward of the hospital, walled in from the
main lobby on one side and the corridor
in front of the snack bar on the other
side. Primary entry into the unit will be
through a door from the lobby, only
steps away from the main entrance, the
gift shop and the business office, and
only a short distance from the cafeteria.
Staffed by a nurse and a DTO (Data
Terminal Operator) who also will serve as
a receptionist, the Discharge Unit will
contain a reception area, a nursing station
and a patient lounge with 20-25 chairs.
It also will contain three smaller
(Continued on page 2)
first major gifts during the campaign
support the university's endeavors in
these areas.
Of interest within the medical center is
the establishment of the $300,000 James
M. Ingram Endowment Fund to support
cancer research and treatment. The
endowed fund was established through
the estate of Mrs. Mary Luceil Vansant of
St. Petersburg, Fla. to honor and pay
tribute to Dr. Ingram. Ingram, a
practicing physician in St. Petersburg, is a
1944 graduate of the Duke Medical
School.
Income from the endowment fund will
be used primarily for cancer research and
treatment within the Department of
Obstetrics and Gynecology at the medical
center.
A previous commitment to the
campaign that supports the leadership
Duke is providing in the area of cancer
research and treatment is the pledge from
the J.A. Jones Construction Company
and the Edwin L. Jones family of
Charlotte for a cancer research building.
Other goals of the drive include partial
funding for two additional buildings at
the medical center for cancer research
and treatment.
Mrs. Isobel Craven Martin of
Lexington, a Duke Trustee and graduate,
has created an endowed scholarship fund
to honor her great-grandfather, Braxton
Craven. Craven was the first president of
Trinity College.
The $250,000 Braxton Craven
Endowed Scholarships are to be awarded
on the basis of academic aptitude,
(Continued on page 3)
CHECKING fffyACr/O/VS—Physical therapist Betsy Denny (left) and student Mary
Ellen Boynton test the reactions and dexterity of a 20-month-old boy with cerebral
palsy. The child was brought to the Developmental Evaluation Clinic, where a team of
experts from psychologist to speech therapist will evaluate his abilities and recommend
to the parents how to maximize them. (Photo by Jimmy Wallace)
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VOLUME 20, NUMBER 48 DECEMBER 7, 1973 DURHAM, NORTH CAROLINA
Delays in Mental, Physical Growth
Are Targets of Development Clinic
Epoch Campaign Creates
Cancer Fund, Professorships