A growing number of health systems are recognizing that serving children in school settings is population-health gold.
By expanding the range of services available in schools, health systems can address acute problems quickly, help students manage chronic conditions and reduce the use of more expensive health care resources.
A staggering one-third of all children are overweight or obese. At least 215,000 people younger than 20 have diabetes, and about 10 percent of school-age children suffer from asthma. These health statistics offer a challenge for America’s school nurses — and a population-health opportunity for forward-thinking health systems.
“If you can improve the health of a child, potentially you will have a healthier adult,” says Jesus Cepero, R.N., chief nursing officer and chief operating officer for Meritus Health in Hagerstown, Md.
Meritus Health has operated the school nurse program for Washington County Public Schools since 2012, serving 23,000 students in 47 schools. During that time, the health system has learned that it can improve students’ health status, and reduce high-cost utilization of health care resources.
For example, when Meritus learned that many children with asthma only had rescue inhalers, its school nurses began calling the children’s physicians to suggest chronic medication management. The result: Students with asthma are managing their illness more effectively, missing fewer school days and making fewer trips to Meritus’ emergency department.
Meritus established school-based health centers — staffed by a nurse practitioner and nursing personnel five days a week — at two schools where many students do not have primary care physicians.
The American Academy of Pediatrics highlighted the importance of such school health programs in a policy statement released in May, stating: “As the number of students with chronic conditions grows, the need for health care at school has increased.”
“If you believe, as we all do, that every child needs a medical home, the school is the obvious place where we can identify that problem,” says Anne Sheetz, R.N., a retired pediatric nurse who helped to write the AAP policy.
She points out that most schools need help with the growing number of behavioral and mental health problems among their students. The AAP statement says that 10 percent of children and adolescents have a mental illness severe enough to cause some level of impairment.
Indeed, an assessment of health needs of middle school and high school students in Washington County identified depression and suicidal thoughts as major problems. Meritus partnered with a behavioral health provider to make on-site services available to students.
“Schools provide a good window into what the community health needs are,” Cepero says.