A spike in severe illnesses caused by a surge in respiratory viruses has strained resources for children’s hospitals across the country over the past several months. For Akron Children’s Hospital, a recent expansion of its school-based health care program has been a crucial factor in meeting the challenge.
“There was no way to anticipate how bad this season would be—capacity is a challenge everywhere,” says Michele Wilmoth, M.S.N., RN, LSN, NCSN, director of nursing, school health services, at Akron Children’s Hospital in Ohio. “When you think about the influx of patients, it’s critical that we all are rowing in the same direction to open up access to care for families, and school is an important way we’re doing that.”
The Ohio Department of Health awarded Akron Children’s a nearly $4 million grant last year to expand its school-based health centers. The program launched in 2019 with about 300 hospital employees embedded as school nurses across more than 60 schools in its community supported by one nurse practitioner. The grant enabled Akron Children’s to increase the number of nurse practitioners servicing the program to nine.
Additionally, it has funded the purchase of remote physical exam devices to facilitate telehealth services. The devices enable nurse practitioners to assist school nurses in conducting comprehensive examinations remotely, including measuring lung and heart function and assessing a patient’s ears and throat. The program utilizes a hub and spoke model, with the nine nurse practitioners rotating among participating schools to see students in person and supporting the school nurses at the other locations via telehealth services, as needed. Since August 2022, Akron Children’s has facilitated about 240 telehealth visits through the program, with plans to increase those numbers in the coming year.
Increasing care coordination and equity
The program provides health care services to treat the day-to-day ailments typically handled by a school nurse, including cold and flu symptoms, respiratory infections, rashes and pink eye. But an important component of the hospital’s school-based health centers allows for students to schedule well-care visits and appointments to manage chronic conditions, such as asthma.
“We all know as we're coming out of this pandemic that kids got really behind in their well-care, and these checkups are so important in discovering issues and coordinating follow-up care for students,” Wilmoth says. “Some of these kids were several years behind, so we're bringing their vaccines up to date and getting them connected with a pediatrician and a medical home, which is the goal.”
Wilmoth says another benefit of the service is to ensure proper follow-up care, whether the initial visit takes place in the school-based clinic or at the hospital. For many families, it’s a convenient means to accessing essential health care needs—parents needn’t worry about coordinating work schedules or transportation hurdles around medical appointments. From the hospital’s perspective, it’s an opportunity to address community health.
“School-based health care is an intervention in health equity,” Wilmoth says. “We know from many years working and partnering with families in and through schools that there are number of children who have multiple barriers to care and unmet health needs; what this does is bring the care where it's easily accessible in the child's school—we remove those barriers.”