Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Communication Partnership Student Health Collaboration Overview – Delaware School Nurses May 10, 2012 1 The Challenge Currently School Nurses are not able to access protected patient information due to the fact they are not routinely recognized as part of the care team. Exchange of information about the care of students/patients would improve health outcomes for children. 2 STORY (Head Injury Example) During PE class a student received a head injury. He was taken to Nemours ED by the family. The school nurse followed up with the family who reported, “A deep wound requiring 11 stitches, a slight skull fracture, and a concussion”. The nurse requested the discharge instructions be sent to school. Two days later the student returned to school, without the discharge instructions. Nurse’s action: Student restricted from PE class and recess. After several weeks of phone calls to the family requesting documentation, the mother completed a release form for the school nurse. The records did not indicate a skull fracture or concussion. Weeks of activity restriction, nurse/parent conflict, and staff frustration could have been avoided if the nurse was able to view the discharge instructions in a timely manner. 3 Authorization FORM 4 The Response Nemours and the Delaware Department of Education formed a multi-disciplinary team that created a process to facilitate the exchange of medical/ educational information between DE School Nurses and Nemours Clinical Providers. A HIPAA / FERPA compliant authorization form was designed to obtain consent from parent/caregivers to allow school nurses to view the medical records of the students under their care The authorization form reinforces that school nurses are part of the care team. 5 Workgroups Technology Dave Nichols, Chair Linda Wolfe Dave West Vicki Sanders Sam Strally Mary Zier Ann Hurst Aguida Atkinson Shari Thomassen Jamie Crooms Claudia Kane Beth Light Marina Kaplan Implementation Design Claudia Kane, Chair Aguida Atkinson Linda Wolfe Vilma Davis Shari Thomassen Ann Hurst Jamie Crooms Vicki Sanders Mary Zier Mary Newman Andrea Littleton Beth Light Pat Guilday Sharon Gandolfo Stefanie VanStan Barbara Wilson Evaluation • • • • • • • • Luanne Stratton, Chair Steve Lawless Linda Wolfe Stefanie VanStan Marina Kaplan Katherine King Jamie Crooms Claudia Kane 6 Information Sharing Treatment – Asthma management/action plan – Diabetes care plan – Medications – Allergy management/action plan – Discharge instructions – PE / Classroom restrictions Non-Treatment – Physical examinations – Immunizations – Letter indicating the types of activities in which students should be engaged – Lead levels and TB screening – Contact information for other care providers Educational – Academic performance – Attendance – Behavioral issues – Frequency of school nurse visits and for what reason – Medication/ Treatment compliance 7 Communication PATHWAY DELAWARE SCHOOL NURSING PRACTICE PATIENT Fax to Nemours Informatics (V.Sanders) Send to Health Info Management – EPIC (M. Zier) SCHOOL NURSES Authorization NEMOURS CLINICIANS Abstractor Fax to Nemours Informatics (V.Sanders) 8 A web-based portal that provides access to Nemours electronic medical records (EPIC) by community health care providers A legal contract between Nemours and School District will allow school nurses a user-account in NemoursLink. School nurses will be able to access current medical information but will not have access to behavioral health records. 9 The Partnership Parent Student Nemours Provider School Nurse 10 Benefits Greater efficiency in accessing current student medical information Commonality of information seen by school nurse and medical providers Reinforces information that families are given regarding their child’s care Minimizes the miscommunication between care providers Reinforces the school nurse role in the care team during the school year. 11 Pilot Sites Schools Red Clay School District (4 schools) Milford School District (6 schools) Primary Care Practices St. Francis Milford Specialty Sites Endocrinology Hematology Oncology Clinic Orthopedics Pulmonology 12 Role of Pilot Participants To identify what works and what doesn’t To identify situations in which this process improved communication and student health To identify success stories To develop workflow ideas, which can be used universally throughout the partner schools in Delaware To participate in evaluation interviews 13 Next Steps – School pilot sites will participate in a NemoursLink training – Pilot sites will be invited to a meeting and greet event (if possible) – Nemours Evaluation & Research team will reach out to school pilot sites to schedule initial (preimplementation) interviews – School nurses and Nemours clinicians will engage in sharing of information across sites – Address questions coming from pilot sites – Develop plan for expansion into other school districts and within the school district 14 Measuring Success: Pilot Short term (Process indicators) – Utilization of NemoursLink among school nurses – Reported ease of use and satisfaction Intermediate – Increased awareness of individual patients’ care plans among school nurses – Perceptions of improved care coordination – Change in quantity, quality and nature of communication between school nurses and providers, parents and students – Less time spent by school nurses on fact checking and searching for information Timeline ≈ 3 months 15 Measuring Success: Full Scale Same short-term and intermediate outcomes as pilot Addition: Long-term outcomes – Decreased absenteeism among students – Decreased behavioral problems & discipline referrals among students – Improved health-related QOL among students – Improved compliance with medications – Changes in health care utilization (ER, PCP visits, hospitalizations) Timeline: 1−3 years 16 Comments from the Field Pat Guilday – Workgroup Member Rossana Palermo, Warner Elementary, Pilot Site Sue Smith – Milford Central Academy, Pilot Site 17