Project Summary
Approximately 10 million children with a special healthcare need (CSHCN) require regular assistance at school. Yet 41 percent of families report not receiving needed care coordination. The fragmented coordination among this vulnerable population, primary care providers, and school services leads to inefficiencies, gaps in care, reduced satisfaction, and poor outcomes. School health services, particularly school nurses, serve a vital role in caring for CSHCN, but are often not considered partners in care. Our project focuses on three distinct communities in Washington, Iowa, and the District of Columbia that have developed partnerships between researchers, school nurses, and families of CSHCN to examine student/family concerns related to coordination. To further the child/family-centered research questions identified in Tier I, we will continue to foster and expand each local team to include other key stakeholders and researchers involved in the care of CSHCN, in order to identify strengths, facilitators, and barriers to coordinated care. In addition, we will establish a National Student/Family-Centered School Health Collaborative (NSCSHC) that will create a formal mechanism for information sharing, provide coaching to local school nurses, and create a national dialogue on care coordination. The NSCSHC will consist of representatives from national organizations that reflect the stakeholders identified by the regional teams and will serve a critical role in breaking down the silos of communication/coordination that exist across groups, which ultimately impact efficient, effective child health services delivery locally. This two-tiered approach—work in local communities and a national collaborative will position us to conduct robust comparative effective research across the US while ensuring local child/family-centered needs are met.