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School-Friendly Health System Framework FAQs
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Developing School-Friendly Health System Principles
Children’s National is leading an initiative to develop school-friendly health system (SFHS) principles to help hospitals and health systems deliver better care and patient experience that enhance children’s prospects for improved health and academic success.
Children’s National Hospital and RESOLVE (a nonprofit based in Washington, D.C., specializing in collaborative process design) have led an effort to help hospitals, health systems and clinics become “school-friendly.” A School-Friendly Health System (SFHS) is one actively working to ensure all children reach optimal health and achieve their full academic potential. Access our frequently asked questions about this initiative below. If you have additional questions or would like to connect to learn more, email us.
In mid-2021, Children’s National released the 5 Core Principles of a SFHS. The SFHS framework builds upon lessons learned from other “friendly” initiatives that help health systems meet the needs of specific populations, such as the nationally recognized baby-friendly hospitals and age-friendly health systems initiatives. These efforts have shown that guiding, organizational frameworks can have significant, positive impact on patient and family experience, healthcare costs, and health outcomes. The SFHS framework includes five principles that reflect a broad range of competencies, practices and policy positions that healthcare and school health experts and stakeholders view as emblematic of a SFHS – some already practiced, some aspirational:
- Awareness. Familiar with, and responsive to, the culture, politics, and needs of the school systems and student populations they serve.
- All touchpoints approach. Consider how they can support children’s academic outcomes at all touchpoints, including patient visits, program development and policy advocacy.
- Accessibility. Provide accessible health services in a way that limits disruption of students’ typical school experience as much as possible.
- Family engagement. Collaborate with parents, guardians and families effectively, understanding that these are the most important conduits between health systems and schools.
- Accountability. Include academic-related outcomes among their organizational priorities and set metrics and incentives that align with those priorities we recognize that how a health system can most effectively embody each SFHS principle will depend on its unique context and that of the surrounding community.
A SFHS is any entity that manages or provides healthcare services or programs, including hospitals, clinics and health centers. School health is an interdisciplinary field and requires involvement from broad professional roles including but not limited to clinical care, administration, family support, advocacy and research. Additionally, this framework could be applied to diverse settings, such as hospital-based education settings, primary and specialty care clinics and school-based health centers. The framework encourages there to be diverse teams of health and education professionals working in collaboration, with input from students and family, to ensure all children reach optimal health and achieve their full academic potential.
Between 2019 and 2021, the project team assembled expert input from physicians, educators, school nurses, parents, health system and school administrators and others at the intersection of health and education to articulate five core principles of a SFHS. Specific organizations engaged through meetings and presentations include:
- American Academy of Pediatrics
- American Federation of Teachers
- American School Health Association
- Association of American Medical Colleges
- Center for Health and Health Care in Schools at the George Washington University Milken Institute School of Public Health
- Children’s Hospital Association
- Children’s National Hospital School Health Collaborative and School Health Advisory Committee
- Healthy Schools Campaign
- Kaiser Permanente Thriving Schools
- National Center for School Mental Health
- School Partnerships in Pediatric Settings Project
The Center for Disease Control and Prevention’s WSCC model is a student-centered framework emphasizing the role of the community in supporting the school’s efforts to advance health and learning outcomes through 10 school health components. As students, educators, parents and pediatricians face the ongoing challenges of the COVID-19 pandemic, it is critical for the health and education sectors to align efforts to address the needs of children. Recognizing that supporting children’s health and learning is a multi-disciplinary, multi-institutional endeavor, this framework is geared specifically for hospitals and health systems. The SFHS framework provides the needed direction for hospitals and health systems to become “school-friendly” through personal interactions, programmatic efforts and organizational structures. The SFHS initiative seeks to provide hospitals and health systems, including ambulatory settings, with a framework to better position themselves to support children’s educational experience in partnership with schools and families. The framework is intended to guide any health system engagement with a student or family and a school/school district that may occur in a clinical setting, at a school or in the community. Long-term, we believe broad adoption of the SFHS framework, and implementation of strategies that align with the principles, can strengthen partnerships, and drive meaningful population-level improvements in health and education outcomes. In developing principles of a SFHS, Children’s National conducted a crosswalk of leading school health frameworks, including the WSCC, to see where there is alignment and understand how this framework could support existing efforts.
Children’s National and RESOLVE now plan to support a national cohort of hospitals, health systems and health clinics in piloting the SFHS framework, putting the principles into practice. Each participating organization will develop and implement a 24-month plan to institutionalize one or more of the SFHS principles using shared planning, evaluation and documentation tools. Pilot participants will convene at least quarterly to exchange experiences, challenges and solutions and learn from independent experts. The anticipated outcomes of the pilot include a strengthened version of the SFHS principles and practices framework, including implementation tools jointly developed by the group as well as case studies on each pilot participant’s experience.
Seven hospitals and a community health clinic have expressed interest in participating as a potential site including, Children’s Health Orange County (Orange, CA), Children’s Hospital & Medical Center (Omaha, NE), Children’s Mercy (Kansas City, MO), Children’s National (Washington, DC), Children’s Wisconsin (Milwaukee, WI), Cincinnati Children’s Hospital Medical Center (Cincinnati, OH), Mary’s Center (Washington, DC) and St. Luke’s Children’s Hospital (Boise, ID). The Center for Health and Health Care in Schools (CHHCS) at the George Washington University Milken Institute School of Public Health will serve as the lead monitoring and evaluation partner for this initiative. CHHCS is a nonpartisan policy, resource and technical assistance center with a history of developing school-connected strategies for better health and education outcomes for children.
Children’s National secured initial resources through its hospital foundation and has been supporting efforts through staff time lead by the Child Health Advocacy Institute school health team staff and hospital operational dollars. To launch a pilot effort, Children’s National, RESOLVE and the potential pilot organizations are seeking funding to support the implementation and evaluation of a national learning collaborative and pilot.
A summary report that introduces the SFHS framework with a link to a webinar is available here. For more information and additional questions, please email us.