O2120: Principles and Practices of School-Friendly Health Systems

Background: Education is a social determinant of health and has long-term effects on health and economic outcomes for children. As students, educators, and families recover from the COVID-19 pandemic, it is critical for the health and education sectors to align efforts to address the needs of children. Hospitals and healthcare delivery systems need a holistic framework for these partnerships. Seven children’s hospitals and a federally qualified community health center led the development of a School-Friendly Health System (SFHS) framework. A school-friendly health system (SFHS) is a health system—meaning any entity that manages or provides healthcare services or programs, such as hospitals, clinics and health centers—that is designed to ensure all children achieve optimal health and reach their full academic potential.

Project Description: Children’s National, Children’s Health Orange County, Children’s Nebraska, Children’s Mercy, Children’s Wisconsin, Cincinnati Children’s Hospital Medical Center, Mary’s Center, and St. Luke’s Children’s Hospital worked with RESOLVE, a nonprofit specializing in collaborative process design. Over two years, the program team collected expert input from physicians, educators, school nurses, parents, health system and school administrators and others to articulate five core principles of a SFHS. Each principle is accompanied by practices at the provider, program, and organizational level to illuminate how a health system can support children’s health and learning.
• Awareness. Be familiar with, and responsive to the culture, policies and needs of the school systems and student populations they serve.
• Alignment. Have a cohesive strategy for collaborating with schools and communities that aligns with those partners’ needs and goals.
• Accessibility. Make themselves accessible to school partners and collaborate with those partners to optimize students’ learning experience.
• Accountability. Set organizational goals that support children’s academic experience and set metrics and incentives that reinforce those priorities.
• Family Engagement. Collaborate and share power with families, understanding that they are the most important conduits between health systems and schools.

Discussion: The SFHS framework complements the Center for Disease Control and Prevention’s Whole School, Whole Community, Whole Child (WSCC) model, which focuses primarily on actions in the school setting. The 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. Recognizing that supporting children’s health and learning is a multi-disciplinary, multi-institutional endeavor, the SFHS framework is geared specifically for hospitals and health systems.

Conclusion: 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.