By Linda Childers
In any given day, Margaret Vasquez, MS, RN, CPNP, and Lisa Kimmey-Walker, MSN, RN, CPNP, see a wide variety of pediatric cases in their role as nurse practitioners in the Houston-based Memorial Hermann Health Centers for Schools program in Houston, Texas.
Launched in 1996, the program added three new school clinics and a third mobile dental van to its growing roster of clinics. The program now has 10 school clinics in five school districts including Houston and Lamar. There is no fee to students enrolled in the school districts, although they do need parental consent to be seen.
The Memorial Hermann nurses work in collaboration with each school’s own dedicated site nurse, who refers more serious cases that go beyond scrapes and falls to the nurse practitioners at the school clinic.
“The nurses who work for the school district can’t diagnose or prescribe, so they triage students, sending cases to us, or in the event of an emergency, they call for an ambulance,” Kimmey-Walker said. “Our goal is twofold: to help students stay healthy and in class.”
And their formula is working. Since the clinics were first launched, statistics show that 92% of students seen at the clinics returned to class on the same day after a visit.
“We treat cases including strep throat, flu and bladder infections,” Kimmey-Walker said. “We also care for children with chronic diseases such as asthma. [We] help them to better control their condition and avoid visits to the emergency room by developing an asthma plan and teach them how to use peak flow meters.”
Vasquez said the clinics are making a difference for many children who lack the most basic of primary care.
“The majority of children we see don’t have health insurance or a pediatrician,” Vasquez said. “We serve as a medical home for uninsured children and a secondary access point for insured children.”
Many of the students who come to the school clinics report using the health system sparingly. Over 93% of the students seen are considered to be living at the poverty-level, and 34% have limited English proficiency. Many of the families may not have received care because of transportation issues, lack of knowledge about available healthcare or because they couldn’t communicate with staff at the clinics.
“At the school health clinics, we can see that many health conditions get regular preventive care before they worsen and become an emergency,” Vasquez said.
Darla Massey, executive director of administrative services for the Pasadena Independent School District in Pasadena, Texas, said the unique health partnership between the school districts and Memorial Hermann has allowed students to remain healthy and in school.
“The clinics have improved both the health of students while reducing absenteeism,” Massey said. “It fills a gap in our system by providing students at risk with quality healthcare without fiscally impacting their families.”
Linda Childers is a freelance writer.
Sidebar: A first-hand look inside a school-based health center
Typically located inside a portable building on school campuses, Memorial Hermann’s school clinics look remarkably similar to any other health clinic. There’s a front desk where students check in for appointments, a waiting room, pharmacy and exam rooms.
Each of the Houston-based Memorial Hermann’s school clinics is staffed by a nurse practitioner or physician assistant, LVN, licensed clinical social worker and receptionist. Medical oversight is provided by a Memorial Hermann family practitioner.
Two registered dietitians and community health workers provide students with social services as needed and they rotate among the centers. A dentist and one or two assistants staff the three mobile dental vans.
“Our school health clinics are open year-round, Monday through Friday, during school hours, and we provide everything from primary medical and dental care, to mental health counseling, social service referrals and nutrition counseling,” said Health Centers for Schools NP Lisa Kimmey-Walker, MSN, RN, CFNP.
Statistics from Memorial Hermann show the school clinics have reduced asthma exacerbations, and that ED visits and hospitalizations have been reduced by 92% since inception of the school clinics.
— Linda Childers