Exploring Innovative U.S. School Health Delivery Models: A Narrative Review
Bennett, Sheryl; Maughan, Erin D; DeCato, Sarah; Poland, Emily; Jameson, Beth E
Why this matters
State education agencies and health departments deciding how to organize school health services can use this review to see the range of models already in use. It identifies traditional school nursing alongside school-based health centers and community partnerships, delivered through telehealth, mobile clinics and system-level care, and reports that no comprehensive innovative approach emerged from the published and gray literature.
Abstract
School health services have been described as the "hidden healthcare" system because of their isolation within schools and from other healthcare providers. This isolation may inhibit innovations in school healthcare delivery. Hence, there is a need to identify and characterize various delivery models. This review examines models to identify innovative approaches and formulate suggestions for public health departments, local and state educational agencies, and policymakers. Toward this goal, published and gray literature were studied and synthesized, identifying three delivery models: the traditional model of school-based nursing and two alternative models: school-based health centers and community partnerships. Mechanisms of delivery included telehealth, mobile clinics, and system-level care. Although no innovative, comprehensive approaches to school health services models were found, innovation generally focused on improving equitable delivery to vulnerable populations. Policies must be formulated and funded to integrate such innovations into a comprehensive, preventative approach, including improved care coordination and data sharing.