Teamwork Helps Children Breathe Easier

A chronic condition like asthma, can produce a ripple effect. If not well-managed, it can affect a child's success at school, their family and the community. But with improved communication and coordination between the child's clinic and school, kids stay healthy and in the classroom, parents don't miss work and the entire community benefits.


The School Health CareLink Program is a proactive approach to managing asthma among children ages 4 to 11. Three Madison Metropolitan School District (MMSD) locations piloted the program with the UW Health West Towne Pediatric Clinic in April 2016, and it was expanded to all MMSD elementary schools and pediatric clinics in August.


The School Health CareLink Program gives school nurses read-only access to health records of any student whose parent or guardian gives consent and can send CareLink messages to clinics, ask questions or share new information based on what they see in the school.School nurses are given read-only access to the health records of any student whose parent or guardian gives consent. The nurses are able to send CareLink messages to the clinic, ask questions or share new information based on what they see in the school. The school has fast access to care plans, and their feedback gives the primary care provider information they use to help the family manage asthma symptoms.


University of Wisconsin Clinical Assistant Professor, Sujani Kakumanu, MD, initiated the program through grant funding. It's a simple idea, yet surprisingly unique, with programs in only a handful of other U.S. cities. Many schools can't absorb the cost of software, or have privacy and security concerns.


But UW Health clinic operations manager, Susan Cox, BSN, RN, says it's well worth it. "What happens at school and at home are important pieces of the puzzle," she explains. "Knowing more about the child's life contributes to what we can accomplish in the clinics."


Cox says in the past, it was difficult to get a complete picture of the child's health. Sometimes a school nurse might not even know a student had asthma. Or, they'd experience a flare-up at recess, forget which inhaler to use and it would take hours to get answers. Now, schools and clinics can exchange instant feedback. "It makes care so much easier and keeps the kids healthier," Cox says.


Leopold Elementary school nurse, Holly Raymond, RN, MSN, CPNP, praises what the program has already done for her students. "It opens up communication so I can talk to the student's parent or guardian, download their asthma action plan or review medication needs with the primary care doctor," she says.


Raymond can think of one family that is now far better off thanks to the program.


One afternoon, student Elijah Richmond came in short of breath and wheezing. His school records did not indicate he had asthma, but Elijah told her he used an inhaler at home. Emergency protocols allowed Raymond to administer a dose for temporary relief, but he needed more help than she could provide, so Elijah's mother took him to the emergency room.


Raymond also learned that the student's brother, Raekwon, had been hospitalized for asthma later that same day after he developed coughing and shortness of breath. "The school didn't know either of these students had asthma," says Raymond. "But both of them needed more care than the school could provide at that point." Raymond reached out to their mother about the School Health program and she immediately signed them up.


"It's made such a difference in their care," Raymond reports. "I can look at their charts and know what's going on and give both boys their medications and treat their symptoms as needed, to avoid future hospitalizations."