632 - Implementing a School Based Health Center Virtual Care Program: a qualitative exploration of school nurses’ perspectives

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 632
Publication Number: 632.455

Honora Q. Burnett, Department of Pediatrics, Denver Health Medical Center & University of Colorado School of Medicine, Denver, CO, United States; Aly Boral, Denver Health, Broomfield, CO, United States; Samantha Schaap, Denver Health and Hospital Authority, Littleton, CO, United States; Christy Haas-Howard, Denver Public Schools, Denver, CO, United States; Sonja C. O'Leary, University of Colorado School of Medicine, denver, CO, United States

Presenting Author(s)

HB

Honora Q. Burnett, MD, MPP (she/her/hers)

Assistant Professor of Pediatrics
Department of Pediatrics, Denver Health Medical Center & University of Colorado School of Medicine
Denver, Colorado, United States

Background: School based health centers (SBHC) have the capability to meet youth where they are, increasing healthcare access. Virtual care programs (VCP) have been proposed as a mechanism to increase the reach of SBHCs. Over 30 years, Denver Health has partnered with Denver Public Schools (DPS) - serving 90,250 students in 207 schools - through 19 physical SBHCs. Denver’s SBHC VCP model allows school nurses without physical onsite SBHC to utilize the VCP, facilitating virtual connection between nurses and an offsite provider for acute care consultation. Little is known about the experience of nurses participating in these innovative SBHC VCP programs.

Objective: To assess nurses’ perceptions and attitudes towards participating in a SBHC VCP.

Design/Methods: Semi-structured interviews were conducted with nurses participating in the SBHC VCP. Nurses were asked about barriers, facilitators and suggestions for the VCP SBHC program. All interviews were coded using an inductive approach. Authors refined codes through discussion and review.

Results: Thirteen, out of 20 (65%) SBHC VCP nurses participated. Five major themes emerged: 1) Challenges exist for nurses in utilizing a new program: nurses noted challenges obtaining consent, finding private space for a visit and having bandwidth. 2) Nurses enjoy the VCP program: nurses felt like valued members of a healthcare team and appreciated resources for students. 3) Nurses perceive benefits in the VCP for families and students: nurses liked providing a free, higher level of care within a larger medical home, valued how the program allowed students to return to class, and for parents to stay at work. 4) Adopting novel technology is both a facilitator and challenge for busy nurses: nurses noted new virtual care technology enhances their resources, but also takes practice to adopt. 5) As on the ground implementers, nurses think additional training and more family pre-consents will improve the program: suggestions included increasing consents and practical tools for use. Examples seen in image.

Conclusion(s): This unique SBHC VCP allows increased access to a higher level of care for youth. However, the success of a program depends on the experience of nurses. Our findings demonstrate nurses perceive the SBHC VCP as valuable with benefits for students and families, but also with it’s barriers. Other insights uncovered in qualitative interviews demonstrate programmatic challenges and suggestions which will affect future practice and highlight further areas of exploration.