Here, There and Everywhere: Splitting a Nurse's Time Between a School and a Community Health Clinic Helps Coordinate Care

Linking a community-based primary health care clinic to neighborhood schools

A partnership in Madison, Wis., established a formal link between the South Madison Health and Family Center and area neighborhood schools to test a model of health care delivery.

In the model, the same pediatric nurse practitioner provides care in the neighborhood's schools and in a community-based primary care clinic in order to better serve the complex needs of low-income children and their families.

The partnership, started in the 1970s, included the Madison Metropolitan School District, Madison, Wis., the South Madison Health and Family Center, and the University of Wisconsin-Madison, School of Nursing.

Key Results

  • The pediatric nurse practitioner provided primary health care services, including:
    • Health maintenance visits.
    • Immunizations.
    • Treatment of minor injuries and health conditions.
    • Management of chronic illness.
    • Referral to specialists.
  • From June 1997 through June 1998, 98 children ages 5 to 19 from approximately 24 different schools (out of 45 in the district) were seen by the pediatric nurse practitioner.
    • Some 67 percent of these children were uninsured and without a regular source for health care.
  • Of the care provided, 54 percent of the visits were for acute illnesses and 36 percent for well-child care.
  • Immunizations were updated for 28 percent of the patients.
  • Some 40 referrals to specialists or recommendations for follow-up at the clinic were made.
  • Twenty-six percent of the patients seen needed coordination with their school in some capacity.
  • In addition to the school-age children, from August 1997 to April 1998, the pediatric nurse practitioner saw 197 infants and 86 preschool children.