School-Based Primary Health Care Model Helps Children with Severe Chronic Illnesses

Starting in November 1996, the Children's Specialized Hospital in Mountainside, N.J. implemented a model of care delivery for children affected by severe chronic illnesses and disabilities and their families.

The project was part of the Robert Wood Johnson Foundation (RWJF) New Jersey Health Initiatives national program.

The model, entitled the Pediatric Practice, focused on disabilities such as cerebral palsy, anoxic encephalopathy (lack of oxygen to the brain), seizure disorders, traumatic brain injuries, congenital abnormalities, and developmental disabilities. It utilized a one-stop, multidisciplinary approach to monitoring and caring for these children in order to prevent life-threatening medical emergencies or extensive hospitalizations.

A core team—physician, pediatric nurse practitioner, and social worker—established Pediatric Practice sites in two schools, with two hospitals providing coverage after school hours.

Key Results

  • The project made services available 24 hours a day, seven days a week. Parents always received a response within 15 minutes of a call.
  • It enrolled 100 children in year one, 185 in year two and 293 in year three.
  • It immunized all enrolled children.
  • The project decreased avoidable emergency room visits among the children enrolled from 29 in year one to zero in year two and eight in year three.