Simpler School Health Documentation
Monroe County School District uses Frontline School Health Management to simplify record keeping, support busy school health staff, improve compliance with state reporting, and easily access data.
Monroe County, Florida
Teachers & Staff
10 public schools, 6 charter schools
Product & Solutions
At the southern tip of Florida and across the Keys, the sixteen schools in Monroe County School District (MCSD) — ten public, six charter — are home to approximately 9,000 students. It’s a very diverse population. “We are a melting pot,” says Dana Portillo, the School Health Coordinator at the district. “We’re a small melting pot, but we’re a melting pot.”
Eleven registered nurses (RNs), one licensed practical nurse (LPN), and five clinic staff provide care to these students. “We are very fortunate in the fact that we have a registered nurse for each of our public schools. Many, many counties, many states, cannot say that. They may have a nurse that shares three or four schools.”
Doing so comes with its share of challenges. Busy nurses show up at least 30 minutes before students arrive in the morning. There are a myriad of details to keep track of: morning medications before breakfast, at lunchtime, or toward the end of the day; managing chronic health conditions; caring for kids who don’t feel well; record keeping; reporting required data to the state; training; taking part in IEP meetings for kids who are part of the Exceptional Student Education (ESE) Program; educating staff about health concerns; keeping certifications up to date; the list goes on. “I was a nurse for 10 years,” Dana says. “It was a very busy, rewarding job. You have to be independent and very organized to get all this stuff done.”
The district receives a high number of refugees. Thankfully, with nurse practitioners in many of the schools, the district can refer these students for physicals, wellness checks, and care in case of illness at no cost to them. But physical and vaccination records may be incomplete or non-existent and many students don’t speak English. “There are a lot of hands involved to make sure people don’t fall through the cracks.” There are many moving parts between the school district, Area Health Education Centers (AHEC) — the organization that employs the nurse practitioners — and the health department staff. This relationship is vital for success.
Simpler Documentation for Nurses
Throughout her entire career in school health, Dana has used Frontline School Health Management (formerly Healthmaster) to make this herculean task more manageable.
“It’s been a godsend for us. It’s very easy to use.”
– School Health Coordinator
The system helps with the enormous amount of documentation that school health professionals handle every day. For example, Florida requires parental permission any time a nurse visit involves physical contact with a child. “I don’t care if it’s to give a Band-Aid or to give a bag of ice, you have to have permission.” Without a signed permission form, a nurse needs to phone a parent for permission. The school health staff utilize a method to manage this information: “One of the things we did was set up an alert in Frontline. Each time we receive that beginning-of-the-year health form that has their health history, it also has the permission signature at the bottom by the parents, and that lets us know that we have permission to see them. So now, as soon as we pull up a child for a visit, the green alert lets us know if we have permission to see them or not.” This information is reported to the state and gives guidance to health staff about the care they are permitted to provide.
When a student visits the health office, nurses can immediately pull up their health history. If a student is diabetic, that appears on the screen. Contact information for parents or guardians is also available, as well as any other relevant information, like medications a student is on.
Everything that happens in the health office gets documented in Frontline — even minor incidents. “That is key… we document absolutely everything. At some point, what may not seem like an important visit may turn out to be an important visit,” says Dana. Documenting details efficiently is critical for legal as well as health reasons in the event that down the line there are questions about a given office visit. “‘Where was this child at this particular time? Who did we talk to, and who did we get permission from, and where did the child end up?’ And without our system, we wouldn’t be able to answer some of those questions. So that’s a huge thing for us.”
For busy nurses, Dana says entering that information needs to be easy. “You should be able to click and listen and multitask and get your stuff done, and then not have that piece hanging over your head at the end of the day.”
“We document absolutely everything. At some point, what may not seem like an important visit may turn out to be an important visit.”
It’s easy for Dana and her team to keep track of which students have undergone required screenings. Not only do they track progress across the student body and see how many students still need to be screened, if a student moves into the county partway through the school year and misses a screening, that will show up on a report as the due date approaches. “By having that end date at the end of the year, we know that they are now prepopulated into what we need to get done. I think that really helps with our compliance.”
Dana says reporting required information to the state of Florida is a lot easier through the system as well. Nurses can easily follow Dana’s instructions to access whatever data is needed. “It allows us to quickly pull the data we need for whatever we’re looking for.”
With Frontline, Monroe County School District can capture and report more data, more efficiently. “Our county will have more documentation, more visits, more screenings, more everything, than a lot of the big cities just because we use it so efficiently and we are very consistent with how we use it. I think that says a lot.” A colleague from another district once shared with Dana how hard it is to collect data about the number of health office visits nurses receive, which isn’t a struggle at MCSD. “When we have these state health reports that are due, it’s very difficult for them. It’s not difficult for me.”
Beyond What a SIS Can Do
One of Dana’s favorite things about Frontline School Health Management is the ability to track required group exams, screenings, health histories, immunization reviews, and the like for all students. Some districts use their student information system to house this data, but Dana says that while a SIS may track data points for individual students, it’s just not built to track screenings for groups of students, care plans, or educational sessions her office provides. “You can do it specific to a child, but you can’t do it across the board where you set up your CPR classes, or you go into classrooms and you talk about X, Y, and Z. That is a big concern to me, not being able to set up true group exams for many other things. It cannot meet all the needs that I have, that Frontline meets.”
“We like the program, and I would be very upset if we did not have it for ease of use. It has been good for us.”