Why Is Integration So Important?
Your school health services and school-based health center (SBHC) programs are most effective and sustainable when they are well integrated into your school community. This integration serves as a foundation for close partnership with school personnel, so school health programs better support student attendance, positive climate, and academic success. Integration is not easy, and does not just happen one time, such as when an SBHC or health services program starts. Instead, the collaborative work between health providers and school personnel is an ongoing process. It is a two-way street, involving a commitment from both the health and education sectors to communicate and work over time to ensure that the school’s health program is not isolated from the school’s educational program.
Core Principles of Integration
In 2011, we worked in collaboration with the Oakland Unified School District, Alameda County Health Care Services Agency, and the national School-Based Health Alliance to begin to develop tools, resources, and a training guide to help SBHCs better integrate their programs into their school community. Initial funding for this work came from the Atlantic Philanthropies as part of the Elev8 Oakland initiative.
Our team determined that the core principles of integration found below capture all the aspects and levels of integration we would like to see in an ideal school health program or SBHC. We readily acknowledge that this is not a comprehensive list, and that our school health colleagues may offer other, better ideas about how to organize the key principles of integration.
In a well-integrated school health program, school and health partners…
- Develop mutually supportive policies and procedures that advance student health and learning
- Adopt school-wide strategies and frameworks that support healthy behavior and academics and help at-risk students
- Establish collaborative systems and structures to plan programs and direct resources to at-risk students and their families
- Implement school/health programs and services that support school goals, and target student populations of concern
- Participate in school and health program leadership, decision making, and advocacy
- Utilize education and health data to drive policy and program development
- Engage in joint resource development to support health program and school priority programs and services
Assessing Current Levels of Integration
Many school health or SBHC staff have benefited from conducting a brief integration self-assessment in order to determine where their program’s strengths lie, and which areas they most urgently need to address. We recommend that each staff member complete this self-assessment privately first, and then the school health team convene to share and discuss each individual’s perspective on strengths and gaps in your program’s integration into the school.
Your team may also complete a more in-depth school health integration rubric to determine what stage of integration your school health services, programs, and providers are currently in. This tool helps outline the qualities of school health programs that are in different stages of integration — so take a little time to identify whether your program is emerging, developing, or thriving for each principle of integration.
Once you have ascertained which general areas or principles of integration your team will work on, you are ready to look at some examples of how some school health programs are working to implement each principle across related structures, processes, and outcomes. You can use this integration principles worksheet to outline goals for each principle you plan to work on. This worksheet also offers an example of a program structure, process and outcome for each principle of integration.
Many clinical service providers have experience using a quality improvement process to plan, implement, and reflect on efforts to improve the quality of their services. The quality improvement plan-do-study-act (PDSA) cycle is a highly effective tool for organizing teams’ efforts to improve integration. Please utilize this PDSA worksheet in a planning meeting with your team, and consider these strategies:
- establish a concrete, short-term objective for each planning cycle (3-4 months is ideal)
- clearly outline each team member’s responsibilities
- get your plan in writing
- select a leader who will convene the team and hold each member accountable.
Learn more about how to use a quality improvement PDSA cycle with your team at the Institute for Healthcare Improvement website.
Related Tools & Resources
Ready, Set, Success! How to Maximize the Impact of School Health Centers on Student Achievement – Our toolkit offers SBHC strategies to support student success in school.
Contact Us for training or technical assistance with improving integration of your school health program or SBHC into your school community.