PEDIATRIC ASTHMA: USING A MOBILE CLINIC TO REACH OUT TO THOSE IN NEED TEAM MEMBERS: SUSAN FINN, MSN; LINDA RUSH, PCT; KAREN JUDY, MD; JOHN ZINKEL, RCP; NURSING AND ADMINISTRATION AT CE HUGHES SCHOOL

Photo of mobile unit

Loyola’s PEDIATRIC MOBILE HEALTH UNIT Began operation in 1998 with a grant from the Ronald McDonald House Charities. Loyola’s Pediatric Mobile Health Unit is the prototype of Mobile Health Units and has been replicated internationally. Began operation in 1998 with a grant from the Ronald McDonald House Charities. Loyola’s Pediatric Mobile Health Unit is the prototype of Mobile Health Units and has been replicated internationally. Operational expenses are paid for by community grants and gifts. Operational expenses are paid for by community grants and gifts. Has seen over 73,000 children since inception, providing no cost health screening, immunizations and disease management. Has seen over 73,000 children since inception, providing no cost health screening, immunizations and disease management. The PMHU staff work collaboratively with school employees and other community members to increase access for underserved populations in the city of Chicago and suburban areas. The PMHU staff work collaboratively with school employees and other community members to increase access for underserved populations in the city of Chicago and suburban areas. The PMHU APN provides education related to community medicine for pediatric residents, medical and nursing students, paramedics and others. The PMHU APN provides education related to community medicine for pediatric residents, medical and nursing students, paramedics and others. CURRENTLY expanding programs by APPLYING FOR RESEARCH GRANTS CURRENTLY expanding programs by APPLYING FOR RESEARCH GRANTS

PROJECT AIM The goal of the Pediatric Mobile Health Asthma Outreach Program was to improve asthma management among pediatric students at a Chicago Public School in North Lawndale by providing increased access to ongoing health assessment and education. The goal of the Pediatric Mobile Health Asthma Outreach Program was to improve asthma management among pediatric students at a Chicago Public School in North Lawndale by providing increased access to ongoing health assessment and education.

NEEDS ASSESSMENT Chicago has a significant pediatric asthma population, with inner-city hospitalization for asthma at over twice the national average(42.8/10,000 compared to 19.5/10,000) A needs assessment related to the impact of asthma on students was performed in Fall 1999, working with the school nurse at CE Hughes School. The school was selected because of a high prevalence of children with poorly controlled asthma in an underserved community for health care. In collaboration with school administration, information was given to parents/guardians of children with asthma. Parent/guardian consent and participation required.

SOLUTIONS IMPLEMENTED The PMHU created a schedule to visit the specific school on a monthly basis to provide on-going education, assessment and asthma follow-up care. The PMHU created a schedule to visit the specific school on a monthly basis to provide on-going education, assessment and asthma follow-up care. PMHU staff collaborate with school nurse and administration to schedule students and to work with families for disease management. PMHU staff collaborate with school nurse and administration to schedule students and to work with families for disease management. Initial assessment of students enrolled in the program included: Initial assessment of students enrolled in the program included: SURVEY OF PATIENT/FAMILY HISTORY SURVEY OF PATIENT/FAMILY HISTORY SURVEY OF ENVIRONMENT(FAMILY REPORT) SURVEY OF ENVIRONMENT(FAMILY REPORT) ASSESSMENT OF PARENT/CHILD KNOWLEDGE OF ASTHMA ASSESSMENT OF PARENT/CHILD KNOWLEDGE OF ASTHMA Pulmonary Function Testing Pulmonary Function Testing Follow-up provided: Follow-up provided: MONITORING(PEAK FLOWS), MONITORING(PEAK FLOWS), Monitor MEDICATION compliance, Monitor MEDICATION compliance, Assist with obtaining medication as needed Assist with obtaining medication as needed Education reinforcement Education reinforcement Communication with parent/guardian Communication with parent/guardian

TEACHERS NOTICED IMPROVEMENT IN STUDENT’S ABILITY TO FOCUS(IMPROVED ATTENDANCE, SLEEP, AND BETTER CONTROL OF SIGNS/SYMPTOMS OF ASTHMA.) Missed School Days due to Asthma FY00FY01FY02FY03FY04FY05FY06FY07 (thru December 06) Number of Days Missed Number of Missed School Days BeforeNumber of Missed School Days After

STUDENT AND PARENT/GUARDIAN FOCUS ON CONTROL OF ASTHMA HAS ENHANCED CONTROL OF THEIR DISEASE SIGNIFICANTLY. Emergency Department Visits due to Asthma FY00FY01FY02FY03FY04FY05FY06FY07 (thru December 06) Number of ER Visits ER Visits BeforeER Visits After

NEXT STEPS Recruit new participants as original students graduate or move. Recruit new participants as original students graduate or move. Work with new administration within the school to enhance collaboration Work with new administration within the school to enhance collaboration Assess opportunity to expand program to additional schools in at- risk communities. Assess opportunity to expand program to additional schools in at- risk communities.