J I L L I A N F R O E L I C K , U N I V E R S I T Y O F N O R T H C A R O L I N A A T C H A P E L H I L LA D V I S O R : A N N S K I N N E R , M . E D , D U K E C E N T E R F O R C H I L D A N D F A M I L Y P O L I C Y

HOSPITAL-TO-SCHOOL TRANSITION FOR CHILDREN WITH CHRONIC MEDICAL

CONDITIONSRECOMMENDATIONS FOR DUKE HOSPITAL SCHOOL

SCHOOL RESEARCH PARTNERSHIP

• Duke Hospital School, Fall 2013• Dr. Rick Lemke, Duke Hospital School Principal

• What characteristics contribute to a successful hospital-to-school transition program at Duke Hospital School?• As of 2010, half of all children with chronic medical

conditions report falling behind in their schoolwork (McCabe & Shaw, 2007)

• Access to hospital schools while receiving treatment, but what next?

CONTEXT

• Growing population of children who are surviving life-threatening illnesses• 80% survival rate as of 2002 compared to 59% in 1975

(Elam & Irwin, 2011)

• Need for effective transition programs to prepare children for re-entry after treatment and recovery• Transition programs vary by hospital• Public School System, Child Life, Independent• Role of Hospital School Teachers

• Need for research evaluating best practices

METHODS

• Literature Review• Interviews at Duke Hospital School and Cincinnati

Children’s Hospital—Qualitative Study • 4 hospital schoolteachers, 2 parents, 2 children, 1 school

interventionist• Interviewing “team members” in-person and over

telephone• Visited Cincinnati Children’s Hospital (Morris Fellowship)

RESULTS

Literature Review

• Teacher training• School-established

protocol for children with chronic medical conditions

• Academic and social support before, during and after treatment

• Frequent and meaningful communication and collaboration between “team” members

Interviews

• Desire or realization that communication and collaboration between team members is absolutely essential

• A need for emotional support and programming during and after the transition process

• Design an advocate for every child

EMOTIONAL SUPPORT AND PROGRAMMING

“I felt alone, and isolated…like there was no one there to support me once I was healthy”

“My illness will never be over emotionally”

RECOMMENDATIONS FOR DUKE HOSPITAL SCHOOL

• Collaborate with other hospital schools that are similarly structured

• Virtual or in-person “peer-in” services• Encourage existing positive relationships between

children and any hospital or school staff with whom they have a supportive relationship with (advocate)• Address child’s emotional needs throughout transition• Both in hospital setting and in school setting

• Additional collaboration between the patient’s school and hospital team members• Emails, meetings, scheduled updates, Skype• Set a clear protocol through policy to determine how often team

members should communicate and who will initiate conversations

SPECIAL THANKS

• Morris Fellowship• Ann Skinner• Dr. Rick Lemke• Cincinnati Children’s Hospital• Duke’s Center for Child and Family Policy• The School Research Partnership