School nurses and pediatricians team up for better care in Camden

A pediatric roundtable held at the Camden Coalition
Date
June 14, 2017
November 14, 2019
It takes an ecosystem: Finding success in complex care
Read the Putting Care at the Center 2019 opening remarks by Kathleen Noonan, CEO
Kathleen Noonan
Putting Care at the Center attendees converse at a table.
October 29, 2019
Camden Coalition partners with the Better Care Playbook to share practical solutions for serving complex populations
Lessons from our local and national innovations that offer guidance for serving complex populations.
Mavis Asiedu-Frimpong
A group of 5 National Consumer Scholars at the Putting Care at the Center 2019 conference in Chicago
September 25, 2019
A community engaged: The Camden Coalition as a local and national hub for community empowerment
The Camden Coalition has built a robust community engagement strategy to recognize individuals with lived experience as key complex care partners.
Whitney Buchmann
August 19, 2019
Translating local innovation into statewide policy: Lessons from a medications for addiction treatment (MAT) prior authorization pilot in Camden, New Jersey
In this brief, we outline our prior authorization pilot program and our work with partners to translate the pilot into successful statewide policy.
Natasha Dravid and Alex Staropoli
August 19, 2019
Camden residents identify barriers to health in their neighborhoods
Members of organizations that have participated in our Faith in Prevention program conducted a health assessment of their Camden neighborhoods.
Whitney Buchmann
Camden Coalition staff and Community Advisory Committee members participate at the Housing and Community Development Network of New Jersey’s Annual Legislative Day at New Jersey State House
July 18, 2019
Camden Coalition joins the call to fully fund the Affordable Housing Trust Fund
To help secure FY2020 funding for the Affordable Housing Trust Fund, CAC members took part in HCDNNJ's Annual Legislative Day at the NJ State House.
Whitney Buchmann

Adults with complex health and social needs are not the only ones in Camden who often visit the emergency department (ED) instead of their primary care providers. Robin Cogan, a school nurse who works at four Camden-area preschools, noticed that when she asked parents to get medical clearance from a doctor to allow their child back in school, parents would often take their children to the ED instead of to their pediatricians. “What I wanted to know was, why the ER instead of their provider?” she said. “I wanted to know what the barriers are.”

Through the Johnson and Johnson School Health Leadership Program, Robin and a team of two other school nurses and two family workers learned the answer to that question directly from the source: the parents. Robin’s team convened a series of six “community cafés,” using an innovative research method based on the World Café method. In these focus group-like meetings, parents, school nurses, and family workers talked about parents’ experiences with the health care system.

Robin said she was surprised by what she learned from parents. “Continuity of care, or the lack of continuity of care, was the number one reason parents gave for why they go to the ER,” she said. Parents described the frustration and difficulty they faced making appointments with their children’s pediatricians. “One dad said, ‘If I can’t see my child’s pediatrician and I have to see a stranger in the office, I may as well go to the ER and see a stranger there.’”

Language and cultural competence was another major theme.

“Our population is mostly undocumented immigrants,” said Candida Rodriguez, a family worker at Mi Casita day care and part of the community café team. “People assume that they’re all Mexican, but they’re not. People assume they all speak Spanish, but they don’t. And even when staff do speak to them in Spanish, it’s not the same Spanish that they speak.”

Other barriers included lack of transportation and parents’ inability to get off of work to take their child to the pediatrician’s office.

The next step was taking these findings to the city’s pediatric practices. That’s where the Camden Coalition was able to help: we convened a meeting between the school nurses and family workers who led the community café project and the pediatric practices that are part of our Accountable Care Organization. The meeting has since turned into a quarterly roundtable focused on brainstorming shared solutions to improve care for vulnerable Camden families.

The city’s school nurses and pediatric providers didn’t necessarily understand each other’s roles, said Kaiya Harris, Program Manager for Community Engagement at the Camden Coalition. That lack of understanding was contributing to the breakdown in care. “The thinking was to get them in a room and get them on the same page,” she said.

The relationship-building seems to be working. “I love the openness and willingness of the [pediatric] providers and nurses to be so positive and proactive in finding solutions that work for everyone,” said Candida.

“Ultimately everyone wants the same thing,” said Robin: “to provide good care to kids and families.”

Camden pediatric providers aren’t the only ones listening. In May, Robin, Candida, and family worker Laura Jimenez went to Boston to present their findings at the Lown Institute’s national conference and to lead a workshop in the community café model. In June their team won a Population Health Hero award from the New Jersey Department of Health.

Robin said she has been grateful but a little surprised at the strong positive feedback. “Talking with patients should not be a novel idea,” she said. “They are the experts.”

Candida agrees. “I could sit here and think of reasons I think care may need to be improved, but that’s my experience, not their experience,” she said. “They’re the ones sitting in the waiting rooms, they’re the ones speaking to the providers. It’s important that it’s their voice [being heard], that they’re advocating for themselves, that they’re getting the right tools. Otherwise it’s not going to change.”

Stay Informed

Join our mailing list to get the latest updates sent right to your inbox from the Camden Coalition.

Sign Up