Helping to keep kids
Healthy and Safe Child Health Advocacy and Outreach Report to the Community 2016 – 2017
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Our Values Our Values
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t. Louis Children’s Hospital has made a commitment to advocacy beyond the
t.hospital Louis Children’s Hospital made a commitment to advocacy setting by investing human and fiscalhas capital for health care services and education for families and childrensetting in need. The Child Health Advocacy and and fiscal beyond the hospital by investing human Outreach (CHAO) department provides health-related resources and education capital forcommunities health care services education for and families and to families and in the St. Louis regionand to help keep them healthy safe. Our commitment to a The region Child that valuesHealth equal access and equity is and the driving children in need. Advocacy Outreach (CHAO) force for our programs as well as institutionalizing a diversity and inclusion department. department provides health-related resources and education to CHAO is honored to provide quality programs that are deemed evidence-based and families and communities in the St. Louis region to help keep them effective practices by Healthy Communities Institute. Healthy Kids Express asthma, healthy Our a region that Safety Street,and Safety safe. Stop, and Headcommitment to Toe have all been to reviewed and graded by values equal Healthy Communities Institute, other programs currently review. access and equity iswith thealldriving force for pending our programs, as well as Providing quality, effective communityand outreach and programming is an important for creating a diversity inclusion department. part of our commitment and mission to do what’s right for children, their families and our region.
CHAO is honored to provide quality, evidenced-based programs. Healthy Kids Express dental and asthma, Safety Street, Safety Stop and Head to Toe have all been reviewed and graded by Healthy Communities Institute, with all other programs currently pending review. Providing quality, effective community outreach and programming is an important part of our commitment and mission to do what’s right for children, their families and our region.
80%
Healthy Kids Express Healthy Kids Express was the first dedicated pediatric mobile health program in the St. Louis area.
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housands of area children and teens are excited to see one of the brightly colored, kid-friendly Healthy Kids Express (HKE) vans roll up at school grounds, health fairs, Head Starts and community organizations each year. Rather than feeling anxious, they know that a caring, friendly HKE provider is there to take care of them. HKE, the first dedicated pediatric mobile health program in the St. Louis area, provides dental, asthma and health care screenings for about 20,000 underserved children and teens annually. On March 27, 2017, Healthy Kids Express Day was declared by the city of St. Louis in honor of the mobile units serving 250,000 children since its inception in 1999.
HKE Asthma During the 2016-2017 school year, the asthma program made greater strides in connecting the underserved with sustained health care. In 2016-2017, HKE concluded a three-year service cycle for nine of 14 schools, in which 40 percent of the known asthmatics in these schools enrolled in our program. HKE provided training to ensure sustainable practices for locations that would no longer receive direct service. It aligned with the Ferguson Commission’s community recommendations by remaining in five of its current schools, and embarked on partnerships with nine additional schools in the Jennings, Riverview Gardens and Ferguson-Florissant school districts for the 2017-2018 school year. To address a service gap for many program participants, HKE collaborated with the Integrated Health Network to assign a Community Referral Coordinator to help asthma patients seen through HKE and the St. Louis Children’s Hospital emergency department find a primary health care provider. The hospital system is committed to training future healthcare providers. In 2016, 101 nursing and pharmacy students shadowed, observed or completed a clinical rotation with the HKE asthma team, in partnership with Goldfarb School of Nursing, Saint Louis University, Maryville University and St. Louis College of Pharmacy. In 2017, HKE began cross-training nurses to support the new Healthy Kids, Healthy Minds program that places full-time school nurses and mental health professionals in area schools.
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The Healthy Kids Express Family Kick-Off Event includes asthma education, free equipment and lots of fun for the whole family.
Providing children with
Friendly Care Asthma During the 2016-2017 school year, 448 of 1,103 students diagnosed were enrolled in the HKE asthma program. Dental Out of the 638 dental cases that were identiďŹ ed between January 1, 2016 and December 31, 2016, 525 were resolved in 2017. Screenings 68,622 screenings were performed, reaching 14,654 children.
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The dental ladies were excellent … my daughter was scared and didn’t want to have her teeth done. They [the dental team] were laughing with my daughter and really showed her love. That helped her do real good.
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— Mom (Jojuana Johnson)
HKE Dental The HKE dental program expanded its outreach, providing dental care for 33 additional locations in 2016, helping 1,939 patients receive services in 279 locations for the year. The need to improve patient education was identified through evaluation assessments. As a result, the pre- and postassessments were modified and showed an average change of 4.79 percent between pre/post assessments across all age groups. Dental care continues to be identified as a top need by the Community Health Needs Assessment; however, there are not enough providers to address the needs. To assist, in 2017 HKE reconfigured its summer service structure to provide care for 561 patients in four ZIP codes — 63112, 63114, 63115 and 63121. Services were provided to these underserved populations through Girls, Inc., Monsanto YMCA, O’Fallon Park Rec Complex and the Ritenour School District. The dental team continues to improve the rate of restorative follow-up care for patients who fail a dental exam by adding more days in which patients may visit HKE vans at its home-base and by introducing hybrid days where cleanings, exams and restorative care are performed during the same visit.
HKE Screening In 2016, the HKE screening program reinforced partnerships with area schools by enhancing health care support within the school setting. When medical gaps were identified, qualifying students received immunizations through HKE. Additionally, to assist school staff, especially in schools with no school nurses, HKE nurses reviewed and entered student health records for immunization compliance. This partnership helped HKE reach more children as it strengthened relationships with overly extended school administrators and school nurses. Each year, service locations are prioritized by a rating scale, based on risk factors such as percentage of children on free/reduced lunches, nurse-to-student ratio, distance to community health centers and health information per ZIP code. Because of new laws requiring additional vaccinations for eighth- and twelfth-graders, as well as outreach efforts to refugee populations, immunizations have increased. HKE provided additional service days at the International Institute of St. Louis to accommodate a surge in newly arriving refugees. Additionally, HKE extends service delivery through collaborations and coordinating care with community mobile vision providers that provide children with glasses.
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Healthy Kids, Healthy Minds Healthy Kids, Healthy Minds places full-time school nurses and mental health professionals in four St. Louis public schools, helping the school system by increasing the district’s nursing staff and providing convenient health care support to students, families and faculty.
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o educate children, a healthy mind and a healthy body are essential. Children with unmet mental and/or physical health needs have a difficult time engaging in the educational process. A new program, Healthy Kids, Healthy Minds, places full-time school nurses and mental health professionals in four St. Louis public schools. The program helps the school system by increasing the district’s nursing staff and provides convenient health care support to students, families and faculty. Through Healthy Kids, Healthy Minds, students’ physical and psychological needs are addressed. Its nurses assess physical needs and mental health care providers consult with staff and parents on the social, emotional and behavioral needs of students. At the beginning of the 2017 school year, Healthy Kids, Healthy Minds placed full-time nurses in the Pierre Laclede, Hodgen, Lexington and Woodward Elementary Schools. To reduce barriers to learning and increase graduation rates, services include: • Identifying and providing case management of students’ chronic health care needs (i.e., diabetes, asthma, life-threatening food allergies, sickle cell disease) • Providing parents with referrals and health care resources • Offering trauma training for school staff members • Providing interventions for students with chronic behavior and emotional needs Nurses average 30 clinic visits each school day, and thus far they have assisted families with identifying resources for immunizations and medical care. Per current plans, four mental health providers will be placed in each school by early 2018.
School nurses address physical needs, and mental health care providers will consult with staff and parents on the social, emotional and behavioral needs of students.
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Preparing children for
Lifelong Learning
Students’ physical and psychological needs are met through Healthy Kids, Healthy Minds.
Healthy Kids, Healthy Minds Students enrolled in school
Total visits to nurse
Visits that ended with student remaining at school
Woodward
285
1,764
1,675
84
Pierre Laclede
170
1,397
1,349
48
Lexington
318
1,098
1,045
50
Hodgen
183
1,615
1,517
82
Total
956
5,874
5,586
264
8.16.2017 – 11.29.2017
Students sent home due to illness
Bridging health and social
Disparities
A new fathers’ support component gives enrolled fathers a platform to connect with one another and reinforces how involved fathers beneďŹ t children.
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Raising St. Louis
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Raising St. Louis bridges health and social disparity gaps to increase healthy pregnancies, reduce infant mortality rates and enhance the quality of life for children.
aising St. Louis is in its third year of bridging health and social disparity gaps to increase healthy pregnancies, reduce infant mortality rates and enhance the quality of life for children and their families in the St. Louis area. Initially created within the corporate structure of BJC HealthCare, in January 2017 the program shifted to St. Louis Children’s Hospital’s Child Health Advocacy and Outreach department in order to better leverage community partnerships and resources. Raising St. Louis addresses the high infant mortality rates found in 22 ZIP codes located in St. Louis City and North County. In 2017, the program expanded from exclusively enrolling pregnant women, to include any family living within qualifying areas who is pregnant or has a child between the ages of one and four. Nurses for Newborns provides in-home health care visits and parental guidance. Parents as Teachers-certified parent educators assess each family’s needs and implement a range of services that include child development, along with individual and family goal-setting. Monthly parent support group meetings, Family Connections, help families explore parenting challenges and gain access to vital resources or health and social services. A new fathers’ support component gives enrolled fathers a platform to connect with one another and reinforces how involved fathers benefit children.
Number of Raising St. Louis Babies by Age
Number of Currently Active Families by Year of Enrollment
Total Number of Babies – 199 6
15
Less Than 1 Year Old 34
71 73
1 Year Old
100
2 Years Old
80
3 Years Old
60
4 Years Old
40
• 55 mothers are pregnant without other children in RSTL • 8 mothers are currently pregnant and have a child in RSTL • 23 mothers have multiple children in the program • 141 mothers have one child in the program and are not pregnant • Data updated through 11.26.17
121
120
20
71
26 9
0 2014
2015
2016
2017
Teen Outreach Program® “I’m proud of myself and of the person I have become.” – Nina
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een Outreach Program® (TOP) is an evidence-based program, promoting the positive development of adolescents through a unique combination of engaging curriculum and community service learning, which is supported by trained facilitators. Used by schools, communities and youth programs, it gives teens essential tools to lead successful lives and contribute to building strong communities. Specifically designed for sixth- to twelfth-grade students, TOP is nationally recognized as a program that delivers real results. During the program’s first year of implementation by St. Louis Children’s Hospital, the 2015-2016 school year, 223 students were served in 11 TOP clubs. Those students provided 4,450 hours of community service. In its second year, the 2016-2017 school year, 317 students in 13 TOP clubs were served; they delivered 5,476 hours of community service. In its third year, the program serves approximately 600 students in 26 TOP clubs; facilitators anticipate that students will provide 10,000 hours of community service by the end of the school year.
Number of Students Served Weekly
Hours of Community Service
(2015– 2017)
(2015– 2017) 12,000
700 611
500 400 317 300
10,000 *
10,000 Hours of Service
Number of Students
600
223
200
8,000 6,000
5,476 4,450
4,000 2,000
100 0 2015-2016
2016-2017
2017-2018
0 2015-2016 * Projected
2016-2017
2017-2018
Giving teens tools to lead
Successful Lives TOP helped me realize how there are so many diverse people in this world and it is great to be nice and great to help them and not be so selďŹ sh. — Cassandra
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Providing families with knowledge and skills for
Healthy Lifestyles
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The Head to Toe program has been an enjoyable and educational experience for my daughters and I. Not only has it provided strategies and resources for my 13-year-old and 8-year-old, with activities centered around nutrition, exercise and social work, it has provided opportunities for the three of us to have meaningful conversations regarding making healthy choices and lifestyle changes. We look forward to our weekly meetings as it provides another way for the Strauther girls to bond and connect as a family. — Lisa Strauther
Head to Toe
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ead to Toe is an evidence-based weight management intervention for kids and teens, ages 8 to 17, and their families. This 12-session program is a highly interactive and engaging fitness, nutrition and social well-being class which focuses on adopting healthier lifestyles through goal-setting, daily exercise and proper nutrition. Program participants are referred by physicians, by word-ofmouth and through the Healthy Start Clinic at St. Louis Children’s Hospital.
Head to Toe has increased healthy lifestyle knowledge and skills among program participants and their families.
The program is facilitated by a registered dietitian, a licensed social worker and an exercise specialist. Each week, one of the three disciplines is taught. In social work classes, topics include family communication, body image, media literacy, stress and coping skills. Portion size, reading nutrition labels and eating away from home are all taught in the nutrition classes. Exercise classes include topics such as energy balance, aerobic exercise, strength training and flexibility. During 2016 and 2017, 220 individuals participated in Head to Toe sessions at our St. Louis location. Overall, participants increased their knowledge by approximately 12 percent, as demonstrated by pre- and post-tests. In 2016, Head to Toe was deemed an evidence-based program by Healthy Communities Institute, a national organization that reviews and certifies that public health programs meet national, evidence-based practices and standards. Also in 2016, Progress West Hospital became an affiliate, replicating the program for families in O’Fallon, Missouri. Other supported affiliates in Missouri are located at Boone Hospital Center in Columbia, Cerner Medical in Kansas City and Parkland Health Center in Farmington. Head to Toe has increased healthy lifestyle knowledge and skills among program participants and their families. A readiness-to-change assessment and a behavior assessment show that even through a short-term program, lifestyle changes begin. These changes in Head to Toe participants provide a foundation for building a healthy future lifestyle.
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Safety Street The goal of Safety Street is to reduce the number of injuries and fatalities in the community by educating youth on how to safely navigate their environment.
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afety Street is an evidence-based interactive learning initiative for children, kindergarten through fifth grade. The goal is to reduce the number of injuries and fatalities in the community by educating kids on how to safely navigate their environment. Using a life-sized cityscape module that is assembled at the demonstration school or community site, children are able to navigate through potential street hazards in a safe, controlled environment. Children receive safety education instruction and practice specific navigation behaviors for pedestrian safety, stray animal and stranger danger, water hazards, home and playground safety, and car or trunk hazards. During 2016 and 2017, Safety Street was conducted at 37 schools and six community events, teaching more than 20,000 individuals injury prevention behaviors. The average knowledge increase, based on pre- and post-test scores, was 20 percent for kindergarten through second-grade students, and 25 percent for third- to fifth-grade students.
Safety Street Participating Schools and Community Partners 2016 Abraham Lincoln Elementary School Baby Kid Expo – St. Charles Blackhurst Elementary School Breese Elementary School Bristol Elementary School Danforth Primary School Gateway Science Academy High Mount School Highland Primary School Illini Elementary School John Weldon Elementary School Kid’s Block Party
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Kratz Elementary School Marvin Elementary School Mascoutah Elementary School Monroe Elementary School New Athens Elementary School North Glendale Elementary School Null Elementary School Riverview Gardens Back-to-School Bash The Spanish School Tillman Elementary School William Holiday Elementary School
2017 Baby Kid Expo Belle Valley Elementary School Dunbar Elementary School East Belleville YMCA Flynn Park Elementary School Fox School District Girls, Inc. Glasgow Elementary School Highland Primary School Illini Elementary School Johnson Wabash Elementary School Keeven Elementary School
Kid’s Block Party Kratz Elementary School Lewis and Clark Elementary School Lusher Elementary School Marvin Elementary School Meadows Elementary School MRH Elementary School O’Fallon, IL YMCA Peabody Elementary School St. Louis Auto Show Walker Elementary School
Providing children with
Safety Education
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We are so happy with how Safety Street supports our health curriculum in a relevant and engaging way. I hear students talking all the time about how they learn so much about how to be safe. I would say that Safety Street has saved the lives of Marvin kids. A few years ago, two students used the skills they learned to evade a possible stranger danger. I could not be more pleased with how Safety Street teaches kids the importance of community and home safety. — Michael Smith, Principal, Marvin Elementary School
Safety Stop In 2017, Safety Stop celebrated its 10-year anniversary and marked service delivery to more than 34,000 parents and children.
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afety Stop is a free service that educates parents and caregivers about car seat, helmet and home safety. Certified child passenger safety technicians provide hands-on education for the proper usage of car seats, bicycle helmets and home safety products. In 2017, Safety Stop celebrated its 10-year anniversary and marked service delivery to more than 34,000 parents and children. Since 2007, there have been 22,850 consultations (car seats, helmets and home safety), and of note, technicians discovered that 3,342 car seats had been installed incorrectly before inspection. During 2016-2017, 1,849 car seat, 320 helmet and 212 home safety consultations were provided. Additionally, a new service was initiated for children with special car seat needs. Subsequently, 116 consultations were provided to parents and caregivers with children who have medical conditions to address their special needs. Through the Sophie’s KISS (Keeping Kids Safe and Secure) program, parents and caregivers learn tips and receive a free tool to help them remember to never leave a child alone in the vehicle – not even for a minute. The Sophie’s KISS program was offered to 562 parents and caregivers. A fourth service will become operational on January 1, 2018. The safe sleep program will address the high incidence of infant mortality in St. Louis. Parents will be educated on the importance of safe sleep practices for children, from birth to one year.
Safety Stop at St. Louis Children’s Hospital Number of Consultations (2007-2017) 18,000
17,165
16,000 14,000 12,000 10,000 8,000 6,000
4,122
4,000
3,255 1,976
2,000 0
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Car Seat
Helmet
Home Safety
Sophie’s KISS
Educating parents and caregivers about car seat, helmet and home
Safety
During 2016-2017, 1,849 car seat, 320 helmet and 212 home safety consultations were provided. Additionally, a new service was initiated for children with special car seat needs.
Ensuring equitable
Patient Care
Diversity and Inclusion
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t. Louis Children’s Hospital is committed to leading the pediatric community in decreasing health disparities and outcomes. In 2016, a manager of diversity and inclusion was added to the Child Health Advocacy and Outreach department. This role addresses education and training to affect disparities in the health care system around gender identity, religion, socioeconomic status and race. New trainings for nursing staff, leaders and departments have been developed and delivered to help ensure equitable patient care. In 2017, the department introduced a film series and dialogue session called “Reel Talk,” an internal and external opportunity to gain understanding and awareness of inclusion and diversity issues through films, documentaries and discussions.
Diversity and inclusion is the inspiration for the Campus Council on Equity and Inclusion, which includes members from St. Louis Children’s Hospital, Barnes-Jewish Hospital, BJC HealthCare and Washington University School of Medicine.
Diversity and inclusion is the inspiration for the Campus Council on Equity and Inclusion, which includes members from St. Louis Children’s Hospital, Barnes-Jewish Hospital, BJC HealthCare and Washington University School of Medicine. The diversity council has four subcommittees — Forward Through Ferguson, Marketing and Communication, Community Outreach, and Policies and Procedures. These subcommittees work on strategies that impact the entire hospital system. In 2017-2018, the hospital will expand its partnership with Generate Health to offer Social Determinants Tours, to help increase the awareness and understanding of health disparities and barriers to health care. This will result in future greater positive outcomes for children and families.
There are four areas of concentration for impacting diversity and inclusion goals: Workforce, Health Disparities, Patient Satisfaction and Cultural Competency. Some 2016-2017 highlights include the following: Workforce • Diversity in the workplace includes setting hiring goals. In 2017 the recruitment team exceeded the goals for a more diverse nursing workforce. • Retention is as important as recruitment. The BJC Connections groups support retention, community outreach and engagement They all grew in 2017. The groups are: Veterans, Disabilities, LGBTQ, African-American Nurses and Blended Connections, as well as new Diverse Leaders group.
Health Disparities • The Human Rights Commission ranked St. Louis Children’s Hospital as Top Performer in its Health Equity Index survey that assesses LGBTQ disparities. • Health care documents were translated into five languages. • 100 percent of new hires participated in diversity and inclusion training as part of their orientation. This training includes race, LGBTQ, nationality and cultural literacy. Patient Satisfaction • Real-Time Feedback Project: data collection from emergency room patients by race, age and gender will assess patient satisfaction and will be used to improve services.
• Community Listening Sessions were sponsored for qualitative data collection. – Five sessions were conducted in 2016. – T wo return visits were conducted in 2017, to provide feedback and updates. – A listening session with Raising St. Louis program clients and their families was held in 2017. Cultural Competency • Like a tapestry, Cultural Competency is being woven into the framework of the hospital. • Training for leaders was held throughout the year and at leader retreats. • Innovative strategies and resources were identified for specific departments. • Hundreds of hours of training and thousands of people were touched, trained or educated about the many aspects of diversity.
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Advisory Boards
The Community and Faith Advisory Board and the Raising St. Louis Advisory Board assist St. Louis Children’s Hospital and the Child Health Advocacy and Outreach department with valuable guidance and feedback to enhance programs and ties within communities served. In 2018, the two boards will join forces to consolidate community resources and further advance positive health outcomes for area families.
Community and Faith Advisory Board Judy Bentley President and CEO Community Health-InPartnership Services (CHIPS) John Bernard Retired St. Louis Public Schools Barbara Bowman Vice President – Controller Urban League of Metropolitan St. Louis Wray Clay Vice President, Diversity and Inclusion United Way of Greater St. Louis Kendra Copanas Executive Director Generate Health STL Marcus Creighton Vice President Wealth Protection Advisors Beth Damsgaard-Rodriguez CEO and Interfaith Consultant Interfaith Quest Steven Harris Partner Rubin Brown Ghazala Hayat, MD Physician SLU Hospital Islamic Foundation of Greater St. Louis Titus Irving Pastor Greater St. Paul MB Church Bob LaPlante Youth Pastor Kenneth Mares, Ph.D. Director, Students and Teachers as Research Scientist (STARS) Program University of Missouri-St. Louis
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Jorge Riopedre Executive Director Casa de Salud Jennifer Strayhorn Executive Director HopeBUILD Wilma Wells Retired Danforth Foundation Keith Willis Director of Sales and Marketing Who’s Who Diversity In Color John Wright Retired St. Louis Public Schools
Raising St. Louis Advisory Board Kendra Copanas Executive Director Generate Health Holly Diesel Academic Program Chair Goldfarb School of Nursing Jane Donahue President St. Louis Public Schools Foundation Allison LaMont MIECHV Program Support Coordinator Parents as Teachers Rhonda Miles Senior Executive Administrator BJC HealthCare Alison Nash, MD Physician St. Louis Pediatrics Melinda Ohlemiller Chief Executive Officer Nurses for Newborns
Jacqueline Randolph Executive Director, Ambulatory Services Barnes-Jewish Hospital Eric C. Rhone President and Chief Executive Officer Visions Management Group, Inc. Amy Tiemeier Director, Community Partnerships St. Louis College of Pharmacy Cheri Tillis Executive Vice President Fathers’ Support Center Ron Tompkins, MA, MS, RN Chief Nursing Officer Nurses for Newborns Kelvin Westbrook Board Chair BJC HealthCare Cynthia Williams Assistant Dean of Community Partnerships Brown School at Washington University
Funding Nearly all CHAO programs are free of charge, funded by generous donations to St. Louis Children’s Hospital. For more information about making a gift to St. Louis Children’s Hospital, please visit StLouisChildrens.org/WaysToGive or call 314.286.0988.
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StLouisChildrens.org stlchildrens raisingstl/ @stlchildrens, @raisingstl stlchildrens, raisingstl St. Louis Children’s Hospital One Children’s Place St. Louis, Missouri 63110