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February 2018Vol. 19, No. 1A Children's Hospital and an Early Childhood Education Center Collaborate to Provide Health-Care Ser

Community agencies serving underprivileged children and families often focus on the social aspects of health and well-being and may not usually have the expertise or resources to provide adequate health-care services. This gap in services can be problematic for parents, as they may lack the resources, time, and knowledge needed to navigate multiple providers. A recent article in Current Problems in Pediatric and Adolescent Health Care highlights a case study of a collaboration between Operation Breakthrough (OB), a federally subsidized daycare and early childhood education and social services agency serving economically disadvantaged children in Kansas City, MO, and Children's Mercy Hospital (CMH), a traditional academic children's hospital.

The collaboration was created as a means to incorporate health care into OB's list of services, since an absence from work to deal with a child's illness may result in lost wages or even jobs for the many parents with children in OB who hold jobs that do not provide sick leave. Onsite health care for children with minor illnesses would alleviate this burden from working parents.

The case study showed there were several challenges that needed to be addressed. For example, OB had to adhere to state daycare licensing policies and federal Head Start administrative and health regulatory policies that did not always coincide with American Academy of Pediatrics recommendations. Another challenge was that parents and caregivers were often wary of social services agencies and health-care institutions because they were worried about being reported and having their children taken away.

To mitigate these and other challenges, OB and CMH decided to conduct listening sessions with key stakeholders, including OB staff, CMH clinic staff, and the leaders of each organization, as well as focus groups with the parents and caregivers with children attending OB. Based on these meetings, OB and CMH determined that there were a number of unmet needs, including the following:

  • Child and adult mental health care
  • A "sick bay" to care for children with minor illnesses who could not, by state regulation, stay in the daycare or the classrooms
  • Including parents and caregivers in the leadership structure of OB

The case study also emphasizes the need for commitment and compromise among the leadership of both institutions. Staff from both institutions must be willing to understand each other's organizational culture and be willing to try new ways of doing things, as well as tolerate the iterative processes that are required to develop and implement collaborative programs to help children.

"Building a Collaboration Between a Children's Hospital and an Early Childhood Education and Social Services Center," by Donna O'Malley, Briana A. Woods-Jaeger, and M. Denise Dowd (Current Problems in Pediatric and Adolescent Health Care, 4), is available at