Healthy students, strong schools: as medical expertise expands and student needs grow, this district's Medical Advisory Board remains an indispensable component of district services to students.

Long the dream of the Manhattan Beach Unified School District nursing team, a district Medical Advisory Board was launched two years ago. An expert team of medical personnel was invited to join with our district staff to guide personnel who deal with student health issues. As this pioneering group left its first meeting in June 2002, members knew they would be making a powerful contribution to the well being of our students.

How it started

Due to the many advances made in the field of medicine in recent years and the increasing populations of students with complex medical issues, school personnel felt a need to tap into additional professional resources. As general medical concerns and treatments changed, district leaders were faced with challenging decisions that affected individual students and the larger student population.

Over the years, district nurses had kept an ongoing list of medical professionals they could contact for specific student health issues. As needs of students grew, this "medical Rolodex" expanded, with the names of pediatricians, adolescent medicine experts and other specialists who were supportive in caring for our students.

In one fortuitous meeting, district nurse Judi Zimmerman had a conversation with prominent endocrinologist Dr. Kevin Kaiserman about the idea of a Medical Advisory Board that could meet regularly to guide our staff. His enthusiastic response and willingness to step in to lead the group was all the impetus that was needed for the board to be formed.

When another district nurse, Tami Simmons, had a similar conversation with her daughter's pediatric ophthalmologist, Dr. Anne Simon, she responded with the same spirited energy.

Now that a core team of professionals was willing to come forward, some logistical planning was required. An outline stating the purpose, participating groups, time lines, focus areas and meeting dates was developed. This proposal provided a protocol for the new board to follow.

In order to facilitate record-keeping, some secretarial time was needed. A grant request developed by our business partnership coordinator was subsequently supported by the nearby Torrance Hospital Medical Center. Since Medical Advisory Board members meet in the evenings after their busy work days, part of the grant included a much-appreciated dinner for the triennial meetings. This dinner perk has prompted greater camaraderie and a "conversation period" that has bonded the group in support of our mission.

The medical personnel on the initial invitation list included an endocrinologist, pediatric gastroenterologist, pediatric cardiologist, infectious disease specialist, dermatologist, dentist, adolescent medicine specialist, clinical psychologist, pediatric ophthalmologist, emergency room physician, allergist, orthopedist and podiatrist. The director of a local urgent care facility and a director of the free clinic were also included. Fifteen letters were mailed to this select group, and all 15 professionals enthusiastically agreed to join the board.

Learning from each other

It is now more than two years later, and the Medical Advisory Board has emerged as one of the most valuable teams guiding our district. Participating physician Dr. Charles Song, an asthma and allergy expert, reflected on the significance of the group: "I thought the idea of the medical board was wonderful, because the physicians could offer expert opinions in their specialties to the school community and they could learn from each other.

"I personally was interested because I have been involved with a summer camp for children with asthma and with an asthma education outreach program. Allergy problems affect more than a fifth of our school children and the incidence rate is on the rise. It was a natural thing for me to be interested in the board and to share whatever expertise I have to assist our children."

No shortage of issues

From the first meeting, it was clear that the health of the students was everyone's primary concern, and the discussions were lively. Issues emerged that would fill dozens of agendas, including childhood obesity, soft drinks on campus, the rise in Type2 diabetes and guidelines for medicine distribution at school sites.

For example, board policies were changed to reflect new information on inhalers/nebulizers at school as well as rules regarding students with rashes. Dr. Joanna Wong obtained donations of nebulizers from a drug company for the schools, so that parents need only bear a portion of the treatment costs.

A subcommittee of the board worked with the Mira Costa High School vice principal to develop a new "Pre-Participation Physical Education" form implemented in 2004-2005 that is proving to be more comprehensive and succinct than the old form.

Physician review of forms

Physicians continue to generously offer their expertise in reviewing standard forms, such as our "Requests for medication during school hours," among others. Templates have been developed related to "Guidance on Ozone Pollution and Physical Activities," and a position paper from a Medical Advisory Team provided detailed recommendations regarding the role of schools in promoting a healthy lifestyle. Our dentist member provided all schools with a valuable protocol for dental emergencies.

Each year, the Medical Advisory Board has expanded to include new members, including more pediatricians and two psychiatrists. We hope in the near future to add a pediatric neurologist. Most telling for our efforts is the exceptional attendance rate and the enthusiastic involvement of all participants during the meetings.

Greater security for students

As medical expertise expands and the needs of our children grow, the support of this Medical Advisory Board team will continue to be an indispensable component of our district's services. Hundreds of hours of contributions, years of expertise, and an exponential commitment from this dedicated and committed team have reaped peace of mind for our staff and students' families and--ultimately--greater security for our children.

The end of 'us vs. them'

Board member Dr. Linda Schack said, "I think many physicians have an 'us vs. them' view of the schools. Doctors have to fill out cumbersome forms, our patients have medical problems that have implications for school and we don't know who to call, or the school is not allowing our patient to attend class because of illness and we don't agree with the decision. We have talked about all of these issues and more while working on the board."

Dr. Schack said, "I have been on several volunteer boards in the past, and sometimes the experience is that there are many meetings and discussions and very little gets accomplished. This board is very different. The district nurses should be commended for such an innovative concept."

Gwen Gross is superintendent of Manhattan Beach Unified School District. Judi Zimmerman (RN, MSN) and Tami Simmons (RN, BSN) are nurses for the district.