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BACKGROUND: Despite extensive literature on school-based health center (SBHC) characteristics and outcomes, their quality of care has not been examined nationally. Standardized quality metrics can inform health care delivery and improvement.METHODS: SBHC national performance measures (NPMs) were developed by reviewing measures from national child health quality initiatives and engaging stakeholders in a consensus-building process. NPMs were pilot-tested with 73 SBHCs and SBHCs nationally subsequently reported data.RESULTS: Five NPMs were selected including the percentage of clients annually who received at least one: (1) well-child visit, whether administered in the SBHC or elsewhere; (2) risk assessment; (3) body mass index screen with nutrition and physical activity counseling; and, if age-appropriate, (4) depression screening with follow-up treatment plan; and (5) chlamydia screening among sexually active clients. SBHCs experienced challenges with reporting during pilot-testing, particularly related to extracting data from electronic health records, and identified strategies to address challenges. Approximately 20% of SBHCs nationally voluntarily reported data during the initial year. IMPLICATIONS FOR SCHOOL HEALTH:Standardized performance measures can help SBHCs monitor and improve care delivery and demonstrate effectiveness compared to other child health delivery systems. CONCLUSION:Ongoing data collection will help examine whether measure adoption drives quality improvement for SBHCs nationwide.

Background: Children and adolescents in the United States face disparities by race, ethnicity, and socioeconomic status, including unequal access to consistent and high-quality healthcare. School-based health centers (SBHCs) promote health equity by delivering primary, mental, and other health services directly to students in their schools. The COVID-19 outbreak in the United States resulted in schools and SBHCs closing their physical sites and pivoting to virtual service delivery.Methods: In the months immediately following school closures, school-based health center practitioners and sponsors participated in an online listening series to share how they used technology to creatively advertise services, engage with students, and continue delivering care. These discussions highlight challenges, opportunities, and future implications for telehealth and the use of technology in SBHCs.Results: With no or limited opportunity to interact with patients in-person, school-based health center staff used technology to conduct marketing and outreach and offer virtual care. Many launched telehealth operations for the first time due to the pandemic, whereas others altered or expanded previously established virtual service offerings. Listening session participants recognize the unique benefits of telehealth during and after the pandemic, but they also discussed unique challenges, such as privacy concerns and the digital divide. Conclusions:The findings outlined in this manuscript should serve as a baseline for future research and programs related to school-based health, health technology, and pediatric care, especially during global crises. Health technology, particularly telehealth, is a crucial tool to mitigate strain on emergency departments, administer screening and preventative care, and provide mental health care as COVID cases continue to rise. Enabling policy solutions, shared best practices, and supportive partnerships are crucial as SBHCs continue to find ways to help students remain healthy and achieve their fullest potential.

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