Healthy Camps: The Quest Continues through Technology and Professional Development

Linda E. Erceg, RN, MS, PHN; Barry A. Garst, PhD; and Chris Smith, MEd

Strong interest in promoting the concept of a healthy camp continues. Supported by data from ACA’s five-year Healthy Camps Study from 2006 through 2010, improved understanding about camp injuries and illnesses triggered more effort among camp professionals to minimize — if not eliminate — these injuries and illnesses. Promising practices were identified, parent materials became more robust, and a variety of online courses for staff training appeared. Each was focused on supporting the quest to improve the quality of camp experiences by reducing the load of injury-illness events for campers and staff. 

Now it’s time to take the next steps. It’s time to build on what we learned, implement the study’s “Promising Practices,” and provide camp professionals with the tools and education needed to continue quality health improvements, especially those improvements that can be customized to meet the needs of individual camp programs.

This describes the purpose of the Healthy Camp Education and Monitoring Project. Supported by a continued Mission Partnership and renewed funding from Markel Insurance, a three-year initiative has been launched to guide this next phase of the Healthy Camp initiative. This new project will focus on building online education modules related to camp health and wellness, and identifying health monitoring tools to assist camp professionals with program improvement goals. But other outcomes are also possible. Just as the original Healthy Camp Study provided indicators for organizational improvement over time, so too shall this next phase of study.

Exploring Health-Monitoring Technologies

One of the benefits from participating in the original Healthy Camp Study was that each camp received an annual summary of national and camp-specific camper and staff injury-illness rates accompanied by educational programs designed to reduce targeted “hot spots.” For example, trips and falls were a significant contributor to camp injury, so an online course was developed that presented risk reduction strategies through proper footwear. Impact of the online course was monitored by noting the change in this contributing factor during subsequent years of the study. Another example of educational program development was ACA’s response to communicable disease in camps, the importance of which was highlighted by the 2009 H1N1 f lu outbreak. Specific strategies for controlling the spread of communicable disease were implemented in 2009 that continued in successive summers through the Healthy Camp Study at camps around the country. Screening practices were improved, parents were reminded to keep ill children at home, and protective behaviors were taught and practiced by campers and staff.

Now camp professionals need a better understanding of, and more robust and efficient tools for, collecting and analyzing their own site-specific data related to the health and safety of campers and staff. This is one of the targeted outcomes for the Healthy Camp Education and Monitoring Project. Whether using a national data system (such as the CampRIO tool that was used in the Healthy Camp Study) or a simple spreadsheet to collect injury and illness data, camp professionals need access to tools to help them understand the experience of their own program so that “just in time” adjustments can be made in pro¬gramming, health care, staff supervision, or other areas as indicated by the data. One camp director (anonymous) involved in the Healthy Camp Study explained it this way:

At mid-summer we thought we were having a lot of foot and ankle injuries. So we pulled the records and started sorting through information, kind of like what we got from the Healthy Camp Study. What we discovered was that these injuries were happening at dusk and in the dark. When we looked closer, we noticed that many were happening to staff, not the campers. So we looked closer still and discovered that staff were slipping into their flip-flops and sandals after putting the kids to bed, then walking to the lodge without using their flashlights. We certainly made some changes, but this would have been a lot easier if we had something to help us with the analysis. Even a simple spreadsheet would have helped. When will something like that be ready?

It’s coming.

Another need that’s emerging with increased gusto is the use of electronic health records in camps. Advances in electronic medical recordkeeping technologies, promoted at conference sessions and through new vendor products, have increased the need for camp professionals to be better informed about technology options and the usefulness of those technologies. In addition, parents are asking why their child’s health history form can’t be completed and submitted online. Medical records are shared among healthcare providers — and camp might be the only place where such record sharing is not happening. Some camp professionals are experimenting with novel uses of technology (see sidebar on page 60), while others struggle to figure out technology’s future role — let alone what questions should be asked about potential products.

Expanding Professional Development Opportunities

If one thing was clear from the Healthy Camp Study, it’s that all members of the camp community can benefit from proper training in illness and injury prevention. Although the need for this training might begin with health center staff, it extends to all programmatic and support positions. Contemporary staff training approaches have moved beyond one-week cram sessions offered immediately before camp begins to year-round models that may incorporate online education, self-directed readings, required or encouraged conference attendance, and enrichment retreats. With this in mind, the Healthy Camp Education and Monitoring Project will also provide expanded online learning opportunities related to camp healthcare and emerging technologies to support healthy camps. These opportunities will be offered via ACA’s e-Institute and Professional Development Center.

The need to explore emerging technolo¬gies and professional development related to camp healthcare is here and will only continue to expand. Indeed, some believe the external environment may impose this upon camps as individual health records become increasingly portable and access is shared among various healthcare providers. Five years ago we would have wondered if camps could support technological devel¬opments, but data from ACA’s most recent Camp Sites, Facilities, and Programs Report (2011) indicates otherwise. Most resident camps (~88 percent) have computer ser-vices at camp, more than four out of five have Internet connectivity, and most of these are with some variety of high speed connection. Among day camps, ~75 percent offer computer access at camp, ~69 percent have internet capabilities, and, like resident camps, most have some variety of high speed connections. Nice for camp — but does this hold true for the camp’s health center? That’s the location where electronic health records are used, where various reports are created, where medications are logged, and where additional health information about specific individuals is entered. Have computers with internet connectively made their way in the front door of the health center?

Before adding technology to health services, there’s also need to educate camp professionals about what they should look for in making such a purchase and/or implementing a self-designed system. Concerns about privacy and the impact of existing laws such as HIPAA, the ability of such a program to interface with existing camp software, potential for customizing a system and teaching end users how to use it — including health center staff who may change every week or two — are some of the concerns to tackle. To date, little of this has been articulated for the camp community, leaving early adopters on their own. There is immanent need to address this gap — a gap that is on the radar for the Healthy Camp Education and Monitoring Project.

What Can Be Expected from the Healthy Camp Education and Monitoring Project?

The Healthy Camp Education and Monitoring Project utilizes an advisory committee charged with guiding the project’s outcomes and deliverables. Armed with data from the Healthy Camp Study as well as information from camp profes-sionals across the nation, the advisory committee will guide development of educational components that address needs associated with camp wellness and champion development of injury-illness tracking strategies. The evolving nature of camp health needs, coupled with the speedy developments of technology, means that additional people will be brought into the discussion as needed. Members and their profile of expertise are:

  • Stuart Weinberg, MD, assistant professor of biomedical informatics and assistant professor of pediatrics, Vanderbilt University
  • Tracey Gaslin, RN, PhD, CRNI, CPNP, medical director of the Center for Courageous Kids and board member of the Association of Camp Nurses
  • Chris Smith, MEd, director of program operational excellence with Endless Horizons in Virginia and an early adopter of technology to support camp health services.
  • Linda Ebner Erceg, RN, MS, PHN, (chair), executive director of the Association of Camp Nurses and associate director of health and risk management, Concordia Language Villages
  • Ian Garner, Markel Insurance Company
  • Barry A. Garst, PhD, ACA’s director of program development and research application

The committee receives additional input on issues impacting camp healthcare from Edward “Skip” Walton, MD — liaison for strategic health and wellness relationships for ACA’s national board — and Julie Gilchrist, MD, of the Centers for Disease Control and Prevention.

Steps You Can Take NOW

  • Put a computer in your health center. If it’s there, add Internet capability. If that’s there too, access bandwidth — is it robust enough to handle electronic health forms?
  • Assess your health center staff’s comfort with technology. Can they navigate a basic spreadsheet? Can they create a form? What about a fillable form?
  • Check out new training opportunities available through the e-Institute in ACA’s Professional Development Center at www.ACAcamps.org/einstitute. Continuing education credits are available for all online courses and webinars. An April webinar will address technology in camp health care.
  • Ask your health center staff to provide the camp’s leadership team with routine summaries of camp injuries and illnesses every week, maybe every session. Look for patterns and points of intervention.
  • Double-check your camp’s communicable disease prevention habits. Are they in place as rigorously as they were during the summer of H1N1?
  • Develop your camp’s protocol for assessing and monitoring campers and staff who have head injuries. If you need a resource, get CDC’s information online at www.cdc.gov/concussion/sports/index.html. Enjoy your tax dollars at work!
  • Audit your camp program for its contribution to camper and staff fitness. How often does a person get an opportunity to increase their heart rate during some activity every day? If snacks are offered, is a healthy snack at least an option? Do campers and staff get enough sleep each night (eight hours or more)?
  • To read the final Healthy Camp Study Impact Report or find resources for injury and illness prevention, visit the Healthy Camp Toolbox at www.ACAcamps.org/research/healthy-camp-toolbox.
The W.E. Skelton 4-H Educational Conference Center in Virginia, which serves up to 435 youth per week through residential summer camp and has two heath care staff on duty at all times, piloted a tablet-based electronic healthcare documentation program during the summer of 2011. The goal of the program was to make the medical documentation process more efficient while providing camp administration with the ability to sort and/or monitor specific data related to health issues (e.g. by illness/injury, camper name, date, treatment provided, etc.). Technologies used included Apple iPad2 devices, Filemaker Pro (software), and Filemaker Go (a mobile application to use software on the tablet). Because this was a pilot program, camp administration used redundancy by keeping hard-copy records (using the ACA Health Record Log) in addition to the electronic documentation. The benefits of the electronic healthcare documentation program included:
  • Both medical staff had immediate access to health history forms (PDFs of all health history forms were loaded onto the devices);
  • The electronic healthcare documentation program was less restrictive than a hard-copy health log in relation to the amount and type of information collected (e.g. participant information, patient complaint/onset date, pertinent history, diagnosis, treatment, treatment provider, treatment date/ time, and follow-up);
  • Records could be sorted and reviewed quickly by a variety of variables (name, injury, etc.); and
  • Storage requirements were minimized (electronic v. hard copy).

 

 

 

The Healthy Camp Education and Monitoring Project is generously sponsored by Markel Insurance.

References

ACA. (2011). Camp sites, facilities, and programs report. Retrieved from www.ACAcamps.org/research/improve/2011-sites-facilities-programs-report.

Linda Ebner Erceg, RN, MS, PHN, is the associate director of Health & Risk Management for Concordia Language Villages and executive director of the Association of Camp Nurses in Bemidji, Minnesota.

Barry A. Garst, PhD, is ACA’s director of program development and research application and adjunct professor at Virginia Tech. His current research interests include the multiple meanings of nature-based experiences and the workforce development outcomes of camp experiences. Contact: bgarst@ACAcamps.org.

Chris Smith, MEd, is the director of program operational excellence with Endless Horizons in Virginia. In the camping industry for fifteen years, he has developed an affinity for innovative programs, risk management, and health/wellness.

Originally published in the 2012 March/April Camping Magazine.
 

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