Children’s Hospital New Orleans strives to go beyond treating kids who are sick

At Children’s Hospital New Orleans, it isn’t enough to treat children when they are sick or facing a medical crisis.

Lucio Fragoso, the president and CEO, says the pediatric system is striving to improve the health of children. He says the organization’s mission is to reach out to help kids before they need to be treated by doctors, or require admission to the hospital.

The health system is partnering with schools to help keep kids healthy and to meet their physical and mental health needs. Children's Hospital New Orleans is now engaged with 180 schools in the region.

“Before they decompensate, let's get to them while they're in school, right before they end up in the ER,” Fragoso tells Chief Healthcare Executive®. “So we do a ton of community type of events that I think really differentiates us. Because then you're out there, you're seeing it, you're living it, you're not just waiting for them to get sick.”

Children’s Hospital New Orleans is aiming to “create a well care model, instead of just a sick care model,” he says. (Watch part of our conversation in this video. The story continues below.)

‘Health of a generation’

Fragoso says he sees his role as a mission and even a cause, and not just a job.

“We're trying to help the health of a generation by helping these kids that, you know, they've been underserved their whole lives,” he says.

“I always say, there's one thing to help kids when they come into the hospital, right? I call it a sick care model,” he says. “You're waiting for them to come to you, if something went wrong, you're going to fix it, you're going to send them out. But is that really changing the health of a generation?”

Fragoso says getting out into the community, in school-based programs and other outreach efforts, can make a difference.

“You take that care and compassion outside the four walls, which I think is one of the things that makes New Orleans really special,” Fragoso says.

Those outreach efforts aren’t a luxury, but a necessity, given the patient population of Children’s Hospital New Orleans. About 75% of the kids in the system come from underserved communities, Fragoso says.

“The kids we're serving are the most vulnerable, whether it's medically or through social determinants of health, financially challenged, one parent, no parents,” he says. “And it just adds a whole other level of kind of motivation and inspiration to try and truly help these kids because what you're doing is, you're not just helping one child, you’re truly helping the health of a community, the health of a generation, right? Because that's who we're serving.”

• Read more: Children’s hospital profit levels hit lowest point in a decade

Addressing mental health needs

In the fall of 2023, Children’s Hospital New Orleans began working with NOLA Public Schools to bring services directly to the city’s schools.

The pediatric health system coordinated care throughout the district, but also focused on 14 schools where children were most in need of assistance. The program, supported by the city of New Orleans, utilized $10 million from the American Rescue Plan.

The program also connects children with a psychiatric care team. Fragoso says much of the motivation to engage with schools is to meet the behavioral health needs of young people. Other pediatric health systems have seen an increase in the number of patients with mental health emergencies, but the challenges in New Orleans are especially disturbing.

• Read more: Children’s mental health crisis is at risk of overwhelming the system

Kids and teens in New Orleans have rates of PTSD four times higher than the national average, and 54% of the system’s kids have experienced the murder of a loved one, according to the school district.

“Mental health has become a crisis in this country, especially for young people,” Fragoso says.

Last year, clinicians were able to do 5,000 mental health consultations in schools. He said the goal is reaching kids before they end up in the hospital.

‘Standing in the gap’

While it can be a challenge to balance those outreach efforts with the demands of providing hospital services for kids who need that level of care, Fragoso says he sees it as the health system’s responsibility.

“I've made it a priority,” he says. “And when we talk about our goals and priorities, community is actually number one. I really believe if you don't do this community stuff and get out in the community, then you're just a for-profit.”

Non-profit health systems have to engage their communities, he says.

“Yes, you have to make your business model sustainable,” Fragoso says. “But if you're not really trying to change the health of a generation, … when you're a children's hospital, what are you really doing? And to me, the community part is number one. It's community, it's fundamentals, and then it's growth. Everything we make here, we’ve got to reinvest back into the community. So we can live out that mission.”

Fragoso recalled how the health system helped one student who had vision and hearing difficulties. Her parents missed appointments because they both work and the family doesn’t have a car. The health system helped deal with the girl’s transportation issues, gave her glasses and a hearing aid, and now she’s doing better in school.

He cites that family as an example of how the health system can make a positive impact.

“That, to me, is the ultimate way of standing in the gap, because it wasn't life threatening,” Fragoso says. “And that kid would have become a statistic had we not been there.”

That’s how a pediatric health system can intervene, by asking questions, not passing judgment, and addressing the factors preventing a child from getting necessary care, he says.

“That, to me, is the difference between a sick care model and a well care model,” Fragoso says.

And he adds, “You don't have to always have all the answers, but you can iterate along the way and just by being in those schools, you can solve some of those problems, and be helpful. And that to me is the mission part of it.”