November/December 2013

Linda Dawson is IASB director/ editorial services and Journal editor

Some may think the only thing schools have in common with hospitals is that they both are large buildings in a community. But on closer inspection they have many similarities.

Both are often among the largest employers in the community with a wide range of employee skill sets needed. Both employ administrators as well as maintenance and food service personnel, whether they are hired and supervised directly or as workers contracted through a private company.

When it comes to people who work at each institution, they can have varying levels of education. Doctors nurses and teachers all can be specialists or generalists. While the public tends to use the title broadly, doctors today are more likely to have a specialty area rather than being a general practitioner. Nurses also specialize by working in specific areas like the neo-natal unit or geriatric care. The same is true for teachers. Teachers have specialized in subject areas for years, especially in the middle school grades and above. But recently some   teachers also are choosing reading and math as specialty areas in lower grades.

Behind closed doors

When you walk down a school hallway the doors to individual classrooms can be closed— a practice   often interpreted as teachers trying to maintain privacy about what is going on with their teaching in that classroom. In some cases it may be just to keep hallway, noise and distractions out. In a hospital hallway doors also remain closed but usually to afford the patient privacy as well as to cut down on disturbances and noise that might interfere with recuperation.

Comparing those who are served by each system, patients come to a hospital to get better whether because of illness or injury, and then they are discharged, hopefully to lead productive lives in a better condition than when they entered. Students actually come to school to be “made better” as well. Both transformations involve a great deal of testing along the way. The educational system wants students to learn as much as they can before they graduate so they can go on to a higher level of education or to lead productive lives in a career of their choice.

Containing costs
Both of these institutions also take a lot of money to operate. Schools depend on tax dollars, but they also depend on parents, teachers and, often, school foundations and fund raisers for some of the extras. It has been said that the amount of taxes most people pay in their lifetime could not adequately cover the actual cost of their education. Hospitals rely on payments from patients and their insurance companies, but most of them also rely on their own foundations to conduct fund raisers for special needs like new construction and expensive pieces of equipment.

Languages and acronyms
Both education and healthcare are infamous for having their own languages, especially when it comes to abbreviations and acronyms.   For the general populace, medical lingo became more familiar after television shows set in hospitals and emergency rooms became popular. Most current “educationese” has not found its way into America’s common vocabulary except as excerpts on the nightly news. Consider the CAT scan, ICU and NICU, then think about RTI, NCLB, ISAT, and PSAE, and both healthcare and education deal with HIPPA and FRpa, to name a few.

Red tape and paperwork
Both systems seem mired in paper despite computerization of many functions, including patient and student records. Vital statistics are now entered into laptop computers that can be easily accessed by doctors and those working the next shift. Grade books may no longer be a fixture on the teacher’s desk and student grades are now often accessible for viewing by parents on a computer instead of waiting for a report card to come home It’s imperative for both to maintain records of permissions and procedures including the professional development activities of staff. Doctors, nurses and therapists must be educated, licensed and recertified to maintain levels of patient care, just as teachers must be educated, licensed and complete professional development to maintain their standard of instruction.

Food service
Both schools and hospitals often struggle with food service demands. Both sometimes elicit stories about quality, including mystery meat and rubber Jell-O. Schools are under mandates to make meals healthier because of childhood obesity rates even as some factions complain that active students are not getting enough to eat. So the new rules are being tweaked. Hospitals are changing food service ideas, too. For many years they served basically the same meal option to all patients at a specific time, but now many hospitals are adopting a room service menu, where patients have a choice of entrees, sides and snacks, even down to choices on a liquid diet At some facilities patients can request the time when the meal will be delivered. Schools transitioned many years ago from a single hot lunch offering when many added an ala carte line.

Sometimes healthcare and education adopt an attitude that things need to be done a certain way because that’s how they have always been done. New technologies are changing some of those practices, but early adopters can feel the wrath of the public if ideas are not well explained, especially in schools. Taxpayers question things like the cost of installing smart boards and providing laptop computers for all students, because those items were not necessary for learning before. A favorite comment is often, “this school was great when I went there and kids can still learn there without all this new technology; give them a book.”

The same arguments are not usually present for hospitals because, in the case of healthcare, patients are more likely to question why a new treatment or procedure isn’t offered, thinking it should be.

Because hospitals and schools operate in the public eye as public institutions, even if they are privately run, they will both always be subject to public scrutiny, and as Abraham Lincoln noted: “You can please some of the people all of the time, you can please all of the people some of the time, but you can’t please all of the people all of the time.”

That would seem to be the best mantra for hospital boards of directors as well as school board members to remember.