Peabody School Community, a Story of Teamwork

Peabody, Massachusetts:

Peabody is a vibrant city in Essex County, along the North Shore region of Massachusetts. With 17.1% of their population under the age of 18, and a blossoming school system, Peabody is the perfect place to raise a family.

Since families within the area rely heavily on the schools for quality education as well as a sense of community, the district felt it was very important to keep students in school.

Collaborative Health Approach:

Prior to the pandemic, because school nurses work within Peabody’s health department, the school nursing team already had a strong working relationship with other members in the department. Health department staff and school nurses have always collaborated on seasonal flu campaigns and any other prevalent infectious disease prevention within the city.

Over the last several years, Brenda Wolff, RN, School Nurse Leader in Peabody, has been working to bridge the gap between the school district and community health at large. Brenda has been collaborating with Chassea Robinson, RN, a Peabody public health nurse, to create an immersive community health program that focuses on promoting a healthy community, which then leads to a healthy school community.

Having school nurses employed within Peabody’s health department has benefited the entire community. This model was especially important when the SARS-CoV-2 pandemic hit Peabody, allowing for a smoother transition into pandemic life than what would have been the case without it.

Transitioning into a Pandemic:

Like many other communities across the state, at the start of the pandemic, school nurses and health department staff in Peabody began contact tracing and investigating positive COVID-19 cases. The cohesiveness between the two teams allowed for a more personal approach to school community safety. The school nurses have strong established relationships with members of their school communities. This allowed community members to speak over the phone with nurses they were familiar with, making for more comfortable conversations for all parties.

As summer 2020 arrived, the school nurses shifted their focus toward a safe return to school in the fall for their students and staff. Because the Peabody health department structure gives school nurses direct access to department resources, school nurses could readily ask experts directly about air quality concerns and could ask health inspectors to assess workplaces and environmental exposure based on their knowledge of COVID-19 transmission.

Schools in Session:

The devoted efforts of the school nurses and health department in Peabody paid off. Peabody Public Schools were able to implement a hybrid learning model in September, allowing all students to return to the classroom two days per week, separated into two separate cohorts. One cohort attended in-person learning on Mondays and Thursdays, and the other on Tuesdays and Fridays. Wednesdays were fully remote for all students. This model allowed time for nurses to contact trace and investigate potential positive cases efficiently, because there was enough time between in-person sessions for students.

Case Investigation:

In October 2020, Peabody Public Schools had a positive case in the school system. As the school nurses began investigating the case, they noticed an alarming number of touch points and close contacts with this case, all occurring within the school building. Brenda and Chassea worked closely together to investigate the large complex ripple effect that emerged from this single positive case.

A New Perspective:

Understanding the reach that single case of COVID-19 had in the school community was overwhelming. Chassea used the information from the case to create a visual aid to help the team better understand the extent of the exposure. The graphic she created resembles a tree, with the positive case being the trunk. The groups of exposures are the branches, and the rectangular offshoots indicate individual potential exposure touchpoints. This image helped the school nurses identify clusters of exposures and narrow the questions they asked while contact tracing (i.e., “what places did you go on X day?”, “what tasks did you do?”, “who were you with?”, and “how long were you there?”).

The graphic also changed the perspective of many community members in terms of the impact a positive COVID-19 case could have. It allowed people to better understand the dangers and risks associated with COVID-19 transmission. As Brenda noted, “you can’t underestimate the powerfulness a visual can provide for someone.”

The graphic also became an effective method to collect, analyze, and use COVID-19 transmission data to ensure meaningful health outcomes for Peabody’s school community. Brenda and Chassea presented their case study and diagram at a regional nurse meeting, making it possible for other school nursing teams and boards of health across the state to adapt and apply the approach to their districts.

Applying What Was Learned:

The visual tool was a learning moment, not just for case investigators, but for the Peabody public school system as well. While the school department had been diligent in its implementation of all the safety recommendations from Massachusetts Department of Public Health and Massachusetts Department of Elementary and Secondary Education, the visual depiction provided an opportunity to identify gaps and to strengthen protocols.

After analyzing the graphic, showing the spread and exposure from the positive case, the administration decided they needed to rethink the use of their staff within school buildings. There needed to be a better understanding of how many staff members were in the buildings, how lunchrooms were being accessed, how tasks were being delegated, and how school spaces were being used throughout the day. Brenda mentions how, “it was honestly a blessing that the case that inspired the visual happened early on in the school year.” School leaders were able to quickly make the necessary and appropriate changes early in the hybrid learning model, so the potential for spread could then be better controlled and the learning environment could be safer for all students and staff. The Superintendent also noted the value of this approach, as large numbers of close contacts would inhibit the ability to keep schools in session. These changes in protocols, done in collaboration with the health department, helped to hinder the possibility of spread within the classroom.

The School Year Carries On:

Since October 2020, Peabody has not had another positive case within a classroom setting that resulted in the extensive exposure shown in the case detailed earlier. Thanks to the revision of policies and procedures the district made because of the case investigation and visual tool, the school nurses were able to improve student and staff safety. The Peabody K-5 students returned to fully in-person learning on March 29, 2021, and middle and high school student returned on April 7. The school nurses have amped up their disease surveillance and revised all safety measures to constantly ensure quality improvement.

The strong relationships between the schools and the health department in Peabody inspired innovation during these difficult times, which has led to a safer school community. The problem-solving skills the team demonstrated over these past few months has allowed for a supportive and optimal learning environment for students and staff.

Written by Hannah Burgess