Within minutes of a school emergency, the first ambulance may leave campus while parents race to hospitals and classmates travel to a reunification site. Hospital staff may be trying to identify injured children as school officials determine who was transported and where. Everyone is working hard, but often from different plans. While responders focus on saving lives, families need one urgent answer: Where is my child?

Most districts have identified reunification sites, developed student-release procedures, and practiced moving students to safe locations. Yet after-action reports repeatedly identify reunification as one of the most difficult parts of response. The problem is not a lack of school planning. It is that many plans stop at the school gates.

What happens when students are transported to several hospitals? When parents bypass the reunification site and go directly to emergency departments? Who helps identify children arriving without identification, confirms custody, and keeps school and hospital information aligned? Those questions became the foundation for the School and Hospital Alliance for Response in Emergencies, or SHARE.

Looking beyond the school campus For more than a decade, the Emergency Preparedness Interagency Collaborative (EPIC), founded by the Irvine Unified School District, has brought education, public safety, health care, emergency management, and community partners together to improve regional preparedness. Exercises and real incidents exposed a persistent gap: Schools could account for students and hospitals could treat injured children, but few communities had a coordinated process connecting the two after an ambulance left campus.

After-action findings from Hurricane Katrina, the Sandy Hook Elementary School shooting, California wildfires, and transportation incidents describe recurring problems: fragmented communication, unidentified pediatric patients, independently operated reunification locations, privacy uncertainty, and improvised family assistance. SHARE partners chose to address those patterns before another emergency exposed them again.

The SHARE model SHARE does not replace a district’s reunification plan. It extends that plan beyond campus by connecting schools, hospitals, emergency responders, and emergency management agencies into one coordinated system. It was developed under the leadership of Shadlie Kensrue, director of Health Services for Irvine Unified School District, and Christopher Riccardi, manager of Emergency Management and Business Continuity for Rady Children’s Hospital Orange County.

Consider a school bus crash involving critically injured students transported to three hospitals. Through SHARE, predesignated school nurses or support staff can report in person or virtually to participating hospitals. Using authorized school information, they can assist with student identification, verify emergency contacts, support family communication, and coordinate with district reunification teams. Schools and hospitals then operate as parts of the same response rather than as isolated systems.

Today, SHARE connects 28 school districts and 26 hospitals, including Orange County’s Level I pediatric trauma center, as well as higher education, emergency management, and public safety partners. The alliance also provides templates, planning guides, and implementation resources that communities can adapt. Its strength comes from relationships built before they are tested.

School nurses are the missing link School nurses sit naturally at the intersection of health care and education. They understand medical terminology, know student health needs, maintain trusted relationships with families, and work within educational privacy requirements. With advance planning, they can serve as liaisons without becoming hospital employees, helping with identification, family communication, and district coordination.

Their familiar presence also matters. During an emotionally charged incident, a school nurse who knows the student or family can reduce uncertainty and help responders communicate with greater confidence. Hospitals gain knowledgeable partners, while schools gain a clearer connection to receiving facilities.

Questions for school leaders The SHARE model does not depend on expensive technology or major organizational change. It begins with six practical questions:

Answering these questions establishes contacts, clarifies expectations, and identifies obstacles while there is still time to solve them. Privacy questions deserve particular attention. Both FERPA and HIPAA permit certain disclosures during emergencies to protect health and safety, but staff should understand their organization’s policies and legal guidance before an incident.

Building relationships before they are needed Successful reunification depends on more than a written annex. Schools that have met hospital emergency managers, discussed information sharing, and exercised communication pathways are better prepared to act under pressure. Hospitals that understand school operations are better equipped to identify students and support families.

Every minute spent trying to identify a child, locate a transported student, or reconcile conflicting information delays care or reunification and erodes trust. Preparedness reduces that uncertainty. When partners already know one another’s roles and systems, they can focus on children and families instead of deciding who should do what.

Five actions to take this month

Looking ahead No plan can eliminate the emotion and disruption of a school emergency. Planning can, however, reduce confusion, improve communication, shorten reunification time, and show families that schools and hospitals are working together.

The ambulance should never mark the point where one emergency plan ends and another begins. It should connect two systems serving the same children from the same playbook. That is what SHARE was built to do.

By Shadlie Kensrue, MSN, RN, CSN, PHN, and Christopher Riccardi, CHSP, CHEP co-chair the School and Hospital Alliance for Response in Emergencies (SHARE), a regional collaboration of 28 school districts, 26 hospitals, emergency management agencies, and public safety partners working to strengthen pediatric disaster preparedness and family reunification.