BOX 3-4

Case Study: 11th Street Family Health Services of Drexel University

A Nurse-Managed Health Center Reduces Health Disparities in Philadelphia

Lisa Scardigli, age 44, has suffered periodically from spasticity, a symptom of the multiple sclerosis she has lived with for more than 20 years. She had been receiving physical therapy at 11th Street Family Health Services in Philadelphia when she had a pump implanted for spinal infusion of a drug that reduces spasticity. But the pump’s catheter punctured in late 2009, and she was hospitalized for several weeks. When she returned to 11th Street, she said, she got “holy heck” from the staff there; they had been worried about her. “Even the people at the front desk were up in arms over the fact that I didn’t call,” Ms. Scardigli said. “It went from the physical therapist to the primary care person to the security guard. I was actually missed.”

This is a small story, but it illustrates a big reason for this health center’s success: it not only serves its community (there were 26,000 clinical visits in 2009); it also creates community. And that may have something to do with the fact that it is run by nurses.

This nurse-managed health center provides primary care and other services in a neighborhood in North Philadelphia where most of the 6,000 residents are African American, have low incomes, and are medically underserved. Nurse practitioners (NPs) and social workers make up teams that are augmented as needed by physicians, nutritionists, and others. Having been launched in 1998 in a recreation center, 11th Street is now a federally qualified health center housed in a $3.3 million, 17,000-square-foot facility, with a staff of 53.

I describe the center as a healthy-living center. And that is what the residents wanted. It’s not just access to clinical services. It’s providing opportunity for a neighborhood that doesn’t have a lot of opportunity for people to get healthier.

—Patricia Gerrity, PhD, RN, FAAN, director, Eleventh Street Family Health Services of Drexel University, Philadelphia

The center’s work began gradually, as a joint project of the Philadelphia Housing Authority and Drexel University’s College of Nursing and Health Professions. In 1996 director Patricia Gerrity, PhD, RN, FAAN, placed a public health nurse at each of four housing developments in the neighborhood. The nurses responded to residents’ immediate concerns: the need for stop signs, animal control, food assistance, and training in CPR. “Over that first year or two we gained the trust of the residents because we weren’t defining the issues; they were,” Dr. Gerrity said. “And it showed that we were making a longterm commitment.”

From there, she met with area representatives to discover their visions for the community. They

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