The 11th Street Family Health Services Center relies on nurse practitioners to serve as primary care providers for the patients served in the center. NPs offer an emphasis on health maintenance, disease prevention and patient education. Nurse midwives using the Centering Pregnancy model of group visits provide prenatal care. The clinical nurse is a vital part of the team providing supervision to the medical assistants and support staff, as well as playing a central role in patient education and triage.
At the 11th Street Center, the core care team comprises a nurse practitioner and a primary behavioral health consultant. The care team approach enables disciplines to learn from each other, as each provider learns from the other’s role.
Behavioral health services are seamlessly integrated into primary care in order to improve the effectiveness and efficiency of treatment, while reducing the stigma typically associated with specialty mental health services. Two therapists, one focused on children and the other on adults and chronic illness management, provide primary behavioral consultation. Behavioral health includes any behavioral factor that might affect a patient’s current or future health status, broadly conceived as real or perceived physical health, emotional health, quality of life and health habits, and behaviors that determine health risk.
This collaboration of behavioral health and primary care strengthens the services provided to patients by placing a primary behavioral health specialist and social worker directly in primary care. The primary behavioral health therapist focuses on the patient’s mental health, and the social worker addresses any social service needs and linkages.
Both of these services are fully integrated into primary care to form a team approach to coordinated and seamless care.
Depending on a patient’s needs, the team may also include a health educator/nutritionist, a physical therapist and/or a dentist.
The 11th Street Family Health Services Health Center provides a unique opportunity for Drexel University students of all types to practice in a real-life environment. Nursing students, physical therapy students, mental health discipline students and others practice side-by-side with center staff and learn how to deliver community-based care. These students also see the effectiveness of transdisciplinary teams working with patients on complex, chronic illnesses.
Since the inception of 11th Street, over 300 RN to BSN students have been involved in health promotion activities, including making home visits, giving immunizations, teaching about diabetes, assessing senior’s homes for fall risks, and organizing community health fairs. Students receive valuable insight into the challenges and rewards of practicing as a nurse in the community setting.
In addition, students from other Drexel University Colleges and Schools participate in the work of the health center through specific projects and programs. Drexel Schools involved in the health center are the School of Public Health, the College of Media Arts and Design, the College of Information Science and Technology, the College of Business, and the College of Medicine.
Reflecting its academic parentage, the center provides a co-op learning environment where Drexel students acquire experience in a genuine work setting. The center also employs AmeriCorp volunteers through the Philadelphia Health Corps.
In fall 2008, in partnership with the University’s School of Law, the center will be implementing a Law Clinic. Services will initially target health-related matters and grow to include a wider array of services.
11th Street Family Health Services offers area residents a centralized location to receive health and wellness services. The center’s holistic approach augments primary, behavioral and dental care with an ever growing menu of chronic disease management, health promotion and wellness services.
In addition to clinical areas, the clinic houses a fitness center, a teaching kitchen and other common spaces for health promotion activities. These include yoga, line dancing, self-efficacy programs, art therapy, smoking cessation, family fitness programs and cooking classes. In response to the lack of neighborhood grocery store, the center has partnered with the Philadelphia food bank and PhilAbundance, to provide free fresh fruit and vegetables to families each week at a local church, a long-standing partner of the health center.
The non-clinical, outreach services and activities reach and attract people to the center where they learn about the full range of services available to them. Often, the activities provide an opportunity for people to come together to share health concerns and life problems. The health center has become a hub for many community activities that improve the quality of life.
The 11th Street Family Health Services looks for opportunities to serve their patient base in the best way possible, whether that is participating in national programs, developing their own programs, or changing the way they deliver clinical services. Center activities are developed in consultation with a Community Advisory Board composed of local residents. A Youth Advisory Board helps plan and carry out programs for children and teens.
In response to patient needs, the health center changed from an appointment-based system to one allowing open access, guaranteeing patients same-day appointments. This shift to open access has dramatically increased the number of patient visits.
When primary care visits showed that past trauma complicates and often underlies many cases, the Center recognized the need to pursue a trauma informed care model, as well as training behavioral health staff to implement in trauma recovery groups.
The center participates in the national program, Nurse Family Partnership, through which four 11th Street RNs offer home-visiting services to first-time, low-income moms and their children. Women enroll in the program while they are pregnant, and continue to receive visits every week or two from nurses until their babies are two years old. Women receive care to improve pregnancy outcomes by helping them engage in good health practices. In addition, nurses help mothers improve their child’s health and development by teaching them to provide responsible and competent care, and improve their family’s economic self-sufficiency by helping mothers develop a vision for their own future. The program is free, and any woman who is expecting her first baby, is less than 28 weeks pregnant, and who meets the program income guidelines can participate.
Although the center has a heavily used fitness center, jointly staffed by a physical therapist and personal trainer, some patients want different opportunities to increase their physical activity. In response, the center holds line-dancing sessions each week, and has added yoga to its list of offerings.
In an effort to improve literacy, the center participates in the National Reach Out and Read Program. At check-ups for children from six months to five years of age, nurse practitioners advise parents about the importance of reading aloud to their children and provide them with appropriate books to read.
The health center uses a sophisticated Electronic Medical Record (EMR) system that receives support and consultation from information technology experts in Drexel’s College of Information Sciences and Technology. In addition, nurses and other staff who see patients work in a wireless environment to access the EMR and document patient care. The EMR is a rich resource for documenting the efficacy of care and for identifying patterns and trends among the patient base.
The center recently received funding to combine data from health promotion and chronic disease management programs with information in the EMR, to provide a full picture of patient activities that lead to improved health outcomes.