Through a nationwide, data-driven search in 2013, the Robert Wood Johnson Foundation identified 30 primary care practices that embody innovative approaches to care, including the integration of behavioral health into primary care and new roles for health care team members.1 The Stephen and Sandra Sheller, 11th Street Family Health Services,2 Drexel University, is one of those 30 practices selected for Project LEAP, Learning from Effective Ambulatory Practices. The Sheller 11th Street health center, initiated in 1998, is located in North Philadelphia in the midst of 4 public housing developments. Developed through the leadership and tenacity of Patricia Gerrity, PhD, RN, FAAN,3 the Sheller 11th Street health center serves 6000 patients and their families with whom the center staff work to transform the health of the community. It is staffed by nurse practitioners, behavioral health specialists, nutritionists, physical therapists, and health promotion specialists. It is a place where mind and body are reintroduced in the quest for health throughout life.
Nurses are playing a significant role in the transformation of health care, particularly for those individuals formerly denied access. I have witnessed the dogged determination of Patricia Gerrity over the past 16 years as she worked with an initially skeptical community and demonstrated to partners and regulatory agencies that services must fit the unique needs and health aspirations of community members. For example, the Sheller 11th Street health center includes a wide range of health promotion services including a fitness center and a full-time trainer, nutrition counseling, integrative therapies such as mindfulness stress reduction, yoga, and weight loss programs. Clinical services include dental, physical therapy, couple and family therapy, and the creative arts therapies: art, music, and dance/movement. Because of the perceived stigma of seeing a behavioral health professional, behavioral services were seamlessly integrated directly into primary care. When the nurse practitioner identifies a behavioral or mental health problem, the behavioral health professional is called into the examination room to conduct the first visit, thus integrating mind and body in one visit. Currently, technology is being employed through a self-administered, kiosk approach, "Check Up from the Neck Up," to identify behavioral health issues early and promote intervention. Recently, the health center achieved Sanctuary Certification, a system that promotes effective, trauma-informed care.4 Most importantly, through Project LEAP, practices throughout the country are learning what works from each other.
Gerrity's determination is akin to the doggedness of Nightingale, who stared down so many obstacles in her quest to legitimize nursing as a profession and change care worldwide; of Margaret Sanger, who fought to improve women's health care through the establishment of Planned Parenthood clinics; or of Lillian Wald, whose system of community health nursing cared for the immigrants in the tenements of New York. Think about your own efforts to change and improve the systems in which you work. Nurse determination can be a powerful force in transforming any health care or educational system.
-Gloria F. Donnelly, PhD, RN, FAAN, FCPP
Editor in Chief
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