Wellness centered in the community

Lisa Ann Plowfield thinks there should be a new model for American health care, one that takes the care to people who need it most, not only treating their illnesses but also teaching them how to stay healthy.

Who can deliver this kind of model?

"Nurses," says Plowfield, chairperson of the CHNS Department of Nursing. "We're already out in the community, spending more time with patients than doctors often are able to do, and people trust us. This is a different way of providing health care, and it's something nurses can do."

At UD and elsewhere around the country, she says, it's already being done. The University of Delaware's Nursing Education and Research Center is part of a national trend toward nurse-run health-care programs, most of them based at academic institutions. Nurses and nursing students at such centers do community outreach, public education and research in various aspects of health care.

The UD center began several years ago as the HEALTH (Healthy Elder Adult Living Through Holistic Health Care) Center, focusing on geriatric clients who needed assessments and referrals to medical and social services. In 2000, the center was renamed and enlarged its focus to include not just elderly clients but also other groups that are at risk for health problems and that lack access to traditional care, Plowfield says.

"We still work with gerontology, but we're spreading our wings a bit," she says. "We see clients, free of charge, at various sites in the community. We target vulnerable populations," such as those living in rural areas, the homeless and those who speak little English, among other groups.

The goal, Plowfield says, is to continue to expand the center's outreach services and to provide numerous "satellites of care" throughout Delaware. Undergraduate and graduate students, as well as faculty members, visit the sites on a regular schedule, working in conjunction with other medical professionals and providing whatever health care the clients need.

"We want to provide more than episodic care by emphasizing wellness and education," Plowfield says. "If you visit one of our sites, we want to teach you about your condition, to keep you healthy for a lifetime."

The center also focuses on research and scholarship, which in nursing, she says, often includes an outreach component.

Plowfield has been involved in the 20-year-old nursing center movement since 1995 and serves on the board of directors of the new National Nursing Centers Consortium. Tine Hansen-Turton, executive director of the Philadelphia-based consortium, says the group includes more than 75 nurse-managed health-center members, which serve almost 1 million vulnerable clients around the country. She estimates that there are 200 such nurse-managed centers in the United States.

And, she says, the number is growing.

"The health centers have incredible community connections, which is what makes them so successful," Hansen-Turton says. "They have gained the community's trust." Until recently, when the movement has attracted more publicity, she says such centers were "the most well-kept secret safety-net provider in the U.S."

The UD center is undertaking a capital campaign, with an initial goal of $2 million, to provide what Plowfield calls "a basic level of support and infrastructure to continue our outreach and scholarship." By endowing the center, which currently is dependent on short-term grants, "We will have a permanent way to serve the vulnerable populations of Delaware," she says.

More information about the UD Nursing Education and Research Center is available on the web at [www.udel.edu/NursingCenter] or by calling (302) 831-0001. The National Nursing Centers Consortium web site is [www.nationalnursingcenters.com].

To make a donation to the UD center, or for more information about the capital campaign, call the Department of Nursing, (302) 831-1117.

--Ann Manser, AS '73, CHEP '73