Model

Puentes de Salud embraces a grassroots approach to health and wellness that values the community's input in identifying health care needs and priorities. Reinforced by a long-term community presence and commitment, Puentes de Salud has earned the trust and respect of the people it serves. This trust has been a key ingredient of Puentes de Salud's success, strengthening the organization's ability to fulfill its mission. Early on, local stakeholders such as the Archdiocese of Philadelphia and other service organizations recognized the community-based platform created by Puentes de Salud, giving rise to important partnerships. These ongoing collaborations facilitate the transfer of much-needed resources and services from these stakeholders to the community (see Figure 1, Organizational Structure).

Trained in a traditional biomedical model of health care that favors a hierarchical structure for providers (see Figure 2), the organization's founders experienced the model's limitations in effectively serving vulnerable communities. Beginning in the early 1990s, Puentes de Salud's leadership gained firsthand experience with nurse-managed clinics in underserved communities.

Convinced that a team approach is essential to optimize the unique, complementary skills of each individual, Puentes de Salud decentralized the role of the physician, creating a truly interdisciplinary model in which promotoras, nurses, nurse practitioners, students and physicians all collaborate in the care of our community as equal partners. (see Figure 3). The centerpiece of Puentes de Salud's innovative model is the community nurse liaison (CNL), who operates as a health care provider, community advocate, and social worker. The CNL, much like former public health nurses, serves to bridge the community and its needs with health care providers and stakeholders, mobilizing resources to areas of need.