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Penn Medicine CAREs Grant Helps Care for More Patients at Puentes de Salud/Bridges of Health

BonacciRobert Bonacci’s passion for medical care for Latinos developed well before he entered medical school.

As an undergraduate student, Bonacci studied Spanish and studied abroad in Argentina. Bonacci also studied tubercolosis epidemiology and tobacco use in Mexico on a Fulbright scholarship. Considering this background, this second year Perelman School of Medicine student jumped at the opportunity to volunteer at Puentes de Salud, a nonprofit health clinic in South Philadelphia supporting all groups, but focusing on its growing Latino community.

“Puentes really fit with my interests,” said Bonacci. “I spent a year doing public health research in Mexico before medical school and my mom is from there. Puentes embodies a lot of what I want to do later on, so it was a natural fit for me.”

Bonacci found out about Puentes while interviewing for medical school and on a second visit in Spring 2010 to city Penn-supported health clinics. Steve Larson, MD, associate professor in Emergency Medicine, gave a talk to the students during this visit.

“Students such as Rob come to Puentes de Salud with a ‘fire in their belly,’ eager to gain exposure to the issues of community health and wellness that led them to choose medicine as a career in the first place,” said Larson. “Puentes de Salud offers them the opportunity, at the earliest point in their medical education, to ‘roll up their sleeves’ and become involved in clinical care on the ‘front lines’ of community health.” 

Puentes de Salud student volunteers are introduced to a wide range of community health issues, ranging from simple access to care to health disparities. They are encouraged to engage and explore these issues in open dialogue.  

A volunteer coordinator at Puentes since January, Bonacci delivers patient care (while accompanied by attendings, resident physicians, and/or nurse practitioners) as a clinical volunteer, and serves as an administrative coordinator, running patient flow at the front desk.

The clinic is open 6-9 pm on Monday and Wednesday nights.

In Puentes’ intake process, a non-health professional student records contact info, demographic data, and the chief complaint from each patient, and then the patient advances to the vitals station. This is where a grant they recently received from Penn Medicine CAREs for a vital signs and blood pressure monitor comes into play.

“On some nights when we have newer volunteers or volunteers who haven’t been to the clinic in awhile, it bottlenecks at the vitals station,” Bonacci explains. “By adding this monitor, we’ll improve the flow of the clinic, get a better estimate of the number of patients we can take, take more patients, improve our triaging of patients, and improve our screening of chronic health conditions.”

Those with very high or low vital signs, such as very high or low body temperature, or in acute distress, can sometimes go ahead of some of the other patients, thus improving the triage process.

More efficiency allows Puentes staff more time for nutrition and lifestyle counseling to help prevent hypertension, diabetes, and other systemic ailments.

Bonacci learned about Penn CAREs from other School of Medicine students, including Douglas Worrall, a previous recipient who received a grant for United Community Clinic.

As the majority of Puentes patients are Latinos whose first language is Spanish, patient care is available in English or Spanish. Clinic volunteers are expected to be comfortable speaking Spanish conversationally. Those who do not know Spanish are able to volunteer for Puentes outside of the clinical setting.

“We welcome all people regardless of whether they are Latino, English or Spanish-speaking, we welcome them all the same,” said Bonacci.

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