Morales, Goldshore, and their mentor, gastrointestinal surgeon and vice chair for education in the Penn Department of Surgery, Jon Morris, launched the Center for Surgical Health (CSH) at Penn Medicine in 2020, with a mission of “improving the surgical health of vulnerable individuals and under-resourced communities” and a goal of serving 60 patients in their first year.
Instead, they helped 180 patients get access to care that would otherwise be out of reach.
Helping patients overcome obstacles
CSH isn’t a clinic, but instead pairs patients with trained volunteer “Personal Patient Navigators” to help them address the barriers preventing them from getting surgery, like applying for insurance, scheduling appointments, and securing transportation to the hospital. Additionally, volunteers screen patients for emotional distress, public benefits, and immigration needs and refer them to partner organizations like the Penn Law Immigrant’s Rights Project and HIAS Pennsylvania. “The perioperative period is a high-stress, high-vulnerability window in people’s lives,” Morales said. “We are honored to have our patients’ trust during that time and try to maximize benefit—connecting them to world class surgical care and resources for stable housing, nutritious food, primary care, legal services, and more.”
CSH paired him with a Spanish-speaking Personal Patient Navigator who helped him apply for Emergency Medicaid based on his inability to eat. They helped him get an appointment with a Penn oral and maxillofacial surgeon and accompanied him to the appointment. The surgeon quickly solved the problem with a procedure called a joint arthroscopy with removal of scar tissue and injection of steroids.
This patient was “a perfect example of someone who was completely debilitated by a surgical condition that for someone with insurance could be quite minor,” Morales said. “He was back to normal within two weeks.”
Major grant fuels growth
Program Manager Lauren Rossi said that having a full-time staff has allowed CSH to formalize and streamline their programs, increase their capacity, and reduce the time it takes to get patients seen by providers. In the last two years, the center has also expanded its network to include more surgical subspecialities and began partnering with advanced practice providers who consult on cases.
CSH has also grown its base of volunteers, attracting many from the medical school. More than a third of first-year medical students at PSOM have applied to be Personal Patient Navigators each year since 2021.
And the center recently received a major boost to support its expansion, with a $310,000 grant from the Independence Blue Cross Foundation. The funds will be used to expand CSH’s network of referring doctors and clinics in the Penn Medicine network and regional community health centers, hire an additional employee, improve data collection and reporting, create a formal certification program for Personal Patient Navigators, and ultimately increase the number of patients being served, with a goal of 3,000 referrals by January 2025.
“Disparities in surgical care are among the greatest barriers to health equity,” noted Lorina Marshall-Blake, president of the Independence Blue Cross Foundation. “The Center for Surgical Health is poised to set a standard in surgical care for vulnerable populations, create a new paradigm for preventive surgery, and present a community health and training model that could be extended to other fields of practice.”
Ambitious goals for the future
Sarah Hamimi, a second-year medical student at PSOM, signed up to volunteer, not just to give back, but also to gain frontline experience in working with patients. In one memorable case, a patient she was assisting sought care because of irregular menstrual periods. In the process of treating her, surgeons found and removed a malignancy that otherwise wouldn’t have been detected.
Scrubs training was just one part of the Center for Surgical Health’s recent training day for volunteers.
“It’s such a privilege for patients to trust us with their care,” Hamimi said. “We’re seeing not just how much impact it has on their lives now, but potentially years down the line as well.”
Morales notes that many in the community can serve as a Personal Patient Navigator, not just medical students. “Our biggest need now is volunteers,” she said. “In order to meet our expansion goals and care for all the patients we know need us, we need more volunteers.” Eligible volunteers include any Penn Medicine staff, Penn graduate students, third- and fourth-year undergraduates at the University of Pennsylvania, as well as allied health students and health care professionals at area medical institutions. All applicants are screened on an individual basis and, if selected, volunteers undergo an onboarding process, daylong training, and weekly check-in meetings.
And the team is thinking even bigger. Long term, the center is working on formalizing and documenting its processes so its model can be replicated elsewhere. Staff have received interest from academic hospitals throughout Pennsylvania and across the U.S., Rossi said.
“While our early success has been phenomenal and excited everybody, it’s also just the tip of the iceberg,” she said. “There’s still so many more people to help.”
People interested in volunteering with CSH can email CSH@pennmedicine.upenn.edu for an application.