 Blockley's geographical isolation from city medical institutions limited clinical care until the University of Pennsylvania, with its medical school, moved to a site just north of the Almshouse grounds in 1871.As the latter 19th century saw advancements in both medicine and psychiatry, Blockley's mission gradually embraced that of a more conventional public hospital.A nursing school was opened at the site in 1885 under the direction of Alice Fisher, replacing ad hoc patient nurses with a system of skilled nursing.