Rebuilding Place in the Urban Space

"A community’s physical form, rather than its land uses, is its most intrinsic and enduring characteristic." [Katz, EPA] This blog focuses on place and placemaking and all that makes it work--historic preservation, urban design, transportation, asset-based community development, arts & cultural development, commercial district revitalization, tourism & destination development, and quality of life advocacy--along with doses of civic engagement and good governance watchdogging.

Friday, February 01, 2008

Dispuptive innovation (once again)

Part of this entry, and the title comes from a 1/16/2007 blog entry.

MinuteClinic inside a CVS pharmacy in Potomac
At the MinuteClinic inside a CVS pharmacy in Potomac, Rachel Herman, 6, checks in with nurse practitioner Anne Pohnert. Rachel's sore throat is typical of problems seen at retail-based clinics, which are gaining in popularity. (By Preston Keres -- The Washington Post).

1. Ever since the quick health centers have been discussed in the trade press starting in 2005, I have been mentioning them as a model for rethinking how to provide community-based health services on the part of government agencies, similar to school-based clinics.

On 1/16/2007, the Washington Post had an article about Minute Clinic and other limited, quick care health services offered by pharmacies such as CVS. See "Is 'Quick' Enough?," subtitled "Store Clinics Tap a Public Need, but Many Doctors Call the Care Inferior."

Extend the model to government. (Compare to the recent blog entries on Arlington County, Virginia.)

The point is to think about these clinics in terms of providing limited care, and wellness services, but not thinking of the clinics as full replacements for doctors or emergency care services.

There's an article in the December 2006 issue of Harvard Business Review about this kind of thinking, and I was having a hard time fully understanding it. This idea is a perfect illustration. See "Disruptive Innovation for Social Change."

This is based on the work of Clayton Christiansen, on Disruptive Innovation.

2. The Rand Corporation came out with a study on health and health care in DC, according to this Washington Post article, "District Lacking In Access To Care: 1 in 5 Has No Medical Provider, Rand Report Says."

The response ought to be to rethink the provision of health care, at least for wellness and chronic conditions. Create "HealthyDC" "stores" in neighborhoods, especially where the need is greatest, with hours like a store, at least til 9 pm a few nights per week.

Think about this in terms of the IdeaStore repositioning of libraries as in the Tower Hamlets borough of London or the CommuterStore "transit" stores in Arlington County.

Make the HealthyDC store not just a place for the provision of health care, but also for health and wellness information and services.

Coordinate the provision of this service with other DC Government services, such as the WIC program for mothers and children, and the Senior Nutrition program.

The HealthyDC store could promote fitness, just as the FitArlington program does, and walking and bicycling.

There could be demonstration capacity. Do things like offer yoga classes. Teach healthy cooking. Make connections with neighborhood-based farmers markets. You could even connect them to libraries, and have expanded health information centers in these places (comparable to how the Wheaton Regional Library in Montgomery County is the designated library in that system possessing a deeper collection of health and wellness resources).

The same old, same old isn't working.

If you want to change behavior, to improve outcomes, you have to focus on the intended audience (the output public), not the traditional system and way of providing services (the throughput public) [although the input public--the public that provides resources, elected officials, and local and federal governments--too often isn't focused on the right levers for change].

From the Arlington blog entry:

1. The Design method;

2. Social marketing principles for behavior change -- A focus on transformation -- not merely "change" or "innovation" (not to mention "system maintenance");

3. Development and execution of complete and strategic campaigns;

4. Built upon the creation of complete identity systems and brands. (Logos aren't brands. They are part of a branding-identity system.)

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