Update on DC's plans to build a new United Medical Center
At the end of April I wrote a three-part series about DC's plans to rebuild the United Medical Center, pointing out there is a once in three generations opportunity to create something fabulous.
The three parts covered super innovative public health programs (#1), creating a biomedical and health sciences education initiative in parallel (#2), and landing big name sponsors to help pay for it (#3).
-- "Ordinary versus Extraordinary Planning around the rebuilding of the United Medical Center in Southeast Washington DC | Part One: Rearticulating the system of health and wellness care East of the River"
-- "Ordinary versus Extraordinary Planning around the rebuilding of the United Medical Center in Southeast Washington DC | Part Two: Creating a graduate health education and biotechnology research initiative on the St. Elizabeths campus"
-- Ordinary versus Extraordinary Planning around the rebuilding of the United Medical Center in Southeast Washington DC | Part three: the potential for donations around an expanded program"
But there isn't any public planning process for the project. Although a public planning process isn't guaranteed to produce innovative recommendations.
Nothing particularly innovative is happening with the new hospital in Prince George's County ("Prince George's breaks ground on new Largo hospital," Washington Business Journal). Still one can hope that at least with a public process, the opportunity for innovation is there.
The planning activities for UMC that have been conducted are out of Executive Branch capital improvements planning ("Bowser wants to speed up design, construction of new hospital at St. E's," Washington Business Journal), which isn't a public process (Government of the District of Columbia | FY2019 Proposed Budget and Financial Plan | A FAIR SHOT | Volume 5 | FY2019- FY2024 Capital Improvements Plan).
Instead, it comes up as part of the annual budget approval process, but not with a separate process of hearings and vetting that is public, as is typical of most local governments.
Concerning UMC, the Executive Branch's priority is, not unreasonably, to find a qualified manager, deal with clear operational and accreditation problems, and right the hospital's cratering finances.
In that situation, it's hard to think innovatively.
According to the Washington Post, for me via the Washington Business Journal ("GWU to oversee UMC replacement hospital in Southeast"), George Washington University has been chosen to run the new UMC. Their hospital is owned by GWU and the for profit hospital management company Universal Health Services, and the university has a medical school which will be a good source for cheaper residents.
From the article:
According to the report, GWU and the District will spend the next several months negotiating the precise terms of the partnership. GWU may eventually own the hospital, according to the report, and Bowser and GWU Hospital CEO Kimberly Russo hope to have an agreement finalized before the end of the year with plans to open the new facility on the St. Elizabeths campus in 2023.In the comments on the three articles, I've occasionally added points that I've come across, including additional ideas that are new to me.
City Administrator Rashad Young told the Post the GWU deal is being made “to get the District out of the hospital business.” The District owns UMC, beleaguered, financially challenged facility located on the District’s border with Prince George’s County.
In April, Bowser released a proposal to replace UMC with a $248 million, 106-bed facility on the St. E’s campus — trimming it down from an initial plan for 144 beds. According to the Post’s report, the new hospital is now being planned for between 100 and 125 beds with obstetric and nursery services.
Now wrt post #1 I have these points to add:
-- I recommend that as part of "the hospital," a separate emergency clinic be included, separate from "emergency room" modelled after public health clinics, to help divert regular cases from the emergency room.
-- Using schools and clinics as hubs to create healthy communities: The example of Briya/Mary’s Center, Brookings Institution
-- Like the proposed program at St. Anthony Hospital in Chicago, but different because it is operational, Bon Secours Hospital in West Baltimore has an extensive community social and economic development program, including the construction and operation of various types of affordable housing--they have 700+ units under operation or in construction
-- the Salt Lake County Library runs a "reading room" in a community health clinic in Salt Lake City (which is interesting in itself because the city has a separate library system which I write about a lot; this is probably the only County Library facility specifically within the City) designed to serve the primarily low income, children, and Hispanic demographics of the client population, with the aim of providing free books to children (Byington Reading Room, case study, Urban Libraries Council
Besides my general idea that library branches by hospitals could have dedicated health and wellness collections (in Montgomery County, the Wheaton branch has a special collection on health, and it happens to be somewhat close but not really near to Holy Cross Hospital), it would be possible to create a public library branch, and a dedicated health information program as part of the proposed allied public health clinic listed in point #1.
Conclusion. But I don't expect any of these kinds of innovative ideas to be incorporated into the building of a new UMC.
Another example of the need to formalize and incorporate the Transformational Projects Action Planning framework into master planning. This is definitely an illustration of the value of a regularized process for what I call "Transformational Projects Action Planning" ("Why can't the "Bilbao Effect" be reproduced? | Bilbao as an example of Transformational Projects Action Planning"), where master plans include "big hairy audacious projects" as anchors, and as spurs to broad-ranging community improvement.
Now I believe such a framework needs to be applied at multiple scales.
For example, writing about the Purple Line recently, I wrote that thinking about that multi-billion dollar capital investment and the and opportunities for complementary improvements not limited to the transit network, propelled and helped me to scintillate my thinking about "Transformational Projects Action Planning" generally but at different scales too.
- macro ("Comprehensive Plan/Master Plan")
- micro (specific elements such as economic development or transportation within a master plan), and
- individual project (e.g., how do we make this __________ [fill in blank] initiative transformational and innovative).
- the city's health and wellness care system;
- as a part of the city's economic development planning;
- public health planning East of the River;
- revitalization planning for East of the River (using the health and wellness framework along the lines of Medellin style social urbanism, e.g., "'Social urbanism' experiment breathes new life into Colombia's Medellin," Toronto Globe & Mail; "Medellín's 'social urbanism' a model for city transformation," Mail & Guardian, South Africa).
Lack of public capital improvements planning process in DC. It's also an illustration that DC doesn't have a public process for capital improvements planning, instead running it through the executive branch without public review, excepting the very full calendar and agenda of the annual appropriations and budgeting process.
By contrast, other local governments almost universally do capital planning through a public process led by the Office of Planning.
Labels: capital planning and budgeting, change-innovation-transformation, health and wellness planning, hospitals, provision of public services, public health, Transformational Projects Action Planning