Thomas Fisher

A design thinking framework for healthcare management and innovation

The business community has learned the value of design thinking as a way to innovate in addressing peoples needs--and health systems could benefit enormously from doing the same. This paper lays out how design thinking applies to healthcare challenges and how systems might utilize this proven and accessible problem-solving process. We show how design thinking can foster new approaches to complex and persistent healthcare problems through human-centered research, collective and diverse teamwork and rapid prototyping. We introduce the core elements of design thinking for a healthcare audience and show how it can supplement current healthcare management, innovation and practice.

Public Health and the Green Building Industry Partnership Opportunities for Childhood Obesity Prevention

Improving the design of the built environment to promote health and well-being is an emerging priority within public health, particularly as a component f efforts to address the ongoing epidemic of childhood besity. Research suggests that environmental design at multiple spatial scales, ranging from regional land use and transportation planning, to accessibility of public transit, to building characteristics such as stair placement, and even the design of food trays in contexts such as school cafeterias, can influence dietary choices and physical activity. Moreover, because the built environment is amenable to change, the environmental design process provides a tangible mechanism for influencing health-related social norms at a population level. This advantage is critical, given growing consensus that individual-level interventions will not be sufficient to reverse the growth in the prevalence of childhood obesity.

Green Health Urban Planning and the Development of Healthy and Sustainable Neighborhoods and Schools

A growing body of evidence demonstrates that alterations in individual behaviors alone are not sufficient to change the course of the enduring public health epidemics such as childhood obesity. Instead, environmental factors that influence what, when, where, and how much people eat and drink and how physically active they are must be addressed at a population scale to promote healthy behaviors. Urban planners have a direct role to play in this work. This focus issue centers on a vision for the role urban planning can play to advance green health by paying careful attention to schools as a critical community resource, meeting place, and organizational feature.

The Built Environment and Actual Causes of Death: Promoting an Ecological Approach to Planning and Public Health

This article reviews empirical scholarship on preventable actual causes of death—namely, physical activity, food, and traffic-induced injury–related built environment interventions that lead to health improvements. A systems perspective built on the ecological health model is offered that addresses social determinants of health- and place-based contexts. In doing so, this article offers examples of upstream approaches to address the actual causes of death and ends with guidance on planning practice, research, and teaching organized around the research divisions of the Association of Collegiate Schools of Planning.

Remote care communities: healthcare housing for the chronically homeless

ABSTRACT The connection between housing and health is well documented; nowhere, this link clearer than with the chronically homeless. To improve population health and reduce costs, healthcare systems have a great incentive to house their chronically homeless patients. However, current healthcare payment models coupled with the high cost of building and maintaining affordable supportive housing prohibit the provision of this type of care. We propose the creation of “Remote Care Communities” to redefine housing as a health intervention: providing preventative care in the form of patient rooms outside of, or remote to, the hospital. This paper describes specific tactics for establishing new collaborative models of funding and creating extremely affordable accommodations at an amount and a rate commensurate with the need. This shift reflects a systemic understanding of housing as a healthcare entitlement and has national implications for the healthcare industry, the housing industry, and local governments.

Research and Architecture’s Knowledge Loop

The American Institute of Architects (AIA) has developed a research roadmap that sends the AIA further down a road it began in 2001, when the College of Fellows launched the Latrobe Prize, and cont...

The Itinerant Architect: Toward a Land-based Architectural Practice

Introduction Modern architectural practice, and its engagement with the environment, perpetuates an ongoing colonial narrative that positions the colonizers (i.e., those aligned with hegemonic power structures who have historically seized and laid claim to foreign and indigenous lands) as external agents divined to manage the commercial production and extraction of resources from colonially acquired property.1 This is the basis of modernism, and by extension modern architectural practice.2 Decisions over land protection, preservation, restoration, and/or exploitation are almost exclusively performed in the interest of colonial agents and in alignment with colonial values and relationships to the land (i.e., property ownership).3 Design performed within this context is a colonializing act that perpetuates a colonialist agenda. This inquiry presents a framework to move beyond these colonial habits. The goal of this research is to sidestep current colonialist agendas for architecture by circling back on a set of precolonial, medievalist habits in order to shift our spatial and temporal relationships to buildings and the land and to move us toward a land-based practice of architecture. For such a transition to occur, we need to unmake a number of modern habits. First, designers need to set altruisms aside and acknowledge the reality of our continued colonial connection to communities, cultures, and the land. Second, we need to move away from the domineering position of modernism that repositioned the architect as an expert physically disconnected from construction and the stewardship of places. Third, we need to reestablish long-term experimental relationships with communities as participants in the design and construction process. With the unmaking of modern habits comes a reimagining of architectural practice as community-, place-, and land-based. Modern practitioners and educators may acknowledge the value of social, cultural, and environmental factors, but we continue to frame them within an extractive and exploitative context, the hypocrisy of which many nonprofessionals recognize and which leads to public suspicion of our motives. A non-colonialist practice embeds itself in communities, honors the history of a place, and draws from the local human and material assets. This forces us to confront uncomfortable new narratives: narratives that acknowledge contemporary settler colonialism and the systemic racism and violence that accompanies it; narratives that question the roles of design professionals and our ability to effect positive change on the complex systems that we have claimed expert sway over throughout the modern epoch; and narratives that question the ambitions behind design and the nature of design delivery and service.

Is there a right to architecture

AbstractArchitecture, defined here most broadly as human shelter, addresses basic human needs of safety, security, privacy, and protection from the elements, but it is often viewed not as a right that every person has, but as a vehicle for controlling people, stimulating investment, and a range of other social, political, and economic interests. This article looks at the ethics of this situation from various ethical perspectives and concludes that, regardless of ones point of view, every human being has a right to shelter.