because CHANGE HAPPENS.....

Welcome to our Dialogue


3 Voices | 3 Perspectives | 3 Areas of Focus | One Vision: Transforming Practice.

Ron Smith, Bernard Mohr, and our guest-blogger Cliff Harvey are sharing this series of conversations, seeking to influence and be influenced by what each other say… and hopefully to share some wisdom.

Our Vision: A new practice of Health Care Architecture which catalyzes whole systems design in support of breakthroughs in New Models of Care

Dialogue 1: “Why focus on Quality now….(and Again!)?

Dialogue 2: “Designing for quality at every level – what does that require of the design process at different levels?

This Blog is about the  transformation of Health Care Architecture in support of the “new quality agenda”* that is giving rise to new models of care**.  Our premise is that this journey of transformation in HC Architecture  can be accelerated and strengthened through provocative dialogue about:

  1. collaborative, multi stakeholder co-design
  2. real time innovation in the design process
  3. embedded action research
  4. and robust prototyping of new design processes and tools, such as
  • storytelling
  • simulations
  • scenario planning

 *By the term “new quality agenda” we mean the reaffirmation of the linkage between organizational design and experiential design; something that was lost or at least confused in the period after World War II, and came to light in the 1970’s.

 ** By the term new models of care we mean both:

  • new conceptualizations of care delivery which are largely contained within existing paradigms of care delivery based primarily on safety and ecomomics…such as PCMH (Patient Centered Medical Homes);  Service/Disease Based Delivery of Care; Accountable Care Organizations, etc
  • and paradigmatic shifts such as Patient and Family Centered Care and  population health focus; where the focus is shifting toward actual HEALTH creation (ie) vs disease response

About this Dialogue

Adapted from Dialogic blogging, a writing technique called ‘essay in two voices’ which is designed as ‘a place to move past agreement and discover shared understanding’ (Blair, 2011). The format comes from Madelyn Blair’s Essays in Two Voices.

The structure begins with a question, clearly understood by the writers even if they interpret it differently, who then write in stages starting with 500 words, and ending with 140 characters. Thus the sequence is:

  • Each partner writes 500 words on the question.
  • Each writes 250 words in response to their partner’s 500 words.
  • This process continues for up to 4 more iterations moving from 250 words to 125 words, to 60 words, 30 words and finally 140 characters (a tweet!)

The value of this approach is that it is easy to understand and accomplish.  

It allows for individual expression without concern for judgment. It creates a comfortable space in which two or more people can converse on a question in a manner that encourages focus and as the process continues, concision.