The clinic and the community: exploring the role of the designed environment in the creation of social value

Saligrama Ramachandra, Aparna

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Description

Title

The clinic and the community: exploring the role of the designed environment in the creation of social value

Author(s)

Saligrama Ramachandra, Aparna

Issue Date

2015-07-14

Director of Research (if dissertation) or Advisor (if thesis)

Anthony, Kathryn H.

Doctoral Committee Chair(s)

Anthony, Kathryn H.

Committee Member(s)

• Dearborn, Lynne M.
• Zerai, Assata
• Farner, Susan

Department of Study

Architecture

Discipline

Architecture

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

Ph.D.

Degree Level

Dissertation

Keyword(s)

• Social Entrepreneurship
• Social Return on Investment (SROI)
• Healthcare organizations
• Designed environment

Abstract

This study proposes that nonprofit healthcare organizations can function as social entrepreneurs, using the designed environment as a critical resource to address health and wellness issues within the community beyond their usual medical services. By taking this approach, organizations would not only help mitigate social problems within the community but also create incentives for themselves. Operating under a resource-based lens, this study explores whether the designed environment can help in the creation of social value as a means by which nonprofit healthcare organizations (called clinics) can become community resources, offering more than just sources of medical care. Acknowledging the inseparability of space and activity, this practical and exploratory study incorporates principles from environment behavior, strategy management, and social entrepreneurship. The ideologies of Social Design (Sommer R. , 1983) and Social Bricolage (Di Domenico, Haugh, & Tracey, 2010) are used as the basic framework, including areas such as stakeholder participation, a local approach, gender and spatial navigation, theories on everydayness, organizational mission, and resource-based theories. Using pre-determined criteria from literature and preliminary research, two sets of social programs, actively supported by clinics, were chosen for a multiple case study methodology. The case studies were grouped into two themes addressing basic issues of food and shelter. The first theme, healthy eating, was addressed by farmers’ markets; the second theme, programs for low income women, was addressed through homeless shelters, transition homes, and community resource centers. The idea of social value creation was also examined from a cross-cultural perspective, examining one case in detail and several smaller cases from India. Each site was visited in the summer of 2013 through winter of 2014. Data were in the form of interviews with program and clinic personnel, observations, note taking, photographs, and official reports and documents procured from each clinic. QDA Miner 4.1.12 was used as a means for verbal content analysis and visual analysis. Further, a Social Return on Investment (SROI) was conducted on some of the cases using the SROI Network’s Impact Map assessment technique. Findings showed enmeshed environmental and entrepreneurial factors. Visibility, access and seclusion (often at the same time), the location (at micro and city level) incorporated into program planning and structure, importance of organizational mission and partnering with community organizations were some of the major outcomes. Contributions of stakeholders stood out prominently in both content and monetary analysis. The SROI study results showed positive returns to the dollar on every analysis done. The clinics in this study realized several additional benefits in supporting the space-based social programs—low or no cost of building procurement, reduction in emergency room / ambulance services and unnecessary hospitalization, safeguarding tax status, brand recognition, awards, increase in volunteer network (thereby reducing staff cost), and avoiding replication of services available in the community. There is a growing awareness of the unsustainability of the current operational model that most nonprofit clinics adopt. Clinics are constantly struggling with resource deficits along with high costs of uncompensated care and pressure from competing health systems. With increasing federal mandates in the form of laws and income tax regulations for clinics to address the larger wellness issue within the community, this study though exploratory, provides an insight into how adopting a physical resource-based view can be a huge incentive for a clinic to address a pressing social need in its community, in a manner that is not only beneficial to the community but to the clinic as well

Graduation Semester

2015-8

Type of Resource

text

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Copyright and License Information

Copyright 2015 Aparna Saligrama Ramachandra

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