Strategies for improving the quality of care for the homeless

Students at Austin Center for Design have spent the last eight weeks working to better understand the systemic view of homelessness in Austin – a problem that’s visibly present to those of us who work and live downtown, and a problem that seems to be intractable. Our students have worked with stakeholders at Austin Resource Center for the Homeless to understand some of the issues they face, and they’ve immersed themselves in the culture of homelessness in order to better empathize with those affected. On Saturday, December 18th, the students presented their work-in-progress (primarily design research and synthesis) to the Director of Development and Communications at Frontsteps, Mitchell Gibbs, and to Dawn Perkins, the Community Relations and Volunteer Coordinator. The response was excellent – Mitchell described that the students had effectively shifted his perspective on the topic, and had opened his eye to a new way of understanding. Students will continue to work through design over the next sixteen weeks, with the intention of creating working software, service, and product solutions to help mitigate the issues they’ve uncovered.

Students have spent time sleeping on the street, volunteering at the computer lab, volunteering at soup kitchens as well as conducting interviews. Many of the interviews involved participatory activities as well as questions and answers. Students have met with case managers, organizing staff at Front Steps and other organizations, individuals on the street, clients of the organizations, and funding directors to gain understanding of the complexity of the issue.

Below is a brief summary of the students’ findings; you can read more in the attached documents (see below).

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Our research changed our perception of homelessness. The project became about the individuals we spoke to and their stories. Through our conversations we realized that society’s perception of homelessness is wrong. The perception of many is formed by the image of the “man on the street with a sign and a cup”, but that describes a very small portion of the population. In fact, many of the homeless – the “clients” – are women and children or adults that recently lost their jobs. Our research uncovered other perception issues surrounding organizations addressing homelessness; we’ve separated these into four categories. While these are specific recommendations for ARCH, there are obviously generalities that can be applied by other organizations, in other cities, that are focusing on the same topic and dealing with many of the same issues.

1. Treat donors like advocates. Currently, the majority of the funding for Front Steps is from the city of Austin. This funding is restricted, dependent on the political climate, and often attached to specific programming. Nearly all grants, in fact, are attached to specific projects, and nearly all forcibly reject funding for administrative tasks and activities. Encouraging individual donors will help diversify funding for Front Steps in the future, and will allow for a more fluid use of funds as appropriate within the organization. To shift towards a more individual-focus for donations, it’s critical to treat donors like advocates, and to arrive at this, the following strategies can be used.

  • Share the stories of your clients with the community. Provide opportunities for individuals to connect to the people rather than the problem. There are a number of vivid and impressive success stories that occur at ARCH and through the various case management activities, but these successes are often lost in the larger view of the “intractable problem.” Celebrate the successes, and share them proactively.
  • Develop internal programs to educate staff and the board about funding, with a specific emphasis on empathy and relationship. Help them understand it is not about asking for money. Track supporters first, donors second, and provide opportunities for your donors to share their stories and become advocates.

2. Make space for planning. Embrace the constraint of a limited staff, and give yourself the runway to take a broader view of the work you are doing. Instead of reacting to your clients’ most urgent needs in the heat of the moment, anticipate and proactively plan to help them meet their more important and long-term goals. By taking time to reflect, you’ll be able to build on what is already working. Creating breathing space for your staff to get out of crisis mode will shift the tone of your organization. Make time to plan like an architect. Build blueprints based around your mission and your client experiences. Become proactive, rather than reactive by considering the following tactics:

  • Find space and time in the work week for planning and collaboration among staff members. Design opportunities for staff to share success and frustrations with each other in order to improve the overall approach.
  • Dedicate team members or specific times for “fire fighting,” so not all staff members have to man the front lines every day.
  • Plan for common client challenges. Design strategies to address client needs before challenges turn into crises, and before clients have to ask for a solution. Create a culture of action, where individuals are empowered to try things that may be outside of the confines of a specific set of policies or procedures .

3. Support understanding through rigorous data collection. Clients want to be understood. Collecting data can be challenging, but it is an important part of providing great service, as the more data and understanding you have about your clients the easier it is to develop appropriate programs (not to mention fund them!) Standardizing procedures for data collection and focusing on the clients will improve Front Steps’ overall understanding of the clients.

  • Standardize procedures and implement consistency in your communication amongst the staff and to the clients. This will help make the procedures easier to understand.
  • Collect the client information in a tiered fashion, thereby breaking the data gathering into chunks. Expedite registration by providing access to registration forms online and printed forms at ARCH that can be filled out before they meet with staff.
  • Develop systems that facilitate easy sharing of data between agencies. Link the IDs clients are using between the agencies, so they do not have to repeat the in-take process.

4. Empower clients to help one another. Clients have a lot to offer and want to help. Providing opportunities that incorporate fun and collaboration will give them new opportunities to explore and discover their strengths. Focusing on strengths and building their confidence will improve their self-perception. Clients are your biggest advocates; think about how you can create an environment that unlocks clients’ skills and their potential by trying the following tactics:

  • Design programs that focus on the clients’ skills and passions in addition to their needs.
  • Create opportunities for the clients to collaborate and help others based on their skills and knowledge.
  • Design opportunities that incorporate the ideals of play and fun for the clients to explore new interests in a safe environment and build social skills.

Download more information

You can download the final report provided to ARCH, and a series of printable posters with these main ideas, below:

spaces and places

We are all busy rushing around to work on our final presentation for our research findings. We are building a new story based on the various stories we have heard and shared throughout the research/synthesis process. The listening has taken all of us to different spaces and many places. We have been to shelters around Austin, parks, foundations, and church held under a bridge to name a few. We have been to new spaces as we have heard stories of isolation, hope and prejudice. Through all  of this I find myself asking what does “home” mean? There are the comforts and shelter that come with the place of home, but it seems like the intangibles are part of the emerging themes from our research. How does the idea of safety reach beyond the physical space as we think about home?  Is the space that it creates in our daily lives as important as the physical shelter—space to reflect, space to relax and let our guard down, a place to gather with our friends or family? What role do our homes play in creating community or belonging in our lives?

This leads to new questions. Can we create services or products that incorporate the qualities of safety? Do the physical spaces create a sense of belonging or community, are they welcoming? How can we empower individuals, so that they can develop more confidence? Can we facilitate opportunities for individuals to explore goals and share their dreams? What support do they need to continue working towards their goals? How can we empower individuals to help each other? What do individuals have to offer instead of what do they need? Where is the space in the day to escape the stress of coping with daily challenges?

These are some of the questions we are asking as we look back at all the information we have gathered, examine opportunity  areas, develop design criteria and explore new ideas for products and services. We are reaching the end of this research phase, but in many ways it feels like just the beginning…

What happens when lens shift

On Aug 27, 2009, CNN wrote this article about Zipcar:
Just a few years ago the notion that you could persuade upwardly mobile professionals to share cars would have seemed as far-fetched as being able to unlock a car with a telephone. But what started as a counterculture movement in places like Cambridge and Portland, Ore., has gone mainstream.

On July 1, 2010, Fast Company wrote this article about the Mango bank:
“There just wasn’t a better option,” so he made one from scratch. The Mango Store, which opened in Austin in April, reimagines the entire banking experience for this market. Tescher likens the store to “a cross between an Apple Store and a high-end yogurt shop,” which could confuse patrons. Yet once customers are inside, Sosa says, the warm, spacious interior is designed “to educate customers and encourage them to stay awhile.”

On Sept 20, 2007, New York Times wrote this article about Couchsurfing.org:

Couch surfing takes an ancient notion of hospitality and tucks it into a thoroughly modern paradigm, the social networking Web site. But, as its members say sternly, it is not a site for dating, or for freeloaders. “This is a generation that’s all about talking to strangers. And why stop there? Why not crash at their place?” For constant surfers, the couch becomes a new sort of home, redefining, in many ways, their own ideas about what a home really is.

Do you see what these three organizations have in common? Sure, they fill a market need, or a gap that is not currently being served. More importantly though, Alex and I think it’s their success in reframing, creating lens shift of what each of these experiences could mean. In each instance, people were not afraid to ask questions such as:
  • What if I own a car only on the weekends?
  • What if going to the bank is like going to the cafe?
  • What if I could hang out like a local in a foreign city?
Relating that back to our topic with the ARCH project on self-identity and empowerment:
  • What if the bulletin board is not just a source of information, but a source of inspiration?
  • What if the homeless are not being seen as helpless?
  • What if they can be teachers?
Far-fetched? Would never happen? We don’t know. What we do know is that something amazing always happen when you get those lens shifted.

Getting back on your feet again

This is not just a story about little ducklings. This is not just a test of your empathy and heartstrings—or of your sense of humor. This is a story about how people can lose their way, and how they can find it again.

After doing a lot of research, especially when you’re in synthesis mode, everything starts to relate to your research. But what made me do a double-take with this video was the fact that we heard young moms (who are temporarily homeless) say: “I hope to soon be on my feet again.” I watched the video again and realized it illustrates a lot of the themes we’ve been seeing in our research about women experiencing homelessness.

The story that makes sense of the research

We’re all trying to navigate this big wide-open possibility space that is life.

Life is great. You have a goal. You’re part of some kind of community.

Some kind of crisis knocks you off your feet. You’re disoriented.

You find yourself away from your support system. Or isolated—physically and/or emotionally.

You’re still struggling, and a friend or family member finds you. Maybe you don’t want to get help, or don’t want to go to the shelter for “directionless duckies,” but your friend/advocate pushes you to just apply. They hold your hand during the first step of the process.

You see that there are other people who are in your same situation to connect with. You start to help each other form a new family. When you see a new person in the same situation, you tell them, “I know how you feel. I was scared, too.”

You’re still a little off-balance. You can’t do things on your own yet, but you know you’ll be able to in the future. For a time, you need some strong directional leadership or authority in your life, leading you in the right direction. You see a map of where you are going because you’re following in others’ footsteps, and you regain your confidence and your bearing.

The research behind the story

Kat and I talked to some women at a local shelter for young moms. We were impressed by the space, their strong bonds, and their drive. Our talks focused less on homelessness and more on their goals and what they were doing in their lives. In fact, we both felt uncomfortable using the word “homelessness” when explaining our research because we didn’t want to imply that they were “homeless” or that they lived in a “shelter.” We realized afterward it was because they don’t perceive themselves as homeless, even though they technically are under the federal definitions. We think this is a strength of the program.

“It’s scary at first. I know exactly what you’re going through. When I first came, I was scared. I just didn’t know what to expect. I’ve never been in this situation, and I never expected to be in this situation. And then it got better when I started to talk to everybody, and them saying to me it’s going to be all right, telling me about the housing and the GED classes…[There’s support] because there’s people to talk to when you’re down. I’m making friends. When I was living out there with the youngest two’s dad, I just stayed home. I never did nothin’.” ~Miranda, 23, who hopes to soon be on her feet again.

These were some of the themes we observed:

  • Each needed an advocate to help them find or apply to the shelter.
  • For each, there was a barrier in their perception of what a “shelter” or “homeless” was in their minds. Once they saw the place, met the people, stayed a bit, they quickly saw that this place was nothing like what they had imagined.
  • There was some kind of isolation in many people’s past, and getting out of that was key.
  • Support from a group of peers going through similar life situations has long-lasting impact. Some of the moms who have moved out and exited the program often come back to visit or hang out.
  • Having a goal, and a roadmap, and constant checks to keep them on track helps people to navigate the larger picture.
  • They were all motivated, and they all had (or found) their drive once they were in the program. Oftentimes, their babies, their kids were a huge part of that motivation. Their youth didn’t hurt either.

Design Research Toolkit

She carries this black bag with her at all times. Day in and day out, everywhere she goes. But what does it hold? School books and art supplies? Secrets and lady things? Blueprints and wireframes? A change of clothes and a wig for quick getaways?

Do not be fooled!

One unassuming bag can contain a treasure trove of data capture for our keen young designer.

As they say:Always be prepared.

[Cue theme music.]

Importance of client experience

This week’s take away from our project was the importance of client experience. When we synthesized our data, we found that almost everyone we talked to emphasized the importance of client experience on some level. Further, it was interesting to note that people who were associated with administrative activities cared about external perceptions (community awareness) while the people who were line workers didn’t care about it much. On the contrary, the opinions were reversed when thinking about quality control.

Matrix showing synthesis results

One question I keep asking myself is on the importance of client experience. Why is it important for these people? Is it because it makes their lives easier or is it because they carry empathy with what their clients undergo? If a design solution makes client experience easier but does not the lives of the employees, does the weight of this perception change in the above matrix? Don’t know..but will find out.

More Architects, Not Firefighters

Throughout our ongoing research, Saranyan and I observed that successful teams are architects. They make plans. They lay the groundwork and build ideas. All too often we slip into reactionary mode- too busy putting out fires to realize that short-sighted focus of “getting things done” may be the biggest distraction from actually accomplishing meaningful actions. There is a degree of recklessness in following a bold directive through to the end. Goals are meant to inspire- to light a spark and orchestrate a conflagration of ideas and actions. An architect may see it through (or change course) but a firefighter will extinguish the momentum before it ever starts. Foresight gives way to formula.

Continue reading More Architects, Not Firefighters

Following the Money

When choosing the focus for our design research, Julia and I were torn between a client service like transitional housing or looking behind the scenes at the less sexy but ever important process of raising money for the organization.  Ultimately, focusing on fundraising seemed further out of our comfort zones as designers (which, after all, is what school is all about), so we dove into the difficult and often uncomfortable world of asking people for money.

When it comes to funding, the biggest challenge at Front Steps is well-known to them and will probably be quickly obvious to you:

Front Steps Current Funding Distribution

It doesn’t take much to understand the dangers of having a single source of funding dominate your revenue.  The problem is even more difficult when that source is the city:

Problems with City Funding

Restricted: Designated for ARCH and existing programs, making innovation difficult.Precarious: Dependent on political climate and funding priorities of the city.Dominates revenue: Unlikely as it is, it would be devastating to Front Steps if the funding were cut.

As I mentioned, Front Steps is well-aware of the issue and has recently hired a great new director of development to help them address the problem.  We spoke with him after he’d only been on the job for a couple of weeks and we were impressed by the firm grasp he had on the organization and his creative ideas for securing new funding.  He also had a clear opinion on what a healthy funding distribution would look like [more after the jump]:

Continue reading Following the Money

Reflection is required for impact

Some of the stuff I made when I worked at Project HOME.

When I worked at Project HOME, an organization addressing homelessness in Philly, I noticed a lot of things that I could design and improve. Better signage, better forms, nicer marketing materials, pretty menus at the cafe, improving training programs, an easier way to organize job listings for clients, etc.

I completed most of these things. I’m not sure they mattered.

I also wrote proposals and plans for larger projects; rethinking some existing services and creating new programs. However, none of those ever got done.

When an organization works with people in crisis, it’s very hard not to feel like every moment must be accounted for. It is exhausting just to maintain the existing processes and procedures, rarely is there time to think about improving things.

This is a pattern that we’re seeing while researching homelessness in Austin. Organizations that don’t explicitly set aside time for reflection default to crisis mode.

Looking back after four years, the only thing still in use at Project HOME is a tool that made it easier for the staff to submit and review incident reports.

So just like webkit won’t accept patches that make it slower, in order for a new program or approach to be successful it must reduce the workload of organizational staff and increase reflection.

After 5 hours of synthesis…

We’ve got some initial design criteria:

  1. Must make it easy to start
  2. Offer environment for peer support
  3. Offer environment to expand network
  4. Allow mistakes
  5. Inspire opportunities
  6. Encourage new interactions
  7. Must be fun
  8. Repeatable
  9. Create intentional lens shift
  10. Must have a new brand identity