Scaling Equals Cultural Transformation

Aug 31, 2013, 9:51 PM, Posted by

An elderly woman users her walker while watched by her daughter and another older woman.

On RWJF’s Vulnerable Populations team, we look for ideas that we believe are going to transform a field; that will create the impetus for significant social change. When we find those ideas, our goal is to take them to scale.

Contrary to popular belief, scaling does not mean hiring more people or growing a bigger organization. When we talk about scaling, it’s about supporting an idea to allow for radical transformation. It is our contribution to creating a culture of health.

One of the ideas that we’re currently working to take to scale is the Green House Project, which aims to transform the culture of long-term care. We’ve tested the model repeatedly in a number of locations and now we’re trying to get it greater national visibility so that it can have the significant impact on the field of long-term care that we believe it can—and should.

As far as we’re concerned, what is most important about the Green House Project is that it is changing how the field of long-term care thinks about the last years of life. The Green House model results in living environments where people can continue to feel like they’re contributing, that they’re LIVING and that their families and friends are still an important part of their lives.

Again, by scaling the idea, we don’t aim to have every single long-term care facility in the country become a Green House home. Instead, we hope to have enough Green House homes that people in the marketplace will demand more options for long-term care that are different than the current prevalent model for institutional care. This is not just about building more homes; this is not just about building small houses. This is about significant social change, where the market is demanding alternatives for older adults for long-term care, where the conversations are changing about how and where people live out the last years of their life, and where we recognize that people may be frail, they may have some dementia—or even serious dementia—but they still need to have a quality of life, and they need to be in environments which promote that quality of life. Through scaling, we fully expect that, in the future, there will be adaptations to the Green House model. And we are hopeful that there will be other great ideas that will come along which have been informed by the model as well.

What excites me most about these efforts is the opportunity to work with the market to scale good ideas like the Green House Project. Too frequently in the philanthropy community we swim upstream. We try to push models out the hard way, funding them in new communities where there is not enough community support, consumer demand, financial resources or political will to make them a reality. It is only when communities—and consumers—become aware of and eventually demand these new models, that they will scale and become part of the mainstream.

You can hear more of my thoughts about scaling by watching this video about the Green House Project. And listen to what my colleague Nancy Barrand has to say about scaling the Playworks model in this video.