Urban triage: Lessons learned from medicine

Tight resources need to be targeted for return on investment. Applying techniques from other fields builds place quicker.

No community has the money and resources to do all the placemaking and sprawl repair called for in its master plan and sub area plans. These projects are essential for quality of life improvements that are key to attracting and retaining talent to communities in Michigan. You can’t fix all the streets to become pedestrian friendly all at once. So how does a community decide which projects and when they should do them?

Urban triage is a technique that steals concepts from the approach in medicine of the same name. The technique is to diagnose and direct for action. The key is to direct appropriate cases for the correct action, with easily fixed cases receiving quick lesser intensive care and those places needing more intensive care directed to those actions. Places that are diagnosed as being in good, but not great, shape can be fixed up immediately.

This quick activation should be low-cost and easily accomplished. By doing these types of projects first and quickly, the community gets immediate benefits and gains inertia without tapping resources significantly. These types of projects would be called “tactical urbanism” or is sometimes referred to as “lighter, quicker, cheaper.” Information on tactical urbanism can be found on the Tactical Urbanism Salon website; Project for Public Spaces has information on lighter, quicker, cheaper.

The next step is to determine which areas to ignore – yes: ignore. That means no place improvements for the six-lane street with no sidewalks and poor urban form that does not connect anything. Continue maintaining the street, patching potholes and fixing streetlights, but incremental placemaking improvements would result in no significant return on community investment in creating place. Turning a corridor like this into a pedestrian-based place would require tremendous amounts of money, planning and coordinated action over a long period of time, which would use up scarce resources that could be directed at projects with higher rates of return.

The last category for urban triage diagnosis is the area that does not fall into the two previous categories. These are projects that need resources and time and expertise but will have significant impact on the community. These are projects that should be identified in local plans or sub area plans and should target centers, neighborhoods and corridors that can be reclaimed as places.

The purpose of urban triage is to quickly create successful small-scale places that build inertia toward having the resources and skills to tackle the corridor that was put to the side in step two. Information on tools that can be applied to triage areas is available from MIplace, a website that showcases the placemaking work going on in Michigan. Information, as well as training on placemaking, is also available from Michigan State University Extension.

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