Having the Right Partner

Kirsten von Reinholtz builds systems that make mission work at scale. She combines Harvard training with on-the-ground public-service leadership to close the gap between intention and delivery. That’s the difference between busy and effective: service principles turned into operational results.

Harvard context and awards
Kirsten completed the A.L.M. at Harvard in 2025, where she focused her work on service, community engagement, and practical governance. At Harvard she was elected Director of Community & Public Service for the Harvard Extension Student Association, coordinating initiatives that connected volunteers, campus groups, and external partners. Her service earned the Derek Bok Public Service Prize, an Extension School honor recognizing significant, tangible public-service impact. Harvard’s prize lists and coverage confirm both HESA leadership and the award. Wikipedia+4The Harvard Crimson+4Facebook+4

What that means operationally

1. Stakeholder mapping into process
   Most programs fail where stakeholders meet the workflow. Kirsten’s approach starts with service mapping: who is affected, what “good” looks like to them, and where process friction lives. Then she codifies this into standard operating procedures and reporting so the map survives contact with reality.

2. Measurable public-service inputs and outputs
   Winning a public-service prize is nice; turning it into a dashboard is better. Her projects set explicit input and outcome measures: participation rates, completion time, exception counts, and post-program outcomes. That forces clarity and allows leadership to redirect resources early instead of after failure shows up in headlines. Wikipedia

3. Communications that move people, not just information
   As HESA’s community and public-service lead, Kirsten learned to recruit, brief, and retain volunteers who are busy and remote. The mechanics—cadenced updates, single-source tasking, and clear escalation—translate directly to operations at any scale. The Harvard Crimson

4. Governance without ceremony
   Kirsten’s Harvard experience rewarded delivery, not theater. Her rule set is simple: document the process, time-box decisions, publish owner and deadline, and close the loop publicly. That reduces cycle time and makes accountability visible.

Selected projects and appearances
• Harvard community service programming and office-hours series, promoted through HESA channels and campus social to drive consistent, staffed engagement. Facebook+2Instagram+2
• Public conversations and media about mission-driven work, including a long-form interview segment discussing brand, operations, and execution. iHeart

Why she fits my work
My operating thesis is straightforward: build disciplined systems that serve people first and hold up under pressure. Kirsten’s background matches that. She brings Harvard rigor, public-service credibility, and the willingness to do unglamorous blocking and tackling—exactly what turns policy into outcomes.

How we use this in practice
• Intake to outcome: define the participant journey, set time-based checkpoints, and require a visible owner at each gate.
• Field-tested SOPs: short, executable steps; tool links where work happens; and change logs with dates and owners.
• Exception management: pre-approved playbooks for the 10 percent of cases that break the rules, with authority and limits spelled out ahead of time.
• Reporting that leaders actually read: one page, four numbers, trend arrows, and what changes next week.

Credentials and confirmations
• Harvard Extension Student Association: elected Director of Community & Public Service for 2024–25, covered by The Harvard Crimson and HESA social posts. The Harvard Crimson+2Facebook+2
• Derek Bok Public Service Prize: listed among 2025 recipients; Wikipedia entry reflects the same. prizes.fas.harvard.edu+1
• Harvard Club of Southern California membership notice lists “Kirsten Brownrigg ALM ’25.” hcsc.clubs.harvard.edu

Kirsten’s value is simple: she makes service operational. The result is less noise, more execution, and measurable outcomes you can defend in a boardroom and explain to the community without spin.

We Can’t Treat Homelessness Only in the Emergency Room

Hospitals, ERs, and Police Are Overwhelmed by Homelessness

Homeless encampments like this one are a familiar sight in many cities, reflecting a humanitarian crisis that also puts heavy strain on public systems. As someone who operates a homeless recuperative care program, I see the fallout of treating homelessness as a series of emergencies. Unsheltered individuals often cycle through emergency rooms and hospitals, racking up repeated visits and extended inpatient stays because they have nowhere safe to recover. One study found people experiencing homelessness visited the ER about 6 times per year on average, versus 1.6 times for those with stable housing. nhchc.org. They also tend to stay ~4 days longer per hospital admission, costing over $4,000 more per visit than other patients. nhchc.org. These frequent health crises aren’t because homeless patients want to be in the hospital, it’s because discharge to the street often leads to complications that send them right back.

It’s not just hospitals feeling the burden. Law enforcement and local infrastructure are effectively running triage for homelessness. Police and paramedics respond to untreated medical and mental health crises on the street. Jails become costly default “housing” for minor offenses related to homelessness. In my county, an analysis estimated that around 750 homeless individuals accounted for over $5 million in ambulance rides, ER visits, and jail costs in a single year. www2.ljworld.com. Likewise, cities spend millions on encampment clean-ups and emergency shelter measures — for example, California’s transportation agency spent $10 million in one year just to clear about 7,000 highway camps. dot.ca.gov. Taxpayers end up funding this expensive, reactive carousel of 911 calls, hospitalizations, jail stays, and street clean-ups. It’s clear that the status quo of bouncing people between the sidewalk and the emergency room is both inefficient and unsustainable. We need a better approach that stops the revolving door.

A Common-Sense Alternative: Medical Recuperative Care

After years of confronting these crises, We’ve learned there is a better way to break the cycle. Medical recuperative care (also known as medical respite care) provides a structured, short-term place for a homeless patient to recuperate after acute illness or injury. Instead of discharging a sick individual back to a tent under a freeway or keeping them in a costly hospital bed for weeks, hospitals can refer them to a specialized facility where they can rest, recover, and stabilize under medical supervision. The National Institute for Medical Respite Care defines this model as “acute and post-acute care for people experiencing homelessness who are too ill or frail to recover from an illness or injury on the streets or in shelter, but who do not require hospital-level care”. commonwealthfund.org. In practice, that means providing short-term housing with healthcare support typically a stay of a few weeks up to a few months, until the person is well enough to move on. Crucially, recuperative care offers what a shelter or sidewalk cannot: a clean bed, regular meals, help with medications, and a safe environment conducive to healing. It’s an intermediate step that closes the gap between hospital and home. From my vantage point, it’s basically “step-down housing” for someone who is medically vulnerable: far cheaper and more appropriate than a hospital, yet far more supportive than a shelter cot. And it’s proven to work.

Lower Costs, Better Outcomes

Inpatient hospital care can cost thousands of dollars per day, whereas a recuperative care bed costs only a few hundred. commonwealthfund.org. This stark cost difference has huge implications. In my program, I often remind stakeholders that we can provide about 10 days of recuperative care for the cost of a single day in the hospital. Multiply that across dozens of patients and it’s evident how much money could be saved by treating recuperative care as a standard discharge option. One successful program in Los Angeles estimates it has saved the health care system over $20 million by preventing unnecessarily prolonged hospital stays. commonwealthfund.org. Simply put, it’s a far more cost-effective use of healthcare dollars.

Cost isn’t the only consideration, outcomes are just as important. Recuperative care isn’t about shuttling people out of sight; it’s about improving health and stability, which ultimately reduces the downstream burden on emergency services. A growing body of data (and my own on-the-ground experience) shows that giving patients a place to properly recuperate leads to fewer ER returns and hospital readmissions:

• Fewer repeat hospitalizations: In Boston, homeless patients discharged to a medical respite program had 50% lower odds of being readmitted within 90 days compared to those discharged to no support. nhchc.org. I’ve seen this firsthand, when people have a safe place to finish their antibiotics, get wound care, and rest, they are much less likely to bounce back to the hospital.

• Reduced hospital days: A Chicago study found that patients who used recuperative care needed dramatically fewer hospital days in the following year (3.4 days vs. 8.1 days) than those who recovered on their own. nhchc.org. In other words, proper post-hospital care cut their hospital usage by more than half.

• Lower emergency service use: Overall reviews of medical respite programs show consistent drops in ER visits and inpatient admissions after a respite stay. commonwealthfund.org. As patients stabilize and connect to outpatient care, they rely less on 911 and emergency departments.

• Better long-term stability: Importantly, many recuperative care programs help clients secure housing or ongoing support, which leads to improved housing outcomes. commonwealthfund.org. Breaking the homelessness–hospitalization cycle means people are less likely to end up back on the streets (and back in crisis).

The evidence tells a clear story: recuperative care improves health outcomes while containing costs. By providing a controlled environment for recovery, we prevent the kinds of complications and crises that would have required another ambulance ride or another costly ICU admission. From a systems perspective, it’s hard to imagine a more outcome-driven intervention, it keeps people healthier and uses resources more efficiently.

More Than a Bed: Support, Navigation, and Accountability

It’s important to understand that a recuperative care facility is not just a flop house or a makeshift clinic, it’s a deliberately structured environment that pairs housing with health services. In running one of these programs, I’ve seen how crucial the supportive framework is to its success. Guests aren’t simply left to their own devices; we create an organized, accountable setting that helps them rebuild stability step by step.

A well-run recuperative care program typically includes:

• 24/7 supervision and care: Staff are on-site at all hours to assist clients and respond to any medical issues or emergencies. This continuous oversight ensures safety and helps build trust.

• Medical oversight and medication management: Nurses or trained staff monitor each person’s health status, check vital signs, and ensure medications are taken as prescribed. gardenavalleynews.org. For example, if someone needs daily wound care or insulin, it gets done. This prevents small issues from escalating.

• Case management and housing navigation: Dedicated case managers or housing navigators work with each client on an exit plan. gardenavalleynews.org. That means helping with paperwork (IDs, Medicaid, veteran benefits, etc.), connecting to primary care or mental health providers, and crucially, applying for longer-term housing programs. In some existing models, staff coordinate with housing transition services and even help clients get into subsidized apartments or group housing when they’re ready. gardenavalleynews.org.

• Transportation and appointment coordination: The program helps schedule follow-up medical appointments and often provides rides. gardenavalleynews.org. This logistical support is key, it keeps people on track with outpatient care that prevents relapse.

• Life skills and stability building: Many recuperative care sites offer basic life skills training and require a level of participant responsibility. gardenavalleynews.org. Clients might attend workshops on budgeting, cooking, or managing their health conditions. They’re typically expected to participate in daily routines (like cleaning their space or checking in with staff). This kind of participant accountability is not about punishment; it’s about preparing people for the expectations of permanent housing and independence.

• Structure and rules: Unlike an overnight shelter, recuperative care has a structured routine and some reasonable rules to maintain a safe, healing environment. For instance, programs usually prohibit alcohol or illicit drug use on site and enforce quiet hours. In my experience, guests appreciate having a stable structure after the chaos of the streets it’s a relief to know what to expect each day. Those who refuse to follow basic rules may be discharged, but that’s rare when engagement is high. The structure actually empowers people: it creates a sense of normalcy and personal responsibility that many haven’t experienced in a long time.

In short, recuperative care provides wraparound support. We address immediate medical needs and the underlying issues that led to homelessness. As a program, We approach it like operating a small supportive community: we have nurses, social workers, housing specialists, and often partnerships with local clinics or behavioral health providers. This interdisciplinary approach means we can simultaneously work on a patient’s health, housing, and social stability. When all these pieces come together, the result is someone who leaves our program far better off than when they came in healthier, connected to ongoing care, and often with a housing plan in motion. And importantly, they leave with the confidence that comes from accomplishing goals in a structured setting.

From Emergency Response to Outcome-Focused Care: A Call to Action

We have spent years in the trenches of the homelessness crisis, and one thing is clear: we have to stop treating homelessness primarily as an emergency to react to. The current pattern of camp sweeps, 911 calls, ER visits, repeat arrests is a costly revolving door that fails both the individuals in crisis and the public budget. It’s time for cities and counties to pivot from that reactive mindset to a proactive, systems-focused strategy. Medical recuperative care should be embraced as a standard, not a special experiment, in our continuum of care for homelessness.

This is not about finding a miracle cure or “solving homelessness overnight.” It’s about investing in practical solutions that are proven to work. We know that when people have a safe place to heal and get linked to services, they stabilize. We know it saves money withevery avoided hospitalization or jail booking is money that can be better spent on housing and prevention. And we know it’s scalable: many communities have small medical respite programs, but they remain underfunded and underutilized relative to the need. That needs to change.

As someone who operates a recuperative care program, I call on policymakers and public leaders to make recuperative care a staple in our homelessness response. Fund more beds and programs that integrate medical care with short-term housing and case management. Encourage hospitals to form partnerships with these programs instead of bearing the cost of avoidable long inpatient stays. Include recuperative care as a key element in discharge planning for every homeless patient. And ensure that these programs are connected to the broader housing system so that clients have somewhere to go afterward, whether that’s supportive housing, a sober living home, or a reunification with family.

The homeless crisis is often described as overwhelming, but solutions like recuperative care show that it’s manageable when we operate smarter. We have an opportunity to turn a vicious cycle into a virtuous one: transitioning people from the street, to recovery, to housing. It’s good for the individual and it’s good for the system. The data supports it, and I’ve seen the human success stories behind the data. Let’s stop pouring money into Band-Aid reactions and start investing in integrated, outcome-driven models that treat homelessness as the complex but solvable problem it is. Cities and counties must step up and make medical recuperative care a standard part of the solution because managing homelessness as a perpetual emergency is a path we simply can’t afford, financially or morally, any longer.

Sources: The facts and outcomes cited in this article are drawn from studies and reports on medical respite care and homelessness, including research by the National Health Care for the Homeless Council nhchc.orgnhchc.org, the Commonwealth Fund commonwealthfund.orgcommonwealthfund.org, and other analyses of homelessness costs www2.ljworld.comdot.ca.gov. These demonstrate the cost savings and improved health results when recuperative care is implemented as part of the continuum of care.

The Human in the SOP

Be the boots on the ground

I am not anti-tech. I build with it, rely on it, live in it. But when I reach for a search bar or an AI window, I skip the part where a person shows me how it actually works. That skip looks harmless. It is not. It shows up later when something fails and the answer I grabbed was clean but thin.

I have written hundreds of SOPs over twenty years. Warehouse receiving. Medication handling. Operating finicky lab equipment that behaves like a different machine when the room is a few degrees warmer. The through-line in all of it is simple. Great SOPs start as human conversations. Bad SOPs start as exports.

What gets lost when we skip people
Search gives answers. People give context. Search collapses time. People expand it. In the compression, you lose the slow, earned parts of knowledge that make procedures durable.

When someone teaches you in person, you do not just get steps. You get the pace, the pressure, the “stop here” warning that never shows up in a tidy checklist. You hear why the shortcut fails on rainy days. You see the pause before step three because that is where people ruin it. Those micro-signals are the difference between compliance on paper and performance on the floor.

Why this matters to SOPs and the business
SOPs are not documents. They are operational contracts. They turn tribal knowledge into repeatable action. They cut onboarding time. They reduce variance. They make audits boring. Done right, they protect people and revenue at the same time.

The fast-answer trap
Instant answers feel great. The problem is that speed wears the mask of mastery. You copy a clean explanation, run it once, and your brain files it under known. It is not known. It is rehearsed text. Without friction, there is no feedback. Without feedback, you do not correct. That is how fast knowledge feeds false confidence, which becomes a fragile SOP, which becomes downtime, scrap, a CAPA you did not want, and an ulcer.

How knowledge actually grows into an SOP
We like to think the right answer is fixed. In practice, the right answer gets bent by constraints until it fits the job in front of you. That bending looks like manipulation. It is actually progress. Someone takes a method, trims it for nights, adds a step for low staffing, removes a step for mornings, and hands you a version that works here. Then you hand a better version to the next person. That is how knowledge compounds. SOPs should capture that evolution, not freeze the first draft.

What belongs in a real SOP that a search result will never give you

• Boundary conditions. Temperature, humidity, torque, hold times. The edges where success flips to failure.

• Cues and tells. The whine of a rotor that means stop. The sheen on a surface that means go. The smell that means throw it out.

• Escalation rules. Who to call, by role, with numbers that work. What to do while you wait.

• Common failure modes. What goes wrong after step two and how to catch it early.

• Adjustments under constraint. How to run it with half the staff, or during a power dip, or when the vendor switches lot numbers.

• Records that matter. The one log auditors always ask for first. Where it lives. How to reconcile it when two systems disagree.

• The why. One short line that explains the risk the step is controlling. Adults follow rules better when they understand the risk.

A short story from the floor
I once documented a centrifuge procedure that had passed every paper review and still wrecked samples on Tuesdays. The fix did not come from a manual. It came from an operator who said it only happens when the morning deliveries sit in the hallway for a while. The hallway had a heater grate. The samples took a small temperature bump before processing. We added a 10-minute temperature equilibration step to the SOP and a line to relocate drop-off bins. Problem ended. Nobody would have found that in a forum thread.

My playbook for SOPs that survive contact with reality

• Sit with the best operator and the newest one. The best shows craft. The newest shows what the document hides.

• Watch the work twice. First for flow. Second for the stumbles.

• Ask five questions that expose the edges:

1. What usually goes wrong right after step two, and how do you catch it early?

2. If you had to do this with half the time or half the staff, what would you change first?

3. What did you try that looked good on paper and failed in practice?

4. Show me once, then watch me do it, and tell me what I am missing.

5. What would you never do again, even if someone swears it saves time?

• Draft the SOP in plain language. Verbs up front. One action per line. No fluff.

• Build in checks. Acceptance criteria, go/no-go points, and visible cues. Pictures beat paragraphs.

• Pilot it with real people. Not the author. Run it at the worst time of day.

• Measure it. Time to complete, error rate, rework, training time. If it does not move a number, it is theater.

• Train with demonstration and return demonstration. If they cannot teach it back, they do not have it yet.

• Version control like it matters. It does. Date, owner, change reason, redlines.

• Audit the reality. Unannounced walk-throughs. Does the work match the words. Fix the words if the work is right. Fix the work if the words are right.

Where AI belongs in this process
Use AI to accelerate the grunt work. Structure, format, cross-references, regulatory citations, table templates, quizzes, translation for multilingual teams. Use AI to draft a first outline or to turn bullets into clean prose. Do not let AI invent the parts that come from scar tissue. The nuance comes from people who have failed and learned and are willing to tell you about it.

The cost of getting this wrong
Thin SOPs look efficient. They are not. They create training debt and hidden risk. They inflate near misses. They turn audits into rescue missions. They chew up managers who spend their day clarifying what the document should have settled. The bill comes due in injuries, write-ups, lost product, and lost trust.

The upside of getting it right
Thick with the right detail does not mean thick with words. It means the document carries the weight of experience in a way a new hire can lift. It means you can move people across sites without starting from zero. It means less variance, fewer surprises, cleaner CAPAs, smoother handoffs, and a culture that treats procedures as tools, not obstacles.

The trade I am willing to make
Choosing a person over a search bar is a trade. You give up speed. You gain depth, accountability, and a version of the answer that fits your world. You also gain a name and a story attached to the skill. That makes the knowledge stick. It makes it yours. Then you lock it into an SOP so the next person does not have to guess.

Use search. Use AI. Then ask a human. Walk the floor. Listen for the part that never shows up online. Write that into the SOP. Teach it. Audit it. Iterate it. That is how you turn answers into competence, competence into trust, and trust into a business that runs when you are not watching.