Strategic Innovation: The Children's Hospital at Montefiore

His dream for the hospital included three nonnegotiable mind flips about health care and the institutions that provide it. First, this facility couldn't just be a hospital -- it had to be the hub of a comprehensive children's health system throughout the Bronx. "The problem with most children's hospitals," says Redlener, "is that they are passive. They are high quality. They are filled with the best doctors. But their function is to wait until kids get sick and get referred in. I wanted to establish a much more dynamic relationship between a children's hospital and the community." Second, there could be no financial barriers to service. The hospital had to be fully free and open to every child in the Bronx, regardless of ability to pay. Third, Redlener wanted to incorporate "an agenda beyond healing that would be appropriate, unique, and perhaps even life changing for this patient population."

The result: the Children's Hospital at Montefiore (CHAM), a new state-of-the-art medical facility staffed by the renowned faculty of the Albert Einstein College of Medicine. The stunning new hospital, which opened its doors late last October, is linked to a network of more than 30 community-based health facilities, including the largest school-based health program in the country, a cutting-edge neonatal intensive-care unit, the city's leading child-protection program, and a fleet of mobile medical units. Most remarkable, elaborate design artistry, inventive technology tools, and Carl Sagan's cosmic worldview have fused there into an engaging discovery zone.

"We wanted to recast the idea of what could be achieved in a children's hospital," Redlener says. "We decided to change the expectation of what happens during treatment and recovery. Our mission was to provide excellent health care and a total environment that ignites the imagination of children. Hospitals are about healing. This one is about changing lives."

"Dreams are Maps": Asking Courageous Questions

There is a VISTA recruitment poster on the wall in Redlener's office at the Children's Health Fund (CHF) headquarters on Manhattan's Upper East Side. It features a haunting black-and-white photograph of a young man with his back to the camera. He is carrying a doctor's bag, walking along a set of deserted railroad tracks in a rural area. It's a meditative image, punctuated by a phone number and a call to arms: "Sign up for a year of tough practice in the other America."

Redlener saw that poster 31 years ago in the dining room of the children's hospital in Denver where he was training to become a pediatrician. He called the number. Four months later, he left for the Arkansas Delta. It was 1971, and he was 26 years old. He never looked back. Since then, Redlener has spent his entire career as a forceful advocate for the most vulnerable children and families. But nothing prepared him for the day in 1986 when he took Paul Simon on a tour of "the invisible New York City."

Fresh from their efforts on We Are the World and USA for Africa, Redlener and Simon wanted to do something about hunger and homelessness in the United States. They visited a series of nurseries for crack babies and other special programs for sick, homeless children in New York. Then they stepped inside the Martinique Welfare Hotel, a once-glorious midtown hotel that had crumbled into a monstrous, squalid building used as a warehouse shelter for homeless families. "There were a thousand children and their parents in that building," Redlener remembers. "It was total chaos. The elevators were broken, there were drug deals going on, and there were about 80 kids waiting outside the dining room for the one meal they'd get that day. Even though I had already been very immersed in the problems of underserved children, I was stunned. And Paul Simon was absolutely speechless. The question after the visit was, What can we do?"

The answer: Create a pediatric clinic on wheels to bring high-quality, continuous medical care to children in the shelter system and on the streets. Simon and Redlener recruited Redlener's wife, Karen -- a health administrator he had met as a VISTA volunteer -- to design the program. The team launched CHF in 1987 with a single mobile unit that Simon paid for. Today in New York, there are five bright-blue, 35-foot vans that function as fully equipped clinics, complete with waiting areas, nurses' stations, the latest computers, two exam rooms, and sophisticated diagnostic equipment. For the most disadvantaged communities, the vans represent a stable source of services. And CHF has expanded into 16 other rural and urban programs that address the problem of access to health care for extremely disadvantaged children. During the past 15 years, CHF has served 300,000 kids in 750,000 encounters across the country. Redlener and his team raise between $6 million and $7 million a year for the fund.