Case Study

Transforming Healthcare Culture and Outcomes

Startup Strategic Design: Karisha Community Center for Wellness


Karisha Community Center for Wellness is advancing whole-person, inclusive community healthcare in Austin, with a new lifestyle-focused medical community. Formed as a Public Benefit Corporation instead of a traditional for-profit model, it’s funded by community investors. The Center provides primary and priority medical care, mental health care, physical therapy, massage, acupuncture, and nutrition counseling services to support the whole patient.

Karisha Community Center for Wellness


As with any new business in the startup phase, Karisha needed to prioritize a huge number of complex tasks with tight deadlines. When they engaged Dr. Duke, the team had no clear plan in place, and was struggling to make tangible progress. They needed to:

Cultivate a strong leadership team

Secure funding for construction of the facility and for operations

Design the building

Design the clinical operations

Build a staff to run the business

Engage community members—a cornerstone of their vision for transformation


Dr. Duke worked with the Karisha team to create their first strategic operational plan. We began with an operational assessment – creating a master list of everything that needed to get done, and staging how the phases of work fit together. To accomplish this, we:

Identified all areas of work that needed to be designed, built, or cultivated to bring Karisha online.

Defined (1) what they had, and (2) what they needed for each work area

Used a customized, user-friendly tool to externalize all the ideas and information swimming in their heads, and captured it in one database

Prioritized tasks based on timing and importance to the project’s success

By design, our assessment tool allowed quick conversion of assessment data into the framework of a strategic operational plan. After we uploaded the initial plan into an online project management tool, Karisha was able to easily review clear tasks and timelines to achieve their goals.


With the full scope of work captured and prioritized, the CEO and her team were able to move forward with clarity and focus on the critical, foundational steps needed for a successful launch. Even as the strategic operational plan was being finalized, the Karisha team was able to secure funding for development operations, address priority building design needs, hire a permanent COO, create a community engagement strategy, and renew commitment from their advisory board.

Case Study Testimonials 

Karisha Community Center for Wellness is a vision to transform the culture of health and health care… no small task! It has been a community driven initiative which has taken its own shape yet with the need for clear guidance and direction for the breadth and depth of the parts and pieces. As Founder and CEO, I knew we needed someone to help us do that. I also knew that someone needed to understand our culture and vision and have a willingness to think outside the box yet bring a deep skill set for strategic operational planning. I also needed our consultant to work with us on budgetary capacity over time. Hallie Duke was this person!

Karisha Community Center for Wellness, a for-profit, for-purpose corporation now has the strategic operational plan we need for the next 24 months to ensure a successful planning and opening! Hallie showed up with her full self and with dedication to our vision and mission. She listened to us first and foremost. She then took the information and created a structure, defined the parts and pieces of that structure while checking in with us along the way. Finally, she searched and found an appropriate collaborative online tool that fits our plans and our teams, all of which are innovative and distinct from traditional structures of organizations.

I highly recommend Hallie Duke as a dedicated, sharp, skilled, and heart-centered strategic operational planner.

Amina Haji, MD, ABiHM

Founder + CEO, Karisha Community Center for Wellness