Ensemble Ensemble
Menu
Home
  • SOLUTIONS
  • Method
    • A Systemic Approach
    • Theory of Constraints
    • Working with us
  • RESOURCES
    • Productivity Scorecard
    • Articles
    • Subscribe
    • Our book
  • Results
  • ABOUT
    • The Just Work Manifesto
    • Our Story
    • Location
Book a call
loader

Culture | Operations | Organisation | Resources | Strategy

View all articles SUBSCRIBE TO NEWSLETTER to get articles and more

STAY CONNECTED AND SIGNUP TO RECEIVE INSIGHT updates

Subscribe

Springboard: One Mission

David Hodes, Founder

The latest in our series that uses the ‘book review’ format as a springboard into a wider conversation about the world of work—and how to do it better.

One Mission by Chris Fussell
____________________________

It’s become fashionable to rail against hierarchy and to assume that people, once energised by their mission, can organise themselves into structures which are flat—at least in intent. But as with the flat-earthers, facts get in the way. Not only do we each have different cognitive capacities, we have different modes of thinking about complexity and the time horizon we can comfortably operate at. The essential question is: How do you get the speed that comes from allowing autonomous action, but maintain coordination and control?

One Mission (cover)

You can’t simply wish away bureaucracies; they fulfil too vital a purpose. Someone has to make decisions, and the power to do so rests within a nested hierarchy. Whether you like them or not, hierarchies are a feature of nature itself and, rather than think of them as always being malevolent and tyrannical, most often they are based on competence and necessity. To avoid the chaos that attends anarchy, we need rules of engagement, lines of accountability and matching levels of authority.

Until I read General Stanley McChrystal’s ground-breaking book, Team of Teams, I felt that every new fad proposed by the supposed gurus of organisational design just didn’t pass muster against the rigour developed by Dr Elliott Jaques with his Stratified Systems Theory and associated book Requisite Organisation. Besides his theory about the three-way correlation between cognitive ability, time-horizon of work and complexity, he also developed a means by which management accountability could be exercised both functionally and cross-functionally.

The means of addressing the accountability hierarchies were contained in the idea of TARRs and TIRRs. A TARR is a Task Assigning Role Relationship in which a manager can assign work to a subordinate by virtue of their position in the overall management accountability hierarchy—they are in the same silo. A TIRR is a Task Initiating Role Relationship in which a manager in a ‘collateral’ function can have differing degrees of authority over resources in another silo by virtue of declared rules. The conception of these relationships is contained in the tables below.

Task Assigning Role Relationships (TARR)
Task Assigning Role Relationships (TARR)

Task Initiating Role Relationships (TIRRs)
Task Initiating Role Relationships (TIRRs)

The trouble with this schema is that whilst it provides a necessary condition for understanding how an overall accountability hierarchy might function effectively—all the way from the front-line worker, through all hierarchical layers and functional silos, up to the unifying role of the CEO—it cannot move fast enough to accommodate the tempo of our modern competitive environments.

Chris Fussell was the aide-de-camp to General McChrystal during the counter-insurgency war in Iraq, a role which he describes as equivalent to a chief-of-staff in private enterprise. His book, One Mission, follows on from where McChrystal’s Team of Teams leaves off. I knew when I first read McChrystal that there was something profound in his ideas. Here was an organisation—the Joint Operations Command of all special forces in Iraq—reinventing how to get the best of bureaucratic command and control to work with the speed and adaptability of a networked organisation. They had made virtue of the necessity of moving faster than their Al Qaeda in Iraq enemy whilst bringing to bear the fearsome organised power available to the coalition forces.

Two observations stayed with me after reading Team of Teams: the degree to which Taylorism and its bureaucratic tropes had been perfected in the US military and how radical transparency and subsidiarity (devolving decision making powers to the lowest level competent to make those decisions) were used to re-energise it.

In One Mission, Fussell provides a good first cut of how a team of teams actually operates and how to go about building one. With easy-to-follow chapters, each major section has a case study to illustrate how the principles learned on the battlefield can be applied across a wide variety of industries—from software (Intuit) to merchandise (Under Armour) and from public services (Medstar) to financial services (Eastdil Secured).

In the context of the war in Iraq, McChrystal’s Joint Special Operations Command (JSOC) had to integrate the highly tribalised special forces, each with their fierce loyalty to their unit—be they Green Berets, Rangers, Navy SEALs, Delta Force and others. In addition, they had to integrate their activities with the CIA, the State Department, the FBI, all branches of the US Department of Defense, the Department of Homeland Security, and a host of other national and international entities and agencies. That they were able to achieve one mission under these circumstances proved to me that the lessons to be learned had to be relevant to any large complex organisation trying to find a new paradigm for managerial leadership in this digital age.

Building alignment through a sense of connection to the mission, echoing my own understanding of Senge’s idea of a ‘shared vision’, was the first order of business. This mission found its expression in the simple equation of what Fussell describes as their aligning narrative—the story each of the disparate teams tells themselves to transcend the tightly held, but more narrowly constructed narrative of their home unit:

Credibility = Proven Competence + Integrity + Relationships

This simple-sounding formulation of the aligning vision is repeated throughout the book and acts as a powerful anchor for everything built around it. Regardless of whom you are dealing with—be it Al Qaeda in Iraq or the President of the United States—you get to be credible by proving your competence, being true to your word and constantly cultivating strong relationships.

In developing his theme of the hybrid organisation—which is to maintain the best of what a necessary bureaucratic structure has to offer with the agility and connectedness of a network—Fussell introduces the idea of an ‘information pump’. Information is always a critical resource in any enterprise, and goal accomplishment is often tied to how fast and efficient is its flow. He quotes Duncan Watts, a network theorist, in answering the puzzle of what a manager actually produces:

The answer, from an information-processing point of view, is that a manager’s principal task is not production at all, but coordination, to serve as an information pump between the individuals whose task is production.

The rest of the book is ultimately about how to debottleneck the flow of information through an organisation so that people can take empowered action with a shared consciousness of any given situation. He starts with the introduction of the idea of people who act as ‘boundary spanners’ between their organisational or functional silo, spanning the divide to adjacent functions or even far-off organisations who all share the same mission. These boundary spanners are not usually identifiable in the hierarchy described by the org chart, but are those ‘go to’ people everyone knows as the ones who know how things actually work.

Priming the information pumps
A critical element of the team of teams idea is to ensure that the cadence of communications runs at a pace at least equal to the rate at which the external environment is changing. In the case of the war in Iraq, this meant daily. And here’s the truly staggering change in thinking—these daily 90-minute video connections called Operations and Intelligence (O&I) forums would have as many as seven thousand people on them. How, I wondered, could you actually fight a war when the majority of the people fighting it were tied up in a one-and-a-half-hour meeting every day? And, perhaps even more remarkably, all the information was shared on the video-conference with no holds barred. I was astounded by the transformation that must have occurred in such a huge military organisation where the ‘need to know’ mantra would have been bred deeply into the bones.

How, I wondered, could you actually fight a war
when the majority of the people fighting it were tied up
in a one-and-a-half-hour meeting every day?

Those meetings removed the information pumps as the bottleneck to a shared consciousness of the whole theatre of war in Iraq. I found the phrase ‘shared consciousness’ unusual for a military organisation, associating it more with revolutionary political environments. The point is, though, that once different operating units understood the whole, they could act in a way that served the greatest possible good for their mission. This modus operandi meant that spending 90 minutes across the entire network of stakeholders to establish a shared consciousness left 22.5 hours every day for empowered execution. How many hours a day, I was left wondering, are wasted in the more normal work organisation trying to get the information pumps working at a rate capable of delivering even a fraction of the shared consciousness the team of teams approach delivers?

An O&I is a virtual space wherein an organisation’s leadership can create, with the required regularity, conditions for the organic interaction of all of its teams, and reiterate an aligning narrative to the assembled organisation. It is a regular reminder of purpose and an opportunity to reconnect with the larger tribe.

Fussell goes on to describe in some detail the idea of ‘decision space’ and its importance in defining for commanders what they could and could not do in the periods of empowered execution between the O&I events. This clarity around decision space meant that real autonomy could be exercised during the empowered execution phase within a team or across the whole organisation, without the need to refer all the way back up the hierarchy and down again. With the team of teams in place, the increase in the number of missions being run was staggering, leaping from ten raids per month in the early days to more than three hundred by 2006. But having to exercise autonomy was not so easy:

Real empowerment, when supported with the correct access to information and the necessary authority to make decisions, can be a lonely place. Properly empowered leaders and teams no longer have the bureaucratic excuse matrix to fall back upon, a luxury most will not realise they depend on until it’s gone.

Another critical piece in the puzzle was the appointment of liaisons. This might seem like a quite normal activity to undertake when spanning a large organisation or having to represent your home organisation in a key stakeholder’s organisation. It’s akin to what ambassadors do for the countries they represent. But ambassadors are career posts. The difference in a team of teams is that the liaisons were drawn from the very best ‘active duty’ folk in each unit. A tough call to ask any leader to give up their best and brightest to an ambassadorial role.

Unless liaisons are selected from amongst candidates equipped to seamlessly represent your senior leadership, their utility is limited, and they may be counter-productive.

Liaisons are different from boundary spanners. The latter remain in their home unit and are valued for what they know about ‘how things get done around here’. Liaisons, though, are selected by the highest level of leadership to represent the home organisation in a key stakeholder’s organisation. Their role is to credibly convey to each party what the thinking is of the other so that all can function without any of the critical nuances being lost in translation.

The whole system is summarised in the diagram below, which provides a remarkably simple conceptualisation of a revolution in the way we conceive of how we lead and manage bureaucracies and networks. You start with a common purpose—such as destroy Al Qaeda in Iraq, double EBIT within five years or become number 1 or 2 in any market you serve.

Empowered execution diagram

These goals operate at the strategic, operational and tactical levels at any given moment in time. At time t1 there are all the meetings and rituals devoted to developing shared consciousness. The time between t1 and t2 is for empowered execution. At time t2, it is time again to reconvene and develop a shared consciousness around what has just transpired and how you are going to address it. During the period of empowered execution, the decision space is set out (the large arrow), with clear guidance on the necessary conditions required for you to act using your own judgement and discretion—what you do and what you don’t do.

In summary, I find the whole idea of a team of teams the most interesting innovation in managerial leadership since Elliott Jaques developed stratified systems theory and published Requisite Organization. The courage required to embrace such a radical departure from our existing norms would make most CEOs I know run a mile. But I am certain that what McChrystal led in the heat of battle—and what Fussell has written about in One Mission—represents the start of something completely new in the field of organisational design and effectiveness.

____________________________

What’s next?

The change from standard thinking to Theory of Constraints (TOC) is both profound and exhilarating. To make it both fun and memorable, we use a business simulation we call The Right Stuff Workshop.

We’d love to run it with you. To learn more:

  • download the brochure (no email required)
  • schedule a call

    ____________________________

    ‘The object of any component is to contribute its best to
    the system, not to maximise its own production. […]
    Some components may operate at a loss themselves in
    order to optimise the whole system’—W Edwards Deming

    ____________________________

  • Culture
  • Operations
  • Process
  • Strategy

The healthcare professional: the hidden constraint in patient flow

Ensemble Administrator

Healthcare professionals are central to the patient’s progress from awareness of a therapy to successful long-term use. They identify risk, interpret evidence, diagnose conditions, discuss options, perform procedures, provide training and monitor outcomes.

Yet many medical device development programs treat healthcare professionals primarily as users to be trained or customers to be persuaded.

HCP-Centered Design takes a wider view. It examines the work healthcare professionals must perform, the system in which they perform it and the constraints that limit their ability to move suitable patients through the care pathway.

“If patient flow depends on a healthcare professional, that professional’s available capacity may determine how many patients ultimately receive the therapy.”

Healthcare professionals govern critical transitions

A medical device patient journey commonly depends on several healthcare professionals:

  • A primary care professional recognizes a problem or makes a referral.
  • A specialist assesses the patient and manages the disease pathway.
  • Diagnostic professionals generate and interpret evidence.
  • A managing physician supports authorization or reimbursement.
  • An interventional specialist confirms eligibility and performs a procedure.
  • Nurses, educators or allied health professionals help the patient adapt.
  • Follow-up teams monitor efficacy and coordinate adjustments.

Each professional governs a transition in the flow of patients.

If one transition lacks sufficient capacity, information or clarity, the whole pathway slows. More marketing, sales activity or production capacity will not compensate for a shortage of specialist time or a burdensome diagnostic process.

This is why HCP-Centered Design is not simply about making an interface easier to use. It is about enabling the system of care to perform.

The HCP works within a system

A healthcare professional’s work depends on information and actions supplied by others. They may rely on referrals, patient histories, pathology, imaging, electronic records, clinical guidelines and the availability of equipment or trained colleagues.

After reaching a decision, they may need to explain it, document it, arrange authorization, coordinate treatment and prepare the next person in the pathway.

A technically strong solution can still create difficulty if it:

  • Requires information that is hard to obtain
  • Interrupts established clinical workflows
  • Produces outputs that are difficult to interpret
  • Adds documentation without removing other work
  • Fails to connect with existing systems
  • Demands training that cannot be sustained
  • Transfers work or risk to another professional
  • Provides a result without clarifying the next action

The relevant design question is not merely, “Can the HCP use this product?”

It is, “Does this solution improve the HCP’s ability to complete important clinical work within the conditions in which care is actually delivered?”

Identify the real healthcare professional personas

“HCP” is not one persona.

A general practitioner, specialist, interventional physician, nurse, technician and clinical administrator encounter different stages of the pathway. Each has different responsibilities, authority, expertise and exposure to risk.

Even within a profession, context matters. An experienced specialist in a major hospital may approach the same task differently from a professional who encounters the condition infrequently or works without immediate specialist support.

Useful HCP personas distinguish factors that influence work:

  • Clinical responsibility and decision authority
  • Frequency of encountering the condition
  • Experience with the procedure or technology
  • Access to information and specialist support
  • Available time
  • Confidence in interpreting results
  • Responsibility for follow-up
  • Exposure to clinical, legal or financial risk

These personas clarify who performs each job and what support each person requires.

Map the HCP journey

The HCP journey often begins before the visible clinical procedure.

It may include receiving a referral, gathering information, forming an initial view, ordering investigations, interpreting results, deciding whether the patient is eligible, discussing treatment, obtaining authorization, preparing for the procedure, delivering care and arranging follow-up.

At each stage, ask:

  • What is the HCP trying to accomplish?
  • What information is required?
  • Where does the information come from?
  • What decision must be made?
  • What could cause delay or rework?
  • Who depends on this action?
  • What must happen before the patient can progress?

The resulting journey map should distinguish processing time from waiting time. A decision may require only minutes of specialist attention while patients wait weeks to access that attention.

This reveals the practical relationship between HCP capacity and patient flow.

Find the HCP constraint

The Theory of Constraints directs attention to the factor limiting the performance of the entire system.

In some pathways, the constraint may be the number of qualified interventional specialists. In others, it may be diagnostic capacity, physician confidence, authorization effort, operating room access or the time required to train patients.

The constraint may also be hidden inside the HCP’s working day.

A specialist supporting a therapy must still manage other clinical duties, administration, meetings, documentation and urgent cases. The question is not simply how many specialists exist. It is how much of their usable capacity is available for the activities upon which patient flow depends.

“The scarcest resource may not be the healthcare professional. It may be the few hours of focused capacity available for the critical work.”

Improvement away from this constraint can make performance worse. Sending more referrals to an already overloaded specialist increases the queue. Adding information may increase cognitive burden. Creating another approval may consume the capacity required to treat patients.

HCP-Centered Design seeks to protect and expand the capacity that governs flow.

Go to the clinical Gemba

Policies and procedures describe how clinical work should happen. Observation reveals how it actually happens.

Healthcare professionals routinely compensate for missing information, awkward interfaces and unreliable handovers. These workarounds may become so familiar that nobody reports them as problems.

Gemba research should examine:

  • How the HCP prepares
  • Which tools and information sources are used
  • What interrupts the work
  • Where the HCP waits or repeats activity
  • How uncertainty is communicated
  • What must be documented
  • How work passes to the next person
  • How the HCP recognizes that the job is complete

The purpose is not to judge the healthcare professional. It is to understand the system surrounding the work.

“A workaround is often evidence that the system has failed to support the person doing the work.”

Define the HCP’s job to be done

Healthcare professionals do not simply use devices. They use them to make progress in clinical work.

An HCP may need to identify risk, reach a confident diagnosis, select an intervention, perform a procedure safely, explain options, monitor progress or recognize deterioration.

A structured job map divides this work into eight stages:

  1. Define the intended clinical outcome.
  2. Locate the necessary information and resources.
  3. Prepare the patient, equipment and environment.
  4. Confirm readiness and choose between alternatives.
  5. Execute the clinical activity.
  6. Monitor its progress and results.
  7. Modify the approach when circumstances change.
  8. Conclude, document and prepare for subsequent care.

This wider view prevents the product team from concentrating exclusively on the procedure.

The greatest value may come from reducing preparation, improving decision confidence, clarifying an exception, simplifying documentation or improving the handover to follow-up care.

Convert experience into measurable outcomes

Comments such as “the interface is difficult” or “we need better information” indicate dissatisfaction, but do not provide sufficient direction for design.

They should be translated into measurable outcome statements, such as:

“Minimize the time required to identify which clinical information is missing before making a treatment decision.”

Or:

“Reduce the likelihood that a clinically significant change goes unrecognized between scheduled reviews.”

A broader population of healthcare professionals can then assess the importance of each outcome and their satisfaction with their current ability to achieve it.

Highly important and poorly satisfied outcomes provide a rational basis for prioritizing innovation.

“Adoption follows when a solution makes important clinical work safer, clearer or easier to complete.”

Apply FOCUS to HCP capacity

The five-step FOCUS process creates a practical improvement cycle.

Find the constraint. Determine which HCP activity or resource currently limits patient flow.

Optimise for it. Protect the constraint from avoidable work, missing information, interruptions and rework.

Collaborate around it. Align upstream and downstream teams so patients, information and resources arrive when required.

Uplift it. Add capacity, redesign responsibilities, improve technology or remove restrictive policies.

Start Again. Identify the new constraint once flow improves.

This approach allows the organization to distinguish activity from value. It also turns HCP engagement into an ongoing management discipline.

Connect HCP evidence with enterprise execution

HCP-Centered Design must connect clinical reality with patient needs, technology, regulation and business strategy.

A Value Management Office can help coordinate these perspectives across the product lifecycle. Its role is to ensure that projects, resources and stage-gate decisions remain connected to patient flow and business value.

The organization should be able to show:

  • Which HCP groups influence the pathway
  • What each group is trying to accomplish
  • How the work happens in practice
  • Which outcomes remain poorly served
  • Where HCP capacity constrains patient flow
  • How the proposed solution changes the wider care system
  • How improvement will be measured

The goal is not simply a device that healthcare professionals can operate. It is a solution they can confidently incorporate into care and a delivery system capable of getting that solution to more patients.


What’s next?

Use the HCP-Centered Design assessment to determine how well your organization understands clinical work, HCP capacity and the constraints governing patient flow.

The resulting evidence should guide product design, process improvement and investment toward better products, delivered faster, with more lives changed for good.

READ MORE

  • Operations
  • People
  • Process
  • Strategy

Patient flow: the missing system in Patient Centered Design

Ensemble Administrator

Medical device companies devote enormous skill and investment to developing safe, effective products. Yet a technically successful device changes no lives while suitable patients remain unable to reach it.

Between a patient becoming aware of a therapy and receiving its intended benefit lies a pathway of referrals, consultations, diagnostics, approvals, procedures, training and follow-up. Every step consumes time. Between the steps, patients wait. At some points, they become confused, discouraged, ineligible or lost to the process.

Patient Centered Design must therefore address more than the design of the device. It must improve the performance of the entire system through which patients reach, receive and live successfully with the solution.

“A life-changing therapy changes no lives while patients remain trapped in the pathway leading to it.”

The patient journey is a flow system

A typical medical device journey may include:

  1. The patient becomes aware of a possible therapy.
  2. A primary care professional or specialist assesses the patient.
  3. Diagnostic work determines whether the therapy is appropriate.
  4. The patient secures authorization or reimbursement.
  5. An interventional specialist confirms and plans the procedure.
  6. The patient receives the device or therapy.
  7. The patient learns how to live with the solution.
  8. Follow-up identifies any necessary adjustments.
  9. Periodic reviews monitor longer-term efficacy.

Companies often manage these stages as separate functions. Marketing works on awareness. Medical affairs supports clinicians. Market access addresses reimbursement. Sales works with specialists. Clinical teams gather evidence. Training teams support adoption.

The patient, however, experiences one journey.

From the patient’s perspective, a delay between two organizational functions remains a delay. A repeated test remains repeated work. An unclear handover creates uncertainty regardless of which department owns it.

Patient Centered Design begins when the organization sees and manages this journey as a connected system.

Processing time tells only part of the story

Every step contains some necessary processing time. A consultation takes time. A diagnostic test takes time. An authorization must be assessed. A procedure must be performed.

The patient’s total lead time, however, also includes the waiting between these activities.

A consultation may take 30 minutes, but the patient could wait six weeks for it. A diagnostic test may take an hour, followed by another delay before a specialist reviews the result. Prior authorization may require little actual work while adding weeks to the pathway.

This distinction matters because organizations often improve processing time while leaving the larger queues untouched. Saving five minutes during an appointment produces little benefit if the patient waits months to reach it.

Patient Centered Design therefore asks:

  • How long does each activity take?
  • How long do patients wait between activities?
  • How many suitable patients enter each stage?
  • How many progress to the next stage?
  • Where and why do patients leave the pathway?
  • How much total time passes before the patient receives the solution?

The answers reveal the true performance of the patient system.

Find the constraint

Theory of Constraints teaches that the performance of any system is limited by a constraint. Improving a part of the system that is not constraining flow may create more activity without increasing results.

If diagnostic capacity is the constraint, generating more awareness may simply produce a longer queue for diagnosis. If specialist capacity is the constraint, accelerating authorization may move patients more quickly into another wait. If training after first use is inadequate, increasing procedures may produce poor experiences and avoidable follow-up demand.

“More activity at a non-constraint creates work in process. More capability at the constraint improves the system.”

The constraint is not always a physical resource. It may be a policy, an eligibility rule, missing evidence, a fragmented handover, an information delay or the cognitive burden placed on the patient.

The most important question is therefore not, “How do we improve every step?”

It is, “What currently limits the flow of suitable patients to successful use of the therapy?”

Understand why patients remain in or leave the flow

Numbers show where patients are lost. Patient research helps explain why.

Two patients with the same diagnosis may respond very differently. One may actively seek new treatment options. Another may delay action until symptoms become severe. A third may want help but lack confidence in navigating the healthcare system.

Meaningful patient segmentation considers characteristics that influence behavior:

  • The importance the person gives their health
  • Their confidence in dealing with healthcare professionals
  • Whether they act independently or need encouragement
  • Their comfort with technology
  • The pressures of work, family and daily life
  • Their ability to understand and act on clinical information
  • Their willingness and ability to pay
  • The outcomes they most want to achieve

These differences affect whether patients enter the pathway, remain engaged and successfully adopt the solution.

Go to the patient’s Gemba

The Gemba is the place where work actually happens. For patients, this includes the home, clinic, hospital and all the places where they manage their condition between formal encounters.

Interviews alone may miss important evidence. People normalize inconvenience, forget workarounds and simplify their past decisions. Observation allows the development team to see what patients actually do.

Good research combines three activities.

Observe. Watch how patients obtain information, prepare, use the solution and respond when something goes wrong.

Immerse. Understand the physical, emotional and practical conditions surrounding the experience.

Engage. Ask open questions that allow patients to describe their goals, fears and frustrations in their own language.

The purpose is to discover the patient’s reality before asking them to evaluate the organization’s preferred answer.

Understand the patient’s job to be done

Patients rarely want a medical device for its own sake. They want the progress it may enable.

They may want to recognize deterioration earlier, preserve independence, reduce pain, avoid repeated visits, return to work or prevent a disease from controlling daily life.

A useful job map examines eight recurring stages:

  1. Define what must be achieved.
  2. Locate the required information and resources.
  3. Prepare for the activity.
  4. Confirm readiness and choose between alternatives.
  5. Execute the activity.
  6. Monitor whether it is working.
  7. Modify the approach when circumstances change.
  8. Conclude or prepare for what follows.

This reveals opportunities beyond the immediate use of the device. The most valuable improvement may involve helping patients prepare, confirm readiness, recognize an exception or understand what happens next.

Turn patient experiences into evidence

Stories create understanding, but investment decisions require structured evidence.

Patient observations and comments should be converted into outcome statements that identify:

  • The desired direction of improvement
  • A measure of success
  • The object being controlled
  • The circumstances in which it matters

For example:

“Minimize the time required to recognize that my condition has changed sufficiently to require clinical help.”

Patients can then assess the importance of each outcome and their satisfaction with their current ability to achieve it.

Highly important and poorly satisfied outcomes represent genuine opportunities. This prevents teams from prioritizing attractive features that do not materially improve the patient’s life or progress through the pathway.

“Innovation becomes valuable when it improves an outcome that matters and remains poorly served.”

Apply the five-step FOCUS process

The Patient Centered Design pathway can be improved through a repeating discipline:

Find the constraint. Identify what currently limits patient flow or successful use.

Optimise for it. Make the best possible use of existing constraint capacity.

Collaborate around it. Align functions and partners so their actions support the constraint.

Uplift it. Add capability, remove restrictive policies or redesign the pathway.

Start Again. Once the constraint moves, identify and address the next limiting factor.

This prevents improvement from becoming a collection of disconnected initiatives. It directs scarce resources toward the factor that most strongly governs the result.

Patient Centered Design is an operating system

Patient insight should influence more than early product design. It should shape clinical evidence, regulatory strategy, reimbursement, manufacturing, education, market development and post-market support.

The organization should be able to show:

  • Which patients it intends to serve
  • What those patients are trying to accomplish
  • How the complete patient pathway operates
  • Where patients wait or leave the flow
  • Which outcomes remain poorly served
  • What currently constrains successful patient access
  • How the proposed solution improves the whole system

The goal is not simply to place the patient at the center of a diagram. It is to organize the enterprise around delivering better products faster, so that more lives can be changed for good.


What’s next?

Use the Patient Centered Design assessment to determine how well your organization understands its patient journeys, priority outcomes and constraints to patient flow.

The result should be more than another collection of patient opinions. It should provide evidence that directs strategy, investment and execution toward the changes that matter most.

READ MORE

More than just work

Discover better ways to do better work.

Fresh insights, every Friday

We alternate our own actionable articles with three relevant links from other authorities.

We’ll only use your email address for this newsletter. No sales calls

    Subscribe to 'Perspectives'

    [recaptcha id:cf7note]

    More Than Just Work
    Weekly productivity insights

    Subscribe
    • EnsembleConsultingGroup
    • Share Page
    • +61 2 9387 3955
    • info@EnsembleConsultingGroup.com

    Site proudly designed by Brand Fibre

    What is to get in touch with you?



    More than just work

    Discover better ways to do better work.

    Fresh insights, every Friday

    We alternate our own actionable articles with three relevant links from other authorities.


    We’ll only use your email address for this newsletter. No sales calls

    white_arrow white_bidirection_arrow arrow-right-green arrow-right-orange arrow-right arrow-left blue_arrow blue_round_arrow tick

    Want us to get in touch with you?

     
    Thank you for your interest. We will call you back.