A passionate organization in a passion-based economy

The Business Innovation Factory’s Saul Kaplan sees a lack of passion in the world today as a result of the evolution to a knowledge-based economy:

We need to move from a knowledge-based economy to a passion-based economy. Who gets excited about a knowledge-based economy? Where is the passion? I have spent a ton of time and effort to rally the troops. If I am honest, people just haven’t connected emotionally. The knowledge-based economy has given us the tools we need but has fallen short in solving the real issues of our time including health care, education, energy independence, public safety, and quality of life. These are all systems issues that will require systems solutions.

A lack of passion in health care.  It’s a disturbing thought.  And it’s right on point.

To be sure, health care careers demand passion.  John Bogle in Enough!:

Contrast the businessmen and businesswomen with others who are chasing what I believe are the real rabbits of life—physicians and surgeons and nurses…  Perhaps these responsible, dedicated souls earn our respect because they serve our society knowing that accumulating great wealth is almost out of the question, that great fame is rare, and that great power–at least temporal power–is conspicuous by its absence.

But there is a problem in the health care organization today.  The practice of health caring is divine, it’s also draining.  It is inspirational, yet demanding.  Many, many great people in this industry do great things every day, very, very passionately.  Many also struggle with frustrations—the cause of which most can be blamed upon the system that we operate in: it makes many silly business practices necessary.  The system can also make “doing the right thing” very difficult to do.

This is where the modern health care organization falls short: it fails to allow for passionate people to be completely passionate about their work.  The very existence of an organization should serve as insulation for the front-line workers inside the organization from the frustration-making realities of the outside.  More often than not, they don’t.  As a result, workers driven by passion often are not.

It’s difficult to determine where the passion is lost.  Talk to most students looking into medical school/nursing school/health administration/etc. (+ early careerists) and you will find that most are idealistic and altruistic in their endeavors.  They are passionate about helping patients heal, about fixing health care, about doing good for the world.

Once the realities of the system come into focus, however, those feelings seem to subside and the health care world suffers because of it.

To be sure, passion still exists for today’s health care worker—on an individual level.  It is passion exuded despite extreme distraction.  The health care worker today is passionate about caring for the individual patient but remains burdened by the business reality frustrations of the industry.  For health care to be great, for the individual organization to be great, passion for what health carers do must be exhibited at the system level.  For it is fact that any progress–any innovation–made in health care delivery will surely be driven by the care givers.

While the modern health care organization is largely responsible for the apathy produced within its bounds, it also happens to be the lone (for now…) solution.  Mr. Kaplan:

If your organization is blindly vested in the way you do business today, it is a good time to explore and test new models and systems with a clear passion at the core. If your organization is determined to resist change, move out of the way because the wisdom of crowds has learned how to mobilize behind a compelling passion. These new purposeful networks will not be stopped.

So are you trying new things?  Are you testing new models?  Have you even thought about such problems within your organization?

Many organizations are trying to find “innovative” ways to bring new nurses on board.  Tactics include giving away gas cards, trips, and vehicle leases…

How about allowing and promoting and creating the most amazing culture ever to be experienced in a health care organization?  An organization where workers can passionately carry out their day-to-day life saving/changing/improving activities?  Workers are finding more desirable outlets for their skill, for their passion, everyday.  They will continue to do so.  Difficult worker shortages will only become more common.  Proper attention to this matter needs to be made.  Building an organization that people desire/long/dream to work for starts with leadership.

Mr. Kaplan for a final thought:

Systems level innovation requires passionate leaders and organizations that are committed to a cause. Passion-based organizations stop at nothing to accomplish their goals and are able to attract people and resources to their causes. A passion economy can arise that unleashes both a new era of prosperity and solutions for the big issues of our time.

Passion-based organizations are a supremely great idea and they require passionate leadership to blossom.  More important, though, are the people caring for patients.  Executives can preach passion from the ivory tower (surely some do) but the passion-based organization is about (all about!) the front-line (read: most important) workers.

Commitment from them is essential, don’t ignore that.

All too many have.

Walmart reduces obesity

A synchronistic finding as Walmart continues efforts to shed its image of old: the presence of a big box retailer seems to translate into community member weight loss.

From Portfolio’s Odd Numbers:

The researchers think this happens because cheaper goods from Wal-Mart allow shoppers to spend more of their budget on relatively expensive healthier foods. Providing some support to their assertion, when Courtemanche and Carden broke down their results by income, they found that the lowest-earning people saw the most weight loss.

Interesting.  Whatever your thoughts on the company (or the rebranding), they do sell stuff for cheap.  Cheap is good right now, especially when it means healthier Americans.

In: Design Excerpt

From The New York Times:

“What designers do really well is work within constraints, work with what they have,” said Paola Antonelli, senior curator of architecture and design at the Museum of Modern Art. “This might be the time when designers can really do their job, and do it in a humanistic spirit.”

In the lean years ahead, “there will be less design, but much better design,” Ms. Antonelli predicted.

There is a reason she and others are optimistic: however dark the economic picture, it will most likely cause designers to shift their attention from consumer products to the more pressing needs of infrastructure, housing, city planning, transit and energy.

May I politely suggest adding health care to the list?  The article goes on to say, “Designers are good at coming up with new ways of looking at complex problems…”

Complex health care is.

Up, Up, Up

Here’s a shocker: health care spending increased in 2007.

What matters, at this point, is what effect the deepening recession will have on spending in 2009 (and had in 2008).  Delivery system job cuts and reduced drug spending (down big) are likely indicative of a tough 2009 (duh.).

The good news from the “U.S. health system” level (and it’s hardly good news) is that outlays increased slightly slower in 2007 than in 2006 (6.1 percent vs 6.7 percent respectively), much of the slow down is attributable to reduced prescription drug demand.  The other side: health care costs grew faster than wages and and GDP. Health care now consumes 16.2 percent (up from 16 percent in 2006) of our nation’s entire gross domestic product.  The dollar figure is a cool $2.2 trillion or $7,421 per person.  Government spending on health care also increased.

Here’s how some media outlets covered the news (updated throughout the day):

Spending on prescription drugs slows USA Today

Health-Care Outlays Climb at Slowest Rate in Years Wall Street Journal

Spending Rise for Health Care and Prescription Drugs Slows The New York Times

Nation’s health spending rises, but not so much Associated Press

Healthcare spending in U.S. slows Los Angeles Times

Health Spending Continues To Explode Forbes

Design: Engage the patients!

A pair of British innovation consultancies are putting design to work improving health care—both involve asking (potential) patients for their input.

The Engine Group asked individuals in a number of vulnerable populations what kind of health care services they would use and then co-designed those services:

The findings showed that all the groups shared simple needs, mainly concerned with emotional, social and low level mental health issues. The findings also indicated a lack of trust towards the NHS in general, although the stakeholders were able to identify an individual with whom they had a productive relationship. The resulting service suggestion ‘Open Door’ emerged from this work. It was built around a place of safety – somewhere warm, safe and non-judgemental – where a variety of services are designed to address peoples needs. Different touchpoints were developed to increase access, so that the user groups could begin to better manage their health.

Live|Work comments on a recent report by the National Health System outlining the need for a new approach: High quality care for all.  Its gist: health care gets personal.  Live|Work says:

The move from quantity of services to quality of services involves switching attention from the productive capability of the NHS machine (how many cancer patients can we treat with these resources?) to the ability of NHS services to meet the needs of patients and the public (how can we support the health needs of each and every person in Britain in a timely manner?).

What is needed is a new way of thinking about services that starts with the individual not the organisation. We call this Service Thinking.

Service Thinking presents a major challenge. It requires a new type of engagement with patients and the public. And it means NHS staff handing over some of the control to patients.

Our experience at live/work, working with NHS trusts and the NHS Institute for Innovation and Improvement, is that engaging patients in the design of services is particularly challenging because of the past focus on increasing the quantity of services.

Engage thy patients!  Their input propels design.


A similar transition has taken place in the medical profession, where the human concerns of the caregiver and the human needs of the patient have been overwhelmed by the financial interests of commerce: our giant medical care complex of hospitals, insurance companies, drug manufacturers and marketers, and health maintenance organizations (HMOs).

John Bogle, Enough.

That from the chapter titled Too Much Business Conduct, Not Enough Professional Conduct in Mr. Bogle’s recent book.  It’s a reminder of a discussion had this summer: should health care administrators be licensed?  Still not a fan, but there’s no doubt there has been some loss of professionalism compared against an environment of the 1950s.

The book is an indictment of the financial industry and it’s many issues—Mr. Bogle makes it seem that it has more troubles than health care!  His solution: focus on the investor; for far too long the industry has extracted value from the system instead of adding to it.  Explains a lot of what we’re going through.  Well worth a read.

d2009: Green Predictions

Inhabitat asked a host of experts their predictions for green design in 2009.  Some interesting quotes applicable to the coming melding of the design and health care delivery worlds:

Allan Chochinov:

In 2009 I think we’re going to see an explosion of Service Design around the world. Many firms are already practicing it, but it will take on a new urgency as more and more people recognize service as the new product.

Sarah Rich:

This means that designers will be working with new ideas around the relationships between people and their stuff, placing greater focus on longevity and durability, take-back programs and renewability, and hopefully on ways to place community at the center, using social networks and human relationships to be sure people have what they need.

Piers Fawkes:

In our new book Good Ideas for 2009 we talk about the concept of ‘Design For Change’ which argues that we should design for our changing world. Staying flexible, accepting new ideas and plans, and acknowledging that things never stay the same allow us the space to work with interesting new possibilities instead of fighting them. If we can see events unfolding on the horizon, we can be ready to take full advantage of them rather than blindly reacting when they come pounding on our door.

d2009: RED’s Open Health

For whatever reason (it must be government provided health care) the United Kingdom has taken the lead in injecting design thinking into health care delivery.

Waaaaaayy back in 2004 the Design Council in the United Kingdom started a project called RED to address social and economic problems through innovation led by design.  Open Health is RED’s solution to modernizing the National Health Service and aligning its service offerings with the patient needs:

By 2010, one in ten of us will have diabetes. By 2030, the incidence of chronic disease in over 65s will more than double. Current NHS spending on diabetes alone stands at £10 million every day. And yet about 90% of healthcare takes place in the home.

Chronic disease and conditions related to an unhealthy lifestyle have reached epidemic proportions and are rising still. This presents a momentous challenge for our current healthcare system.

Improving existing services is not the answer. Preventative approaches to health mean radical changes in our individual lifestyles – eating well, exercising more, self-managing chronic conditions. These changes can’t be delivered through hospitals and GPs surgeries alone. We need to design new types of services that tap into people’s motivations and relate to their daily lives.

Read the entire RED pdf report for the specifics.

2009: Design!

Bill Hollins:

Many senior managers involved in the service sector are still unaware of the benefits that design can bring to their offerings and, as a result, many organisations are operating at a sub-optimum level.

Mounting economic pressures combined with a gloomy 2009 outlook make innovative design investments for health care organizations seem silly.  Au contraire.  Mr. Hollins writes:

Only recently have managers in organisations involved in the service sector realised that a conscious effort in applying design techniques to services can result in greater customer satisfaction, greater control over their offerings and greater profits.

From the International Herald Tribune:

The economic crisis has also squashed any lingering doubts about the urgency of finding new ways to address acute social problems more efficiently – from caring for the expanding elderly population, to improving the management of over-stretched health care services. This newfound realism is already benefiting the emerging breed of “social designers.” (bold and italics mine)

Your job in 2009 (if you truly consider yourself a health care transformer) is to fully comprehend the concept of design and the power it holds for improving our health care system.  By no means am I a design expert in the traditional sense; but design excites the heck out of me.  New thinking (ideas…solutions…execution…) is required in a time (this year…next year…the year following…) of significant transition through a difficult operating environment.

That said, we all need tools to help expand our thinking and diversify our perspectives.  Throughout the entirety of 2009 (upon occasion) our own system will supply design-minded information focused upon aiding this quest.  Thoughtful debate is always welcomed.

Here is the start: a couple of definitions worth more exploration.

Service Design (from Wikipedia) “is the activity of planning and organizing people, infrastructure, communication and material components of a service, in order to improve its quality, the interaction between service provider and customers and the customer’s experience.”

Social Design (from Wikipedia) is “a design process that contributes to improving human well-being and livelihood.”

Here’s to a designfull 2009!