Category: Design

The Titanic, Dinosaurs and Burning Platforms


Thank goodness for Peter Fuda. More on that in a moment.

For the past decade, the “sky is falling” change management approach seemed to be THE way.  The sky did seem like it was falling, and it was a quick way to get employees and organizations to rally around a new concept, initiative or change. And it worked…for a time. But then the sky kept falling more and more, faster and faster, and with little fanfare the sky was perpetually falling.  Without exception,  gloom and doom ruled.

“We’re dinosaurs.”

“It’s like trying to turn the Titanic.”

“Can we link this to a burning platform?”

If innovation is the breath of fresh air to build new, valuable stuff, the burning platform is the life-sucker that stole the joy. I wish I was the one smart enough to know this.  But alas, it wasn’t until two years ago when my friends at the National Health Service Helen Bevans and Lynne Mayer (now at Ko Awatea) introduced the ILN.org to a poweful youtube video by a researcher named Peter Fuda.   (Please watch it and share widely). He laid the foundation of moving from “burning platform” to “burning ambition.”

Now I have to admit one of my fabulous fails. Ten years ago I proudly used the burning platform metaphor, and didn’t even use it correctly.  I thought a burning platform was an intensely important political issue (as in a plank in the Democratic platform).   However I actually used the image of a real burning oil rig platform for the presentation.  Indeed as most of you know the oil rig is the metaphor. And it’s a dark, scary, death-y one to boot.

And so, two years ago I stopped using it. Then lo and behold while teaching at an innovation event it reared its ugly, fiery head. An attendee shared and asked, “Fear is our motivator.  How are we supposed to get stuff done if there isn’t a burning platform?”

Its a good question, and paraphrased, here is my response (knowledge courtesy of Fuda):

The “burning platform” is only a metaphor.  Its not real. We are not on fire. We don’t need to jump off a real burning platform into the dark freezing ocean.  It is a paradigm shift; an intellectual choice to view our current challenges from a different len and with a different metaphor.  You can choose any lens or metaphors you want.  But why are we so sure that fear is the only tool we have?

So let me say loud and clear:

We are not the dinosaurs.

We are not on the Titanic.

We are not on a burning platform.

Our asses are not on fire.

 

We are working really hard to make a difference in the lives of patients and the people who serve them.

We are making healing and wellness the best it can be.

We are doing this work with our hearts, minds and souls.

 

It’s our Burning Ambition, not a Burning Platform.

 

Thank you, Peter, for shattering this fear metaphor.

 

 

Video Series: Don’t Forget!


Don’t Forget the Humans (UX – 2010) explores the magic of being an internal design team. How human centered design can unleash and unlock new opportunities.

Don’t Forget the Organizations (MX – 2014): With success comes, new challenges and expectations. Sophisticated leaders are asking to democratize design and innovation. They are asking for deeper insight into gnarly challenges. They are asking to apply the design facilitation skill to meetings at large. And the list grows. Just exactly what do we want to be in our teenage years? We don’t know! But we hear the clamor, “Don’t Forget the Organization!”

Part 2 from 2014: Don’t Forget the Organization:  http://vimeo.com/90917267

  Part 1 from 2010: Don’t Forget the Humans: http://youtu.be/JFsswJrSEes

ILN Insights Magazine: the Blurry (R)evolution Issue


Insights Vol.8

Get your Insights copy here ==>  goo.gl/1AOspQ

Director’s Message

I ended last year’s ILN director’s message with “The year ahead of us promises to be exciting and turbulent. If ever there was a time that innovation and design are needed, it’s now.” Little did we know how exciting and how turbulent, nor how much innovation and design are still needed. We spent most of the year with an anxious anticipation for the ACA Exchanges. And their launch was messy to say the least. Big change and big innovation are messy, but this also points to the lesson we all know well: fail early to succeed sooner.

So 2013 for the ILN was a year of experimentation, with little failures guiding us to bigger success. The Spring InPerson hosted by Boston University and the Center for Integration of Medicine and Innovative Technology (CIMIT) is a great example. We learned from past meetings that the basic Open Space format is great, but there was something missing to jolt the work to the next level. And so, we added seed funding distributed by crowdsourcing. The jolt was felt. Via experimentation the theme of (R)evolution inspired three projects to move forward. You can explore one of these (r)evolutionary projects on page 80.

The experimentation continued with the Autumn InPerson co-hosted by the UCLA Institute for Innovation in Health and the Center for Care Innovations. This meeting’s experiment was size. Just how big can an ILN InPerson get and still be meaningful? Over 160 attendees proved that bigger is sometimes better. It also was fitting that our theme was Blur. Although it was intended to suggest the disappearing line between care and life (and wow, were there some cool ideas!), it also doubled as an inflection point for ILN InPerson Meetings. The ILN meetings are getting big. Do we constrain them or open them up? It’s blurry. There are no right answers. But we have some surprises in store for 2014 and 2015. Stay tuned.

And so here is to celebrating the blurry, the unknown, and the experiments; it’s where great things live.

Yours in innovation,

Chris McCarthy

#Healthcare, #FineArt and #Hockey


getty ilnAs a part of the InnovationLearningNetwork.Org InPerson Meeting in Los Angles this week, attendees split into a dozen groups and were set loose to hunt for insight and inspiration. My team and I found it at the Getty Museum exploring the evolving museum industry and its future. It was remarkable how similar its challenges are to healthcare…and how much we can learn from their experience.  Nik Honeysett, its Administrator gave us the 101.

First of all, the industry changed “overnight”.  For centuries, highly skilled curators would collect and interpret.  And the public had only one option; go to the museum to see it. Then with little warning, the public got a voice via the internet. And the paradigm began a monumental shift: the public wanted new ways to see the collections, they wanted to talk about it, and they wanted to help influence it.  The museums were not prepared for this voice, nor have most learned yet how to harness it fully; but they are learning.

Nik shared a story of a Canadian museum of fine art that attempted to crowdsource an exhibit.  The public submitted and voted for a hockey exhibition – not exactly what the museum had in mind; or even in the genre of fine art.  Although this was shared as crowdsourcing gone wrong, I can easily image a twist where the museum could have commissioned a series of oil paintings of hockey scenes; dragging in a whole new audience into their world.

Next technology seeped into the museums.  Most often it was a random employee who just happened to know how to flip on a PC, they were the first museum technologists. Interestingly, museums were the first to bring touchscreens and hyperlinks to the public in 80’s.  Not so bad for being homegrown. Recently there has been a shift to bring in trained technologist, but at the expense of “sullying” the inner museum world with those who did not rise through the ranks. Finally, new and interesting business models began to emerge.  As most museums are not-for-profit, and have similar missions, rather than competing, they focused on cooperating. Deals like two venues for the price of one began to emerge.  “Retail museums” began to appear as popup stores in downtown areas .  And unique combinations like museum and DJs began providing new experiences for new crowds.

And so healthcare is not as unique as it perceives, and has much it can learn by simply going out into the world.  I am certain that the other eleven groups found an equal amount of insight and knowledge in their LA exploration.  Meanwhile, go to the museum; the inspiration is curated for you.

The Lowly and Mighty #Anecdote


Once Upon A TimeThere is a mantra that I’ve been hearing:  “No data without stories, and no stories without data.”  At first blush, this sounds awesome.  It honors the art of storytelling; elevating it to the powerful level of data.  And it also helps the storyteller fully grasp the power of data; their stories now pack a powerful data-driven punch.

However those of us who live in the world of innovation, this mantra can be crippling. There often is little to no data to pair with the stories we discover. And many stories in the early phases of innovation work are just anecdotes. As the innovator accumulates knowledge and more anecdotes, opportunity areas start to emerge; and from opportunity, innovation springs.

And that is the conundrum.  In a data driven world, the simple anecdote is looked down upon, but often is where the richest untapped insight exists.

“No stories without data, and no data without stories” is a great rule of thumb. But it is not a law. For the vast majority of what business does, this rule of thumb will keep us safe. But for the innovator, the company rule breaker, the anecdote is a mightly lens to view the system cracks and failings.

So this blog is dedicated to the lowly and often maligned innovator tool: the anecdote.

Use it well.

Use it wisely.

#ILN Insights: the #Play and #Spread Edition


Normally, at this time of year, my organization the Innovation Learning Network compiles a “best of” from the previous 365 days. This year, we decided to try something radically different – having members of our network contribute articles and artwork that reflect our 2012 themes: play and spread.

The result is a completely new look and feel.

Please enjoy and share widely.

Get your PDF here.

#Innovation with Information Technology in #Healthcare


I am thrilled to announce our book’s release.  You can order it here:

Hardcopy or Kindle

 

From Chapter 1 of “Innovation with Information Technology in Healthcare” by Lyle Berkowitz and Chris McCarthy:

“Let’s face it, most of our healthcare clinical processes are so last century. However, a revolution is brewing. More and more providers are slipping into the Twenty-First Century quietly and without fanfare. They are figuring out how to deliver care that is not only medically superior, but is operationally modern as well. And they are creating stories which are helping to awaken our spirits and move the rest of us forward. And this is good news for everyone!

These stories range from a rural healthcare system leveraging telemedicine strategies to an academic medical center using EHR decision support tools in a novel way. They span from a small clinic using a new type of home monitoring device to one of the largest healthcare organizations in the world trying new and exciting ways to manage and relate to their patients. What these organizations have in common is their relentless pursuit of making healthcare delivery better for patients and providers alike. They are defining a new type of health system, where technologies are seamless and delivering perfect care is easier and more cost-effective than the alternative.

Most of the innovations in this book are not revolutionary nor radical. In fact, they are expected and obvious in many ways. Consumers in other industries have demanded far more than they have of healthcare. Imagine if a bank told a customer that it would take a few weeks to see a bank balance. Imagine if an airline wouldn’t let you book your own flights. Imagine if there was no way to compare car features or prices.

We in healthcare have just moved beyond the start line, and have a long way to go. Fortunately, healthcare organizations which are already innovating in this space are setting the pace and moving in the right direction, towards their own “Healing Edge”.  And hopefully this book will help you get there too!”

#ILN12: Emotionally Charged


The Spread, Scale and Sustain Edition

I’m on a Virgin Train barreling out of Coventry towards London, and I am tired.

And charged.

But more tired.

We’ve just finished the fourth and final day of the InnovationLearningNetwork.org (ILN) InPerson Meeting. It is a bi-annual gathering of leaders and innovators who explore design and innovation in healthcare. And its magical.

This, the fifteen gathering in seven years, meeting’s purpose was to explore spread, scale and sustainability (S3) of innovation. It’s a topic I’ve avoided…purposely. Healthcare leaders and designers new to healthcare had enough to deal with trying to understand how to be explorers, ideators, and prototypers.

Until now.

With enough experience under our belts, we opened the spigot of the S3, with insight from the UK’s Institute for Innovation & Improvement (our host), the Institute for Healthcare Improvement (our friend), and Kaiser Permanente’s Innovation Consultancy (my other love). Through several workshops, it made clear what is nearly self evident about the S3:

  1. Its HARD and a LOT of work.
  2. There are no silver bullets
  3. There are no perfect methods
  4. Its not binary; you can’t just turn it on
  5. It should be a design element that is designed for from the beginning
  6. Its really about shared purpose
  7. Its really about the human experience.

These insights give me great joy as a thinking person. They give me great pain as a designer and leader. It means that in 2012 our jobs are much harder and more exciting. If you like complex system, this is eureka. For most, it’s heartburn.

The NHS shared a model of energy from Loehr and Schwartz. It blew me away, and crystalized a new power view of the Innovation Learning Network. The model suggests basic energies of change: Intellectual, Physical, Emotional, and Spiritual. You can guess where most business leaders lead their business lives. And you can also guess where innovators/designers live theirs. For me the ILN is a recharger for all four energies, but with an extra boost of emotional/spiritual.

And so, I am tired. I am charged. I am changed. I am pulling into London. I am signing off.

Keep Calm and Innovate On.

Bob’s Braciole (Or How Improv Wrecked A Childhood Memory)


My Dad serving his famous Braciole

I love improv. I love it for the laughs, for the nuance, for the unexpected, for the discovery. As much as standardization makes our lives easier on a grand scale, improv is the one constant that makes life simpler moment-to-moment.   The classic “workaround” is usually when an improv unintentionally becomes a standard.  Workarounds are neither good or bad, they are simply coping mechanisms.

The most celebrated improviser is the chef.  He is continuously enhancing his recipes, pushing his knowledge, and testing new methods, all with the explicit goal: to make it taste good.  Which takes me to my newly wrecked childhood memory.

By far my favorite dish growing up was my dad’s Braciole: cheese and garlic rolled into thinly sliced steak, tied into a roll, and simmered in tomato sauce until the meat nearly falls apart. (my mouth is already watering). Decades of these delicious rolled morsels dot my memory.

On a recent visit home, I encountered a bit of blasphemy.  My dad no longer rolled his Braciole; he made them into envelopes.  How is this possible? Braciole MUST be rolled. His simple answer, “The meat browns more easily as a flat envelope.  And I don’t have to tie the rolls which is a lot of work. I just put two and only two toothpicks to hold the envelope shut.  When they are done cooking, I know to pull out two and only two toothpicks from each one.”

I didn’t like his answer.  He was screwing with my delicate childhood memories. But what his answer reveals is the truism: simple wins over complex.  Workarounds are simply trying to find the path of least resistance from A to B. It doesn’t matter if you are a doctor, mechanic, engineer or chef; accomplishing our tasks with less pain (and more joy) is what we’re all shooting for.  So, with a big sigh, I must confess I love the envelopes too.

Bob’s Braciole

 Ingredients:

  • Flank steak or top round or bottom round (sliced 1/8 to 3/16 inch think)
  • Salt and pepper to taste
  • Thinly sliced garlic
  • Bread crumbs
  • Grated Pecorino Romano cheese
  • Dash of Oregano
  • Dash of Parsley,

Lay each steak out on wax paper,

lightly salt and pepper,

lay six slices of garlic,

spread a 1 tablespoon of breadcrumbs,

spread 2 tablespoons of cheese, a sprinkle of oregano and parsley.

Fold the each steak into an envelope, and secure it shut with two toothpicks (scroll to bottom to see video).  Contents of the steak should be sealed in.  In a hot pan with olive oil, quickly sear the steaks on each side (about 90 seconds a side).

Submerse the steaks in tomato sauce and simmer for 4 hours. Or place into a crockpot and cook on low for 8 hours.   Remove steaks from sauce and remove all the toothpicks.

Enjoy with side of pasta, salad and a good red Italian table wine.

 

 

 

 

HOW TO MAKE AN ENVELOPE:

Pissed Off Operating Systems: The Clash of Culture and Behavior


I’ve had the strangest experience returning to my hometown Springfield Massachusetts. I have not been back here for more than a couple of days at a time usually around the holidays.  However this trip I settled in for a full three weeks, and have noticed some odd behaviors emerging in the general population.

1)   people cross the street anywhere, anytime.  There seems to little to no fear of cars, and sometimes mothers are pushing baby carriages directly into four-lane traffic. Rarely are crosswalks used, and crossing lights used even less.

2)   many people are choosing not to use sidewalks, but instead are walking in the roads, sometimes in the middle

3)   drivers no longer pay attention to lines on the road; they have become meaningless

And this got me thinking about design, behaviors and culture.  The design of the roads, traffics and sidewalks work because culture and behaviors cooperate with the design elements to make the whole system flow.  Without culture and behaviors, the design elements are simply silly remnants of the past.  I pushed the crossing light button to cross a major thoroughfare, and was laughed at by two pedestrians who darted through the traffic. I felt really silly.

When I visited Vietnam a few years ago, I marveled at the organic-ness of city traffic. Thousands of mopeds, car and pedestrians zoomed and darted in SEEMING chaos. More time there revealed the elegance of the known behaviors.  There are social contracts that safely move a pedestrian across the street.  If you don’t know the norm, you can get hurt and hurt others.  In fact, my partner did just that by hesitating while walking across the road.

Back to Springfield: there seems to be two different cultural and behavioral systems in clash, and all with the same design elements – the old rules-based and new free-flow.  The real danger is that different operating systems are driving these different systems.  I follow the traffic lines. I am less concerned that others will “disregard” them.  I am surprised when I almost crash.

And now back to design:  how many systems in the environments that we live and work are in flux or outdated?  How many designs are simply relics that make less sense in today’s world? How can we ensure that we are paying attention to and design for these changes? For surely, culture and behaviors are not static.

I know a lot of pissed off drivers and walkers in Springfield Massachusetts.  I don’t know what the answer is, but I do know the clash between the different operating systems is really dangerous.  People are pissed.  People are dying.

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