W 501 – Management of Organizations

DESIGN AT MAYO

Submitted to: Mr. Shakil Huda

Date of Submission: 05 April,2020.

Batch : 62 (E)
Nam : Nahian Hyder (36)
e
: Rabbi Al Rahat (55)
 1. What is original about the Center for Innovation? What is the significance
of establishing an in-house innovation lab versus hiring outside
consultants?

Center for Innovation (CFI) founded with a view to studying the processes of end to end health care
provision ranging from initial phone call to the follow-up.
Business evolves at a rapid pace. Innovation is more critical than ever, and health care is no exception.
During the past 60 years, there have been significant advances in medicine. There is clearly an
opportunity to do more

● Originality of CFI

o Pioneer at integrating design thinking with healthcare delivery

 to transform the experience and delivery of health care with a patient-
centered focus
o Improving healthcare delivery to patients
 new ways the medical services are provided rather than medicine or medical
technologies.
o Collaboration of multidisciplinary professionals
 offers a multidisciplinary team to turn innovative ideas for medical practice
into practical solutions that change how patients receive health care
 Physicians | scientists | nurses | administrators | designers | analysts |
software programmers | engineers | legal | human resources departments
o Outcomes from the projects undertaken
 were never practiced before
 provided a way to experiment the hypothesis of service innovations through
“rapid prototypes”.
 Several projects
 Whole pediatric ENT practice redesigning
 Redesigning dermatology practice
 Making clinical assistants to take charge of completion of
medication reconciliation forms also increased competency in terms
of the number of patients attended on each day.
 Diabetes education cards
 Exam room redesigning
o doctor-patient meetings
 o Redesigning the consultation room in a way that does not
require any physical examination helped the patients to retain
their health records more efficiently.

● In-house innovation Lab vs Hiring outside consultants

o In house innovation in sync with culture?

 the designers are also a part of the organization
 Outside consultant will not be familiarized with organization’s culture
 Inhouse innovations can be financially more viable than hiring outside
consultants?
o Data Security
 Sharing medical records outside the organization obviously generates
additional risk for the clinic’s management and authority
 Risk of data breach

2. What are the special risks and benefits of experimenting with service
innovations in the health care environment?

● Benefits of Experimenting with Service innovations:

● a better way of providing care to those who seek medical help. As medical
technology is improving with time, these new techniques and equipment will
be utilized in a more effective way by improving the delivery of these
technologies to patients.
● lead to a better study of the patient behavior and their responses to different
technologies. It will increase the interaction between physicians and patients,
thus ensuring better experience towards patients.
● A better system will ensure the doctors can spend more time treating the
patients rather than wasting time in bureaucratic luggage ? or administrative
chores?
● A better service will increase the trust / credibility and reliability of patients
towards the medical institute. (no need of providing them, better delete it or
add : with treatment). As shown in the passage, Mayo Clinic has (had) been
trying to provide better services to their patients, from proper scheduling to
soothing environment, beautiful buildings, which in the end increased the
number of patients, or in this case, customers significantly.

● Risks of Experimenting with service innovations:

o No metrics/measurement of success
 Single technique may not be applicable for all cases
  Result can be measured only after service deployment
 Healthcare service is a delicate industry
o Collaboration requirement among professionals of different fields
 Physicians and designers?
 Risk of communication barrier
o Possibility of service interrup
 Services in Medical or any other sectors are a way of communication
between providers and receivers (customers), thus sudden change in
services is not possible. So the experiments have to be done in small
projects first, minding the balance of stability of the whole system.

3. How does Mayo's physician-led structure affect the focus and results of
the CFI? What are the advantages and disadvantages of this structure?

● Physician-led structure affecting the focus and results of the CFI

● advantages and disadvantages of Physician-led structure

o Leaders of SPARC and the CFI faced a number of challenges in bringing designers
into the medical clinic environment. In general, they found that providers were open
to allowing designers to do observations of the health care delivery processes. It
was relatively easy for CFI staff to gain access to various areas of the clinic and to
conduct their field research. What was more difficult was to present their findings
and propose new experiments in care delivery. Physicians were busy, and they were
data-oriented; as a result, they could be skeptical about trying an unconventional
way of using a pager or a different office setup or a new patient education brochure
without proof that it would improve their daily lives. CFI staff found that it was
essential to show physicians data demonstrating the problems that they had
observed and to show that proposed changes would make a difference to their
patients. They also found that temporary changes, called "rapid prototyping" in the
design world, were easier to sell than any kind of proposal for a permanent change.
Designers became used to testing numerous short-term innovations and negotiating
with all of the stakeholders in a medical practice in the course of an engagement.
● Advantage:

o Easy accessibility to all the research tools

 bridging the gap between outside designer’s input and making the whole
process through
o More integration and success rate
 while having a third eye through the outside designer’s eye
 ● Disadvantage:

o Physicians were deeply guided by tradition and risk-averse

 because they bore the responsibility for the patient's life and well-being
o Physicians needed to see data and proof before trying something new
 Conservative culture affected doctors' willingness not to try only new drugs
and treatments but also new administrative procedures and educational
methods.

4. What is the role of designers at the CFI? How do they facilitate innovation
in health care delivery? How might their contributions compare to those of a
management consultant, an industrial designer, an organizational
psychologist, or a poet?

5. What is the rationale behind the five platforms? What are the advantages
and disadvantages of organizing innovation experiments around these
categories? Are there other ways to structure innovations in health care
delivery?

6. What conflicts, if any, are there between the goal of "small changes for
big impact" and the goal of "transforming the way health care is delivered
and experienced?" Do these two kinds of innovation need to be balanced?
How does the CFI's organization affect the types of innovation that they
develop?

Center for Innovation (CFI) started with a mission to transform the way health care is delivered and
experienced in a broader sense. In order to accomplish the mission, CFI formed five platforms, each
focusing on different broad themes of innovation activity. CFI was experimenting on finding new ways to
improve the patient’s experience and make the delivering processes of health care a bit more efficient.
The design of Mayo Clinic, art, landscaping and medicine expertise of Mayo doctors along with the
group practice of medicine was all accompanying the mission of CFI. CFI was basically trying to make a
breakthrough in the field of health care.

Keeping focus on the mission statement, CFI undertook different projects and initiatives like: Outpatient
Lab, Launchpad, CoDE Project, Innovation Curriculum, Transform Symposium, Dermatology Practice
Redesign, Pediatric ENT Practice Redesign, Diabetes Education Cards, eConsults etc.

For some projects, the results could readily be measured. For example, the dermatology practice
redesign had resulted in an intense increase in the number of patients treated. Clear results were also
available for the diabetes education cards and the exam room redesign project.

Some other projects were evaluated in a more casual way. For instance, the e-consults and the RIOS
projects were enthusiastically received by Mayo doctors. According to project manager Dan O’Neill, for
the RIOS project, different departments were stepping up and asking if their department could be the
next to implement the RIOS project in practice. The spontaneous responses from these departments
were indeed a success but according to LaRusso, scientific rigor was not the best way to measure
success.

Though CFI was at first aiming to transform the way health care is delivered and experienced, it ended
up doing small changes for big impact. The main reasons of conflict between the goals of the above two
are the constraint in planning size, time to implement different size projects, sample size on which
above projects could be tested and speculation of whether large-scale innovation in real life could get
acceptance, not just in theory but also in practice etc. When it comes to “Small changes for big impact”-
the trial projects demand less time in planning and implementation, less sample size on which the trials
need to be tasted, less expense in the projects with minimum risk of loss and mass acceptance. On the
other hand, when transforming the way health care is delivered and experienced in the larger health
care industry is concerned, all the above-mentioned points become complex, structured and uncertain.
Financial risk becomes unavoidable. Speculation of whether large-scale innovation in real life will find
acceptance becomes strongly evident. Therefore, it becomes very tough to transform or improve the
health care system in the larger health care industry in general.

There should be a balance between the two kinds of innovation. In case of “small changes for big
impact”, local problems associated with efficiency can easily be solved with prompt change in action.
Since trial-based projects are easier to implement than long term projects, small changes in usual
practice can ensure significant solutions to delimited problems and improve the ways of delivery within
a short period of time. So in short, small changes are basically good match for internal problems. On the
other hand, when “transforming the way health care is delivered and experienced” is concerned,
universal change in actual practice is permanently required in the healthcare field.

Small or local changes are usually made to complement the process of universal change. Rapid change in
global practice is not possible overnight. Therefore, small changes are made sequentially as per plan. It
can be compared to drawing a line by connecting a number of dots. If the dots are not aligned, the
central line becomes scattered and loses its main focus. Similarly, if the small changes are abrupt and
not balanced with the global changes, the main focus will not prevail. So there must be a balance
between small changes for big impact and transforming the way health care is delivered and
experienced.
7. How would you recommend that the CFI measure its results? How should
they present their work to physicians, to patients, and to outside
supporters?