USAF Medical Clinic Redesign

My mission, if I should choose to accept it: Design a new, medical clinic that will keep the airmen mission-ready for decades into the future. The medical group commander responsible for the project was a full Colonel that wanted the best for her troops but insisted on the optimum use of the designated funds for the project. The Lieutenant Colonel (Lt Col) that she assigned the work to wanted to do it the typical Air Force way. We began the work and quickly identified they could reduce the new clinic’s footprint by fifty percent. We were still meeting demand, working faster, and meeting the target of having no waiting rooms. The Lt Col didn’t believe it could be done.

As always, there was some pushback. The Lt Col became an active resistor to the new possibility. We pushed with data. Ultimately, it was a compromise between our capability and their comfort level with the approach. Although they ended up adding some space back for their peace of mind and comfort, it was a great result. The output thrilled the Colonel. I earned a commander’s coin for that work. That clinic now serves as a model for the Air Force. What happened with the Lt Col? He was unceremoniously pushed on to his next role.

I loved this project, not because we were achieving our mission to improve the accomplishment of their mission, but because it was a base with fighter jets. In junior high, I had dreams of becoming a fighter pilot. I wanted to fly the F-15 Eagle. It was the premier fighter jet during the ‘80s. I had models of it, drew pictures of it, and stood in awe at its performance at the annual air show. However, my dreams died when I got glasses to correct my nearsightedness. Although, the F-22 replaced the F-15 and the F-35 is replacing the F-22, there were still some F-15s around on this base.

During my training runs in the evening, there was a road next to the airstrip that the F-15s would use. One run allowed me to “race” an F-15 as it taxied down the runway. I shared my story with the Colonel and the next day I was standing in a hangar, climbing into the cockpit of my childhood dream. We didn’t go out for a flight, but I was sitting in the jet, looking at gauges and controls of this once-elite fighter. I loved it.

VA Cardiology Suite Redesign

The task seemed relatively easy to me: design a new cardiology, surgery suite that can provide world-class care while simultaneously keeping up with future demand for our veterans. This project was at a major, regional VA hospital. I had done similar work before, but not for a government agency. Apparently, it was a big deal. The local press was at the kick-off event for the work. I was partnered with a high-powered, architectural firm. Our goal was to develop and finalize the design to build.

We established a team of stakeholders and subject matter experts. They conducted interviews with patients, surgeons, nurses, and staff. We began the process and analyzed existed demand, procedures and available technology as well as budget. We discovered great information. The government building-requirements binder was as thick as I had ever seen but despite the significant number of rules and regulations and requirements for cardiac surgical suites, we made them work for us.

The team created an optimized layout for the entire department, with specific attention to where clinicians delivered the medical care, the surgical suite. We used a Lean tool known as Process Preparation (2P). For this, we made small-scale, “paper doll” cutouts for everything that might go into a surgical suite. Then we moved things around on an architectural blueprint until we found a good solution for the suite itself and the entire floor. Eventually, we mocked-up an actual suite with surgical tables, full-scale cardboard cutouts, and auxiliary equipment until we finalized a solution that would work for everyone at each stage of use: before, during and after surgery.

We had created the goal. From there, it was figuring out how to make it happen. A team took our work and delivered it. It was a great plan with great teamwork that yielded great results. Our veterans are receiving better care, at a lower cost, because of it.

Solving Children’s Food Insecurity with Innovation

The goal was to help feed the 50,000 children who don’t get meals on a regular basis. Not getting enough to eat is called food insecurity. Police, educators, public policy makers, industry, and nonprofit food pantries would have to partner together. Although I have worked with several federal agencies over the past several years, my first foray into the local public domain was in Indiana. They asked me to play the process expert and facilitator for a project that could have a significant local impact to urban residents. In setting up the team, we included execs from the police, public policy, food pantries, donors, healthcare and local media.

Secondary research indicated 20% or over 50,000 children in the identified area were food insecure. This number was a significant gap, and we needed to understand what, besides food, was necessary to fix the issue. Reporters conducted our primary research by interviewing dozens of food insecure families. The core team visited multiple food pantries. These combined efforts gave our team the necessary information to make informed decisions. After several months of preparation, the team spent a week together thinking about what solutions would be effective. Several great project ideas came out of our session: police delivered food, food pantries at every school, and an app for information. We named project leads for each idea, and the teams began their work.

It took a while to build some momentum. Sometimes, it looked like it was over before it started. There was a great dream but it faced some obstacles. Fortunately, months after the initial session, the effort is making serious progress. They are delivering meals to hungry children across the entire metropolis in new ways not previously imagined. It took a strong realization to get this effort started, continue it through some tough times and start to impact actual lives. The project is positively affecting people’s health and future.