Nearsightedness Kills Innovation

This system became famous in its industry for its original implementation of lean in the early 2000’s. Following their heyday, the CEO went on to be quite famous and started a consulting firm helping implement lean in other healthcare organizations. However, they were still not achieving the breakthrough level of performance improvement they needed or wanted. They called me in when they were looking to redesign their care model for their high-risk patient population. By definition, we included the top five percent of these patients. It would require a new way of thinking about things.

Per my typical requirement, they named a leader and set-up a cross-functional team to successfully execute this massive project. We established stretch goals and began work. The team developed an in-house, risk stratification method to define the patient population for the new care model. This patient population was then studied to determine their barriers to care and better health. The insights were staggering. One patient traveled over 5,000 local miles annually to get to all of their appointments. Another patient had 66 physician interactions in one year; more than one per week!
Patients were interviewed, observed at home and brought into focus groups.

We studied their engagement with the healthcare system. Their needs and pain points became evident, and the brainstorming of solutions began. Soon, a new model of care began to coalesce. It was different than anything this healthcare network had done before. Every patient would have an interaction with a patient care team that acted as an extension of the primary care provider. The team included all critical elements determined during research: a pharmacist, a social worker coordinator, a behavioral health counselor and a triage nurse. The experiments began. The team saw multiple successes in medicinal accuracy, blood pressure control, blood sugar reduction, physical activity and patient engagement.

My involvement stopped when they were expanding the patient cohort. It was then the Operational Excellence team swooped in and almost destroyed the efforts. This company struggled the entire length of the project despite years of Lean implementation and associated subject matter expertise. Eventually, the COO disbanded the effort, even though the health outcomes were outperforming even the best physicians in their network. This organization struggled with many of the Becoming Endurance principles outlined in this book and the results have become obvious.

If you talk to the former CEO of this organization, he will say he wonders why they only came up with two “new” things during his tenure. My analysis and involvement made it clear that they were expecting the operational excellence tool kit to innovate. It is unable to do this; you need innovation techniques. Teams can’t innovate when you’re staring at the bottom line every month. Executives have to be 100 percent committed to the project once they decide to do it. The project should keep going until it’s time to stop it altogether. Why? Because nearsightedness kills innovation.

Priceless Gems

I was standing in a heavily secured room in the diamond district of Manhattan. In the palm of my hand was a large, pink diamond worth hundreds of thousands of dollars. I then held a smaller, yet more valuable, blue diamond worth millions of dollars. The value of those diamonds was legitimate, but their value wasn’t always known. A few decades ago, diamonds were worth whatever a salesperson could get for the diamond, often not even selling an actual one, but a knock-off gem. That doesn’t happen much anymore, or ever if the stone is certified. Why? In the early twentieth century, founders started a non-profit organization with the distinct purpose of protecting consumers from jewelry con artists.

The most, publicly famous output of this non-profit organization was the 4 Cs of a diamond: color, cut, carat, and clarity. Diamonds could now be valued based on criteria established by each of the Cs. This judgment is what determines how much a diamond is worth. Diamond owners can, for a small fee, have their gemstones assessed by expert graders, giving confidence to buyers and sellers about its quality. This organization created criteria not only for diamonds, but also all types of gems as they expanded their protection of consumers. They trusted me to hold the blue diamond in my hand, and they also trusted me to help them on their next part of the journey.

The biggest gap in the jewelry world then became the jewelry itself, not the jewel that goes in it. Most of us don’t think about it, but the shape of prongs has specific best practices that hold and display the stone forever and can be disastrous if done poorly. Cutting, polishing, soldering, casting and many more techniques can be done well or done poorly too.

Ring mold
Mold for platinum ring.

Under the leadership of their VP of Education, they hired a Director of Jewelry Design. He was responsible for growing and teaching tomorrow’s bench jewelers using world-leading, best-in-class techniques. This direction meant a complete overhaul of a specific certification program from the ground up. We recreated the entire program using innovation processes and visual management techniques. We interviewed instructors and students and identified pain points for each. Brainstorming began.

The team gutted the hands-on focused, outdated classrooms so students could easily interact with the instructors during praxis. We threw away the educational, paper-based study material and recreated in an electronic, interactive, tablet format for all classes. The response was overwhelming. Both students and instructors raved about the changes. Attendance grew, and the company was back on track to better protect and inform consumers in another area, jewelry design.

At the same time, I was able to successfully have my wife’s twentieth anniversary ring designed and built. I relied on contacts made while working there. With certified diamonds, the right precious metal, and a recommended bench jeweler, I was confident of what I was getting would last forever. It all came together, and I was able to present her with the ring during our anniversary trip to Alaska. She gets compliments all of the time, and I’m confident in what she wears everyday is worth what I paid.

anniversary ring
Ring I designed for my wife on our 20th anniversary.