Often, in traditional business settings, we are wired to follow a linear path. When we start something new like a project or implementation, we expect to affect a certain indicator or achieve a certain result. A little over three years ago our team became one of the first robust design-based innovation teams embedded in a community hospital. Along the way, some of the best learnings have been the ones we never would've predicted. While we beam with pride over the growing list of creative processes, inventions, and new things our team has been a part of, one of the greatest experiences has been learning to appreciate the journey itself.

It feels like a line from the grateful dead. To talk about the trip, the journey, the very process as the thing that changes us feels a little strange in most boardroom settings. But we know in life, it is most often the whimsical hand of serendipity that creates the moments which define who we are.

For us, working inside a living, breathing, fully functional and, at times, overwhelmingly complex health system, has provided those same types of opportunities. We have had the transformative experience of changing physisian's clinical practice as the result of participating in a design activity. We've seen countless patients and family members react warmly (and sometimes with ingratiating surprise) to visits from our designers. And we've seen the seeds of culture change start to grow by teaching an entire organization to start with one simple question:how might we?

One of our breakthrough projects was chartered by one of the hospital's senior VPs. She brought together a team of nurses, physicians, managers, and others to partner with our innovation team in improving the experience of people going through treatment for breast cancer. In our kick-off meeting we use one of our favorite tools for level setting the project expectations, hopes and fears. We ask everyone to list with they hope the project would accomplish and what they feared would happen if we were unsuccessful. Almost all of the hopes spoke to immediate an obvious low hanging fruit related to clinical processes. What we learned from patients was totally different.

People told us, in some way or another, almost all of the emotional and physical parts of being a cancer patient happen outside the clinic. People spoke about spending 15 minutes with a doctor only to go home and spend 3 hours sobbing in their driveway. Others told us about moments in the middle of their treatment where taking control became the most important thing. And, some spoke about the desire for deeper connections with everyone in their life.

Our clinical team was floored by these insights. While they are all compassionate, caring, skilled providers, they had not considered the enormity of emotional breadth that comes with a diagnoses, treatment and survivorship. One doctor told our team: "this, the experience of designing for patients, will change my practice forever. I had no idea, when I was giving someone news over the phone that it might be a moment that impacts them for years."

Many of our other projects take us directly into patients' spaces -inpatient rooms, waiting areas, clinics. Unlike other healthcare providers, we don't generate bills. We don't have RVUs to accumulate. And our time is generally not constrained. When we coach people on design interviewing, we say a good interview starts after the first 30 minutes. It takes that long just to build a relationship with someone. Our time in patient rooms can often span 45-90 minutes. And, it turns out, and that's often what matters.

When you are laying in a hospital bed, much of your day to day routine is put on hold. And that routine is where many of us get or reinforce our self identity. Laying there with only daytime tv, the occasional blood draw and the uncertainty of what's next feels extra lonely. So when we come in to talk about whatever project we're working on, the conversation itself if a welcomed reprieve. And the nature of our conversations is part of the magic.

When we interview patients, we invite stories. We ask people to tell us about themselves, and how they experience things. We ask why a lot, even to things that may seem obvious. "I hate being in the hospital..."

"I can imagine, can you tell me why?"

"...because I miss my doggie"

"awww what's your pup's name?"


"why is missing Oscar hard?"

"because our walks are what make me feel independent" Wow! Getting to learn and listen and hear what's important to someone is a gift. While we've just learned that this person values independence -which could be hugely helpful to our project -they've felt truly heard. They've got someone in their room genuinely curious about them and their life. So even if they never see the impact of whatever we do with the insight about independence, the time we've spent together seems to brighten up their day. We've had people tell us that our visits are what they look forward to. Some ask us if we'll come back the next day. (we do!)

A good percentage of our work over the last year has been coaching hospital staff through innovation projects. We learned making it easy, fast and fun to get started is the key. Our team radically simplified our design process into three easy steps: Listen, Imagine Do. In the first step, we help people prep and conduct interviews with patients or other colleagues. Just like our experience talking with patients, our hospital colleagues often come back and tell us how amazing it was to connect with someone else. For them, despite working in patient care every day, our design projects give them permission, encouragement and confidence to have a completely different kind of interaction with patients.

These kinds of interactions are sadly missing from the day-to-day routine of clinical care. They are curious, empathetic, and open-ended. People feel heard, and hearing people feels good. We've prepped our leadership team to expect about a 90% failure rate in staff-led projects (even with support, it's really hard to affect change) but they can expect a 100% success in culture change. For our team, our colleagues, and our patients, the journey is the innovation.