Design Thinking for a Brighter Future in Healthcare

Bill Zybach, Information Security Risk & Compliance Analyst/Consultant at U.S. Bank

Design Thinking for a Brighter Future in Healthcare

Promoting innovation in design and operation to create accountable and responsible organizations

Design Thinking for a Brighter Future in Healthcare

Recommended Book:

Reinventing Organizations

Mentioned Book and Link:

Designed to Adapt: Leading Healthcare in Challenging Times

Company Website

Design Thinking for a Brighter Future in Healthcare with Bill Zybach, Information Security Risk & Compliance Analyst/Consultant at U.S. Bank (transcribed by Sonix)

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Saul Marquez: Welcome back to the podcast. Today I have the privilege of hosting Bill Zybach. He has a long career in management and leadership consulting and is currently in-house at U.S. Bank. Bill’s current position integrates his eclectic experience and organization, design, development, leadership, and I.T. with agility in the financial industry. As a board of the organization design forum from 2009 to 2018, he established virtual offerings to expand the forum to a global and year round enterprise. He’s Co-Founder of ZTC Consulting which promotes innovation in design and operations because so many institutions and their change efforts are failing to meet expectations. His upcoming book Syngineering: Building Agility into Every Organization integrates new thinking, new behaviors, and new approaches that can be used in any organization to create responsive and accountable enterprises which are required by businesses that desire to thrive in the complexity and volatility of today’s world. So I had the privilege of meeting Bill at the Doc S.F. meeting. He took us through this wonderful workshop where we did do some really deep digging on and his method for decision making. We walked out of that forum and a lot of the health leaders present in the meeting were just enthralled. They loved it and they thought “Man what a great opportunity to share with everybody listening here.” So Bill I just want to give you a warm welcome and an opportunity to fill in any of the blanks of the intro that I may have left out. Welcome.

Bill Zybach: Well thank you Saul. It’s a pleasure to be here. And I think you did it quite the job of providing an overview and an intro and it was a pleasure as well to meet you in San Francisco at the conference. It is always a wonderful opportunity and you never know how it’s going when you’re going to introduce a new method to 50, 100 people who are highly professional folks and you’re gonna get them to do an experiential activity. Again what we wanted to do in San Francisco was actually give folks of flavor of what it’s like to really feel that kind of the new world, the new thinking, the new behaviors, the new way of interacting that we’re seeing around the globe really move us towards a new kind of approach to organizing the challenge and again it’s this isn’t really understated. You know our institutions aren’t working. They’re just not able to respond as rapidly as the world is changing and we have business models that are designed based on old thinking the church, the military, the Industrial Revolution which that kind of thinking that occurred to develop… Max Baber Frederick Taylor those folks scientific management and the development of bureaucracy made incredible sense at that moment in time.

Saul Marquez: Yes.

Bill Zybach: But they don’t actually work really well now. And so the way we’re looking at how do we operate organizations in across sectors is in ways that no longer actually match the volatility in the complexity. And so what you get to experience in San Francisco was just a little sampling of what is actually occurring in organizations. But it is it’s kind of the emerging wave if you will as opposed to the standard operating procedures.

Saul Marquez: It was certainly a very well guided informed process. Folks we had a huge piece of white paper on a large wall where we jotted down a timeline past present and even future and key things that happen in healthcare, one of the concepts was keeping in mind you know the continuum of what’s happened in our industry now a good thing to note is that bill actually does this process cross many many industries. So he has the benefit of bringing in ideas from other industries parallels that really help shape the thinking because yesterday’s tools will not no longer meet tomorrow’s needs and so Bill you’re obviously you know sampling across these different industries but what’s a hot topic that you feel you’ve seen when working with your help companies.

Bill Zybach: I would say the biggest challenge is the shift in thinking and the biggest challenge in relation to that has to do a little bit to do with ego and that is that when we need to change or modify our organizations rather than everyone from the C suite to the front line focusing on what do I have to do differently, how do I have to shift a really big challenge is to have the leaders actually shift as well because ultimately unless the people who are setting the direction and managing the minds of business change then it won’t occur. The biggest challenge and we see this globally is the silos that are created from a hierarchical model and we estimate it globally maybe 85 to 90% of organizations particularly larger or midsize to larger organizations have that business model which served really well when things were slow and simple rather than volatile and complex. So I think that’s the biggest challenge and it’s ubiquitous. It’s like we see this kind of thing in our family models. We see this kind of thing in our community practices, we see this kind of thing across organizations globally. And those models are great. If we don’t have the kind of challenges that we’re faced with now. And so and again a big driver the biggest driver that is challenging the existing model is the changes of incredibly rapid changes in technology. We used to think of technology as a supporting mechanism. When you’re designing organizations you know when you’re designing an organization the first thing you have to do is you have to think about what the strategy is. Second thing you have to think about is what are the business processes, the activities, the work to support that’s accomplishing that strategy then what are the skill sets that you need in order to support that. And then what are the supporting system, HR, technology that can stop. We used to think that way and technology was one of those things that we came in and it was an enabler to the last 20 years that has really shifted to we have to think about technology when we’re designing an organization because that is the core of the ability to mine information and get the right things at the right place at the right time. And so you know these actually are not new things and they may be relabeled and renamed as you know the latest the hottest the thing but they are core issues that we have been struggling with really for 50 years and maybe longer as the complexity significantly increased and as the volatility that the innovation the disruption are off the wall in industries that used to think that they were pretty well insulated from the kinds of disruption you don’t see that anymore everyone is seeing that this disruption.

Saul Marquez: Yeah I completely agree Bill and with things like large mergers and acquisitions, implementation of EMR across hospitals, companies, and service providers wanting to work with hospitals and the insurers. I mean it is no easy task. You know one of the infamous things about healthcare is that it takes forever you know a sales cycle is long to get anything done takes a long time. So complex decision making is certainly in the fabric of our industry. Give us an example of you know it doesn’t have to be health care Bill but something that you have done with an organization that’s helped them create results.

Bill Zybach: So let’s do a healthcare example because I think one of my favorite healthcare examples is the work under the Affordable Care Act to create a patient centered medical homes. Great idea. Again it attends to all of the kinds of dynamics that organizations are faced with. Shift from doctor centered to patient centered to creating an actual space that is focused on the interactions and servicing the patient. Collaborative participation based on staff and nurses and doctors and collaborative approach really a great great model driven by again under the Affordable Care Act, the Obamacare. The real focus there was how do we make healthcare really attend to rather than the silos of each different department and function doing what it needs to do and then handing it off really in care. So this the patient centered medical home was a great really prototype for that and in many organizations the Cleveland Clinic, Mayo Clinic, took this on and over a period of the first year of trying to move towards these each of those organizations had one or two up and operating as a smaller organization less well-known called allegent healthcare used the kind of experience that we demoed at the San Francisco conference and they actually have a big conference center that is specifically designed for their decision making and rather than having the board go off and you know executives make decisions when they need to make a decision about any major issue they get a cross-section of the organization together. And these are not the people who are entitled positions. These are the people who know… so for example I also did a project on oncology and we brought 80 people together for a three day prototype of an end in oncology system and said that effort is focused on bringing everyone who has the knowledge together and they design they go from looking at kind of the context like at the San Francisco Conference that big whiteboard the idea is you do the past present and the future and you think about the context because context is critically important. And unless we do something like that in a group and have everyone get somewhat of a similar idea of what the context is and what the strategy is we have lots of well-intentioned people going in different directions. So the idea is when decisions get made rather than a few people at the top making those decisions. And what we know from large organizations is those people there may be this illusion that they know what’s going on but the truth of it is that’s a facade. It’s way too complex. And so with the patient centered healthcare system the same kind of thing we’ve brought in. But in that instance we’ve brought in and healthcare those folks together and they in a three day time frame, they prototyped the patient centered medical home by the end of the year they had twenty six patients that had medical homes operational versus I think Mayo had two and I think Cleveland had one and that was because Mayo and Cleveland were still doing it the traditional way of how to project manage it instead of prototyping and the project management way of doing work again worked really well in the 70’s and 80’s and 90’s and but not so much anymore. And so that the idea of shifting to prototyping which is kind of what we model that at the conference so you get the right people in the right room at the right time and then the next piece that is so critical is those people leave and they come back every month check in check progress and there’s a group of people who are assigned to make sure that there’s communication and information, that the idea is then the people who are operating in the organization’s vertical structure the management structure their job is to implement the outcomes. To make sure that those ideas that were developed are actually implemented. It’s the idea that the leadership and this is a big mind shift change the leadership’s focus is not to make the decisions but to bring the people together who need to make the decisions and then support the implementation of the outcome. It’s kind of like from one perspective and this is a big jump. It’s kind of like the old town halls of the Northeast and as opposed to kind of what we call town halls today which are people just talking at each other. What happened there is the politicians would sit in the back of the hall and the people would have a conversation and decide what needed to be done and the politicians would then go out and implement them. So that’s a big stretch but it’s the same thing where the leadership structure the highest paid people in the room their jobs are not to make the decisions their jobs are to bring the people together who have the knowledge to make the decision because the other amazing thing about that is when you do that there are informal organizational networks. The trust network, the advice network, the communication network, you bring the people together who have the knowledge in the system and they will communicate out into those webs and adoption is really fast so rather than having and again I’ve made all the mistakes you got expressed in your interview sheet about the mistake made all the mistakes we used to take leaders off to the mountain. You know we’d spend a week and then we’d decide the strategy and I had a my favorite experience of that is with the Department of Agriculture. We did that with the folks who are at the borders checking for fruits and stuff like that. They came up with a great vision and strategy to implement it and nothing happened. It was a union environment. We brought the union folks together we engage. We did satellite which was awesome for you know the 90’s and we engaged. We had vision conferences. We engaged everyone talks about three months after we realized nobody was doing it. The outcome was almost exactly the same as the leaders who went off on the mountain. But the difference was we had engaged the people who had to do the work and they came up with pretty much the same thing. And it was implemented. So this is the shift that we’re seeing and the shift is really around understanding human dynamics and engaging the people who are doing the work. And that engagement means the customers and the suppliers. You know again we’ve got complex ecosystems and what we know again when we shift from kind of the Newtonian perspective, cause and effect to really quantum mechanics in addition to the Newtonian perspective we know everything is connected. And so one of my early experiences with in terms of understanding that kind of thinking that is beginning to happen in healthcare is went to a conference with the Plexus Institute. Their focus is getting talk about mind shift their focus is getting people to shift out of the kind of Newtonian cause and effect that the linear perspective about how organizations operate to complexity theory. And I met a guy named John Carnegie and John Carnegie is has been… he was a Executive in healthcare and then he’s written a book called Designed to Adapt: Leading Healtcare in Challenging Times and he’s using complexity theory which is the best approach to deal with complexity as opposed to kind of linear project management kind of approaches that are not fast enough and so to me… and I met him early on and before we started working with healthcare in terms of these decision accelerators and those kinds of things and I was amazed that there were healthcare leaders who really got it. And again I was inspired by him. He’s contributed to my thinking again in San Francisco when we did the mini sampling of the decision accelerator people got it. And to me part of what we’re seeing happening now is there’s a readiness to adopt new models.

Saul Marquez: Yes.

Bill Zybach: There’s a big risk though and again part of the challenge is what are some of the primary drivers of the business industry. And if the primary drivers are fear or risk which are important considerations but they’re not necessarily the thing we want to drive your business on, they can paralyze an industry. And we have seen that in multiple industries but we’ve seen it in healthcare as well too. So I don’t have an answer but I’m delighted to see you know over the last 10 or 15 years some great thinkers and some really innovative approaches being used in healthcare and we still have a long ways to go.

Saul Marquez: Yeah Bill some great examples there. The leaders on the mountaintop versus bringing people in. Look at the end of the day. There’s a lot of companies and organizations that like you said medium to large that are struggling to move the needle and there’s a reason for that folks. There’s a reason why you’re not moving the needle every single year like you’d like to. And it’s a change in thinking that needs to happen. And so Bill the people in the room were excited when we did this exercise like very excited. I’m like wow I didn’t expect them to be excited about anything. I’m like Okay you know it’s going to be a process but no I mean everybody was excited and I was excited because I’m thinking wow these are some great tools we could leave here with. So nice job and thanks for walking us through that. Folks it’s the tip of the iceberg. The work that Bill does is super powerful. You could learn a little bit more. Go to his website it’s www.ztcconsulting.net we’ll leave a link to that in the in the show notes as well but tell me one of your proudest moments has been with the work that you do Bill.

Bill Zybach: So for example when I do a workshop and the kind of energy that you experienced comes out of the group and the light bulbs come on and people start really shifting, that to me because ultimately and part of the work as you as you got to experience is it’s moving people out of their heads. People are again in our culture Western culture business very head oriented and our head is you know in our mind and our brain and our intellect is awesome but it’s only one of the tools we have. Our heart, our gut, our body, are also part of our toolkit. And to me, these sessions the ones you experience are designed to take advantage of all of those really bring your whole self into the process. And so for me ultimately when someone has an experience like that and it’s a full kind of experience and they’re getting again we’ve got this incredible instrument this vehicle that we’re in and we don’t always use it all the time and it’s got some great capabilities. And so part of the design process is really to fully engage people and to me ultimately how do we access the potential the human potential that we have. And I think we’ve got a lot of opportunity to do that part of that is getting us out of our boxes. The design you know we use design thinking design approaches in these decision accelerators and we bring them into a new place as get people out of the cubes and out of the dish. We as human beings get into patterns really well you know we are designed our brain from a neuroscience perspective loves patterns and things that can easily solved. So to me we’ll talk with the clients about that kind of detail but we think about it in the design process and setting these up and so people have an experience that they walk away from and things have shifted and they may ultimately for sustainable change it has to be change that is embodied. And so when I see people light up and I see people become excited about things that could be really mundane and probably have been in the past like organizational planning stuff.

Saul Marquez: Exactly.

Bill Zybach: I think that’s what I get most pleased about.

Saul Marquez: That’s awesome. Yeah. Now that’s really great. And it did happen and I mean one of the things that I remember Bill is is that you gave us. I mean sometimes like 60 seconds to come up with ideas and that’s like that’s really fast but because we kept doing it all of a sudden like everybody’s brains started working faster and it’s just like this agility concept that was awesome. And I think that’s one of the reasons people got excited is like wow we don’t have to take months on end to do organizational planning and so love that you did that it’s clear that you’re driven by the people shift and and having them see and and then seeing the breakthrough that these types of decision thinking has on their organizations. So this part of the interview getting here to the end is a lightning round so I’ll ask you a couple of questions we’ll put together a mini syllabus for the listeners and then we’ll ask you for your favorite book. You ready?

Bill Zybach: Okay.

Saul Marquez: All right. So this is around design thinking for organization. So what’s the best way to improve outcomes through that?

Bill Zybach: That is a really simple question and that is to engage the people you know who are doing the work.

Saul Marquez: What’s the biggest mistake or pitfall to avoid?

Bill Zybach: Thinking that any one particular individual has the answers.

Saul Marquez: How do you stay relevant despite constant change?

Bill Zybach: Continuous inward journey. You know it’s like know thyself. So that I don’t get in the way of what’s trying to emerge or what my clients want.

Saul Marquez: What’s one area of focus that drives everything in your organization?

Bill Zybach: Learning.

Saul Marquez: These next to Bill are a little more fun. So what is your number one health habit?

Bill Zybach: Yoga.

Saul Marquez: I love it. I just started. I just started a couple weeks ago. Its awesome.

Bill Zybach: I got my teaching certificate in India…

Saul Marquez: Did you really? No kidding. Wow. So you’ve been at it for a while then?

Bill Zybach: I have.

Saul Marquez: Wow good for you. Yeah. It’s incredible. And what is your number one success habit>.

Bill Zybach: Humility.

Saul Marquez: Powerful. And the last one Bill. What book would you recommend to the listeners?

Bill Zybach: I think one of my favorite books that kind of captures really the whole spectrum of what’s happening in organizations is called Reinventing Organizations. It’s a guide to creating organizations inspired by the next stage of human consciousness. The level of consciousness in which the current business models were created is no longer existent. And we have to design our organizations at the level of consciousness that we are at now. I love this book.

Saul Marquez: Great recommendation. Folks, you could find a link to the book the entire transcript or just them the mini syllabus of our discussion at outcomesrocket.health in the search bar. Just type in Bill Zybach you’ll find it there or type in ZTC Consulting. Both of those searches will yield you the the episode for today. Bill we’d love if you just left us with the closing thought and then the best place for the listeners could follow your work or get in touch.

Bill Zybach: Yes sure. In spite of the challenges that we’re faced with, there are amazing things happening all over the globe. They don’t necessarily always get the attention. You know that the information machines love replicating. But to me it is about slowing down, breathing, and taking in the amazing lessons of nature. To me that’s always my true north. And what was the other question Saul?

Saul Marquez: And what’s the best way to get in touch with you or follow your work.

Bill Zybach: The best way is at the website at www.ztcconsulting.net.

Saul Marquez: Outstanding. Bill thanks again. Really appreciate you carving out some time today to to share these transformational decision making skills. And this topic that I think could serve all of our listeners so I really appreciate you making time. Thanks for coming.

Bill Zybach: Thanks Saul.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.

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