Points of View – Hospital Control Room

A hospital initiated a project to build a Control Room in order to place Operations and Clinical decision-makers in the same physical space. Because of the way things worked, the team claimed a space before they had the chance to figure out what needed to be in the Control Room and how the Control Room connected to other processes in the hospital.

The team aimed to build the Control Room incrementally, reusing a method applied to build an electronic patient record system.

The team asked us to come up with a framework to hold discussions across operations, clinical care, and trustees.

We explored how the hospital supports Care Pathways and Operational Pathways. Care Pathways refer to the medical care staff behaviours while the Operational Pathways refer to administrative behaviours supporting the operation of a hospital.

Understanding the hospital’s needs

Highlights included:

  • Read minutes of Board meetings, Strategy and Vision documents.
  • Dug into Performance Measurements prescribed by national and international bodies.
  • Reviewed previous projects and the implementation of Control Rooms around the world.
  • Visualised how practice develops into evidence for Pathways.
  • Interviewed key project Stakeholders, nurses and doctors at the hospital, International medical practitioners.

Initial Framework Idea

Care and Operational Pathway teams work independently even though they are dependent upon each other. What would if happen we mapped the pathways to the Patient’s Experience? From first touchpoint with hospital to discharge?

What We Did Next

  • Created a map of the Patient Journey showing where the Care and Operational functions fit in the flow from the Patient’s perspective.
  • Prepared a set of questions to tease out more information and to give the hospital a feel for how we would like to work with them on the project.


“We’re very impressed with your knowledge,” they said as we left. “Those are some hard questions.”

Transforming Operations – Banking

In order to retain sales and cross-sell new products, a Banking Giant needed to re-think the Back Office operations model of its most profitable unit. The strategic goals included:

  • Develop pro-active customer relationships.
  • Prepare for the shutdown of a 30+ year old piece of software.

The business unit decided to apply Design Methods to explore possibilities.

Design Research took 6 weeks – and provoked considerable scepticism. But it changed everything.

What We Did – Applied the Powers of Ten (Charles & Ray Eames)

  • Interviewed and shadowed all Back Office, Risk, Control, and Audit roles.
  • Ran Therapy Sessions.
  • Organised and delivered Co-Creation Sessions to explore new ways of working.
  • Mandated participation for Stakeholders to join us on shadowing sessions as note-takers.
  • Held open-door analysis sessions of research-in-progress.
  • Read Strategy & Vision documents, and Standard Operating Procedure Manuals.
  • Learned about International Regulations, Industry Standards, and Company Policy.
  • Crunched data.

Next, Synthesis – Making sense of the inputs

  • Mapped universe of the bank – from international regulations to individual roles.
  • Proposed 3 root causes which formed the building blocks for proposal evaluation.
  • Workshopped and defined a measurement framework that cascaded Strategy from Company through Business Unit through Team to Job Role, ensuring all goals wove together.
  • Ran several co-creation workshops to prototype hypothetical solutions.
  • Documented a backlog of hypotheses/ideas and how to prioritise them.

We ran 3 experiments:

1 x Business Design
1 x Digital Prototype
1 x Marie Kondo-ing a process

Employees contributed to the new way of working, live, as we developed it.


“Pure brilliance” said the Project Owner. After working through the uncomfortable bits, the Project Sponsor declared, “there’s no turning back.”

The vocabulary and methodology refined throughout the project became the lingua franca. Employees felt confident with the new way of working – they had built it. They served as mentors for the next cohort embarking on the process.

Nudging a Tanker – Energy

The Ask

Why do employees continue to use Excel when they have more robust tools at their fingertips?

We set out to uncover the mystery.

How We Started – Gauging the lay of the land

  • Shadowed employees across the work flow of key tasks – software users, software developers, software procurers, and other influencers.
  • Read Standard Operating Procedures.
  • Talked with managers about how they believed teams were doing work.

Next, First Synthesis – Theory vs Practice

We observed differences between the Standard Operating Procedures and the carrying out of work.

We documented, and verified with employees, the key tasks in workflows and where they used Excel over the newer tools.

We ran weekly presentations of research-in-progress to a cross-section of employees, making sure several teams had representation at each session.

Playback to teams

We created posters with maps and diagrams showing how data points worked their way through projects:

  • How teams connected.
  • Data lifespan – up to 25 years in some instances.
  • Tools inventories.

Consequences of using Excel

  • Information locked down in Excel files on local hard drives.
  • Knowledge sharing handicapped  – unable to search company-wide across all project information.
  • Employees developed custom macros that the next team did not know how to use/fix/amend.
  • Adherence to the Standard Operating Procedures varied.

Building, Together

We ran some targeted Design sprints to help teams move toward revising the Standard Operating Procedures and weaning them off Excel.

Then we planned some projects to test the proposed processes.

Over six months, we worked with individual teams to action projects, inlcuding:

1. Benchmarking Team – Put an Excel sheet on line in O365. A simple hack that reduced errors, freeing up time for analytical work that added business value.

2. Mud Engineering Team – Developed a GANS / Dueling Neural Networks experiment in a Chemistry lab.

3. Finance Team – Rolled out a new Financial Memoranda Process.

4. Lab Team – Planned a Roadmap of software, hardware, and organisational projects to hit the Business Unit’s Strategic goals.

5. HR Team – Prepared and delivered a Design Thinking taster session for HR recruitment that was subsequently embedded into the recruitment process.

Reviving a Brand – Sleeper Train

Based on our past work, the client commissioned a future scenario piece about travel in general and overnight train travel in particular over the next 5 – 15 years.

What We Did

  • Booked tickets and rode trains – mystery shopping the experience.
  • Talked to passengers, staff – from Engineers to Call Centre Workers to Directors
  • Researched travel trends, luxury trends.
  • Crunched data.

Top Insights

  • Travel is by tribes – demographics no longer provide sufficient insight.
  • Strong nostalgic sentiments.
  • Middle East and Asia are markets to watch.
  • Staff motivation low.
  • Current customer base don’t want service to change.
  • Engineers treat passengers like cargo.
  • Tourists boards’ data points don’t map to industry trends.

We proposed 10 experiments. Two were immediately commercialised. TheFTSE 250 company received positive attention from City Analysts for the experiments.