d’Amore’s solution? Rebrand seven separate beverage brands – including the redesign of more than 1,100 different packages (cans, bottles, etc.) – and launch all the new brands by the 2009 Super Bowl. The results have been mixed, to say the least. For example, the redesign of the Tropicana brand packaging raised such a consumer backlash that Nooyi cancelled the redesign (after it had already hit the stores). The new Pepsi logomark, featuring upturned curves meant to reflect smiles and grins, has also received much ridicule. (When the initial presentation of the new logo by branding guru Peter Arnell was leaked on the Internet, many thought the presentation was so ludicrous it had to be a hoax). On the other hand, the new campaign for SoBe Lifewater featuring a dancing lizard and the relaunch of Gatorade as “G” have both received positive reviews. In the end, Pepsi has research showing consumers have increasingly positive reactions to the new brands, and Pepsi has begun gaining market share against Coca-Cola in the U.S. (though how much of the gain can be attributed to the rebranding is of course debatable).

There are many aspects to this story that illustrate how not to approach branding, as well as some innovative strategies for which Pepsi should be applauded. But here’s one aspect that relates well to hospital branding. According to the BusinessWeek story, the rebranding effort was well under way (the new Pepsi logo had been presented, for example), when d’Amore, realized he was falling behind his self-appointed deadline, appointed three senior PepsiCo veterans to help oversee the effort. One of them, Frank Cooper, saw the challenge this way:

“The main charge was simple: It was to get Pepsi into the conversation again within the culture. But the only part of the puzzle clearly in place was Arnell reinventing the Pepsi graphics.”

The group decided what was needed was a new “brand manifesto,” or an expression of the desired Pepsi brand (or what we might call a brand strategy). After creating the new “brand manifesto,” the group was ready to proceed with developing advertising.

The question here seems obvious: how do you decide to create a “brand manifesto” – describing the desired traits and audience of Pepsi – after you’ve redesigned the identities and packaging for all the brands? That’s like drawing up the architectural plans for a house after it’s been built. Wow. No wonder there were some disconnects between the new packaging and consumer audiences.

Unfortunately, this situation happens quite frequently in healthcare. With only an estimated 5-10% of hospitals having an active brand strategy in place, it becomes hard for those developing a new corporate identity to leverage a “manifesto” in creating the new logo. Most simply make do, as often hospitals are reluctant to invest in the time and energy required to develop a brand strategy in the first place.

I recall a conversation with a branding consultant who was new to healthcare, as we discussed the possibility of developing a new brand strategy for a health system. The consultant asked what the current brand strategy was, given we had recently completed the redesign of the system’s corporate identity. When I replied “they don’t have a brand strategy,” the consultant was aghast. In his experience with other industries, this was virtually unheard of.

I simply smiled and said, “welcome to healthcare.”

“We’re excited to continue focusing exclusively on serving hospitals and health systems,” said agency owner Chris Bevolo. “As always, we’ll be monitoring the impact of trends like consumerism, changing competition and new media, and applying that expertise to help our clients address marketing challenges in new and better ways.”

For more on the name change, view the official news release.

So what’s the deal with health care?

Missing the Boat

If there’s one industry that desperately needs the power of design, it’s health care, and specifically it’s hospitals. After all, in what other industry are systems, organizations and environments — people relating to other people — literally a life and death proposition? Yet look around in your organization. Look at your competitors across town. Look at your peers across the country. Do you see well-designed, consistent communications? Do you see well-designed patient experiences? Do you see well-designed processes and systems? Health care in this country has made miraculous advancements, and the care patients receive is arguably the best in the world. But it could be better — much better.

Sure, there are some hospitals that have clearly embraced the philosophy of design, but they are few and far between. And maybe a service line here or a physician there in your organization has designed something remarkable. There’s a trend across the country to redesign emergency rooms to be more appealing, more “patient-friendly.” Unfortunately, these are usually the exceptions, not the rule. You want evidence? Look at hospital marketing — Why is so much of it derivative, stale, uninspiring or undifferentiated? Look at hospital finances — The hospital bill is still one of the most confounding pieces of paper you’ll ever look upon. Look at hospital procedures — Why are there so many medical errors? Look at hospital processes — Why is the way a patient moves through the system so confusing and discombobulating to that patient?

Why is this? Why does health care seem to be the last in line to embrace the power of design?

Reason One: Design is Misunderstood

It starts with perception. Unfortunately, many hospital leaders look at design as simply a subsegment of marketing, and we all know how most of them see marketing, right? Marketing is an expense. An ancillary expense not related to patient care. Marketing is a necessary evil. Or perhaps marketing is seen as “advertising” or “publicity.” How many times have you had a prominent administrator or physician say to you, “If we just put up some billboards, we’d have more patients?” Marketing is often subjugated to creating brochures, Web sites, or those “silly” logos. It’s rarely valued as the discipline of building business over the long-term. Now, if marketing traditionally has that type of reputation in a hospital, imagine where design falls. At worst, it’s a practice in “making things pretty.” At best, design is seen as a visual discipline than can help you clarify and differentiate your organization. But even taken in this light, design’s potential place in helping a business succeed is misunderstood.

The problem is that many in health care look upon design as graphic design only, or what we call in our industry, little “d” design. But design in its fullest sense is capital “D” Design. Design certainly can involve aesthetics, but it also involves utility, efficiency, comprehension, connection and fulfillment. It goes beyond the traditional role of the graphic designer and applies the philosophies and principles of design to products, environments, systems, processes and even whole organizations.

Reason Two: Layering

One of the principles of design is starting with a blank slate. It’s considering a challenge without being constrained by what currently exists, looking at the whole universe of solutions without letting existing realities limit or restrict possible solutions. Which leads to another reason design seems to be lacking in hospital organizations — the concept of layering. Layering basically means addressing challenges as they come, and simply layering the answer on top of what already exists, without considering how the most recent solution affects previous solutions. Without looking at the situation holistically. Without starting with a blank slate. Eventually, the layers can become so numerous, the end result is an incongruent mish-mash of solutions that individually may have solved a problem, but now combine to cause different, and sometimes more complex, problems.

A classic example of this is wayfinding. Look at the signage throughout your hospital — Is it a seamless system of information that anticipates and guides patients, families and others in the most effective way? Or is it a maze of old signs, new signs, posters, flyers, messages and more? If you are lucky, your wayfinding system was designed from the get-go from a patient perspective (many aren’t). But even if it was, how many times has your organization simply added new departments, wings or offices to current signs, without considering the overall impact on wayfinding?

Now take the idea of starting with a blank slate and go beyond just the visual relevance of design. A few years ago, a client of ours set out to improve their outcomes in open-heart surgery. Instead of tweaking a procedure here, or adding a program there, they took a look at the whole process. The result was the adoption of the Single-Unit Stay model. In the past, patients scheduled for heart surgery were admitted, moved to surgery, and then to a different room for recovery. Many then went to the ICU, and then moved again to PCCU for rehabilitation prior to discharge. With Single-Unit Stay, patients are admitted to one room in the CV ICU, and other than for the surgery itself, remain in the same room until they are discharged. The goal is to keep the patient in the same environment for his or her entire stay, receiving care from the same team of caregivers. The response to this patient-centered approach to care has been exceptional, with positive reactions not only from patients and their families, but also from the surgeons, nurses and other staff involved. And the results? In just two years, patient safety has improved, recovery times have been cut in half, and survival rates have increased to among the best in the nation. Now that’s a well-designed solution, and it started with a blank slate.

Reason Three: It’s the Patients, Stupid…

Effective design requires studying a problem from a consumer’s perspective, or in this case, from a patient’s perspective. But like many other businesses, hospitals have traditionally struggled with considering the consumer’s perspective. One of the reasons for this is what’s called a “silo mentality.” In business, the silo mentality is the phenomenon of internal departments and teams within an organization thinking within their own narrow, disconnected world, or “silo.” An organization afflicted with this type of thinking will find it very difficult to take a consumer’s perspective in a meaningful way. And hospitals are notoriously susceptible to silo mentality.

For example, consider the treatment of a heart attack. The patient may start in the emergency department, then encounter radiology, the cath lab, cardiovascular surgery, the CV ICU, education and rehab, followed by regular visits from their internist. To a hospital, those are naturally separated areas, with different names, different staffs, different managers, sometimes even different floors or buildings. But to a patient, that is all heart care. Patients don’t see the separation that exists behind the curtain at a hospital. And when they are exposed to it, it confuses them.

Embracing design also requires collaboration, which is the antithesis of the silo mentality. Designers learn to seek out multiple perspectives, to work with other critical contributors to a business, such as sales, engineering or customer service. Only in that way can they truly gauge how a product or service touches a customer. Do the leaders in your organization actively, honestly seek collaboration?

Take facility improvement, for example. Your organization may spend millions of dollars on a new addition, building a new heart or cancer center, or completely renovating your hospital. When this happens, how congruent is the planning? Are the architects talking to the brand manager, is your marketing department talking with patient services, are the physicians talking with IT? Forget talking. Is everyone on the team coming together to design the best solution, considering everything from patient flow to room design to signage? Or is everybody doing their own thing, and adjusting their plans whenever they bump into somebody else? Is there someone designing the entire project from a patient perspective?

Reason Four: No Time to Think

Perhaps the most significant reason design philosophy is absent in health care is time. Who has time at a hospital? Everyone is under-staffed and over-worked. But successful design takes time. Time to really consider the situation. Time to explore solutions. How often have you come together in your organization to solve a problem? Usually there’s a meeting or two (or more), a solution is arrived upon, consensus is reached, and the solution is implemented.

Designers are trained to generate a solution, set it aside, and then create another solution. And then another, and another, and another. Designers work until all angles are explored, all options considered, all variations entertained. Why? Because a well- designed solution requires consideration of all influences over time, such as customer interaction, feasibility, effectiveness and so on. And the odds of adequately considering all of those elements in one solution, or even worse, the first solution, without missing something important are long odds indeed. So designers are trained to purposely continue exploration, even if one, two or a dozen solutions have presented themselves. In addition, as part of the exploration, designers use time to let the subconscious mind go to work on the challenge. You can put a group of people in a conference room for hours and tell everybody to really think about the challenge at hand. But the best solutions will come after your brain has had a chance to stew for a while, and that requires time.

Bringing Big “D” Design to the Table

So, how can you begin to incorporate the power of design at your hospital? First, check your own perceptions of design. Are you still viewing design as a “graphic,” visual discipline, or are you open to design in an all-encompassing way, a different way of thinking about all challenges you face? Apply the process and philosophies of design to non-visual challenges and measure the results. Once you’re there, start working on your organization’s perception. And the best way to do that is practice what you preach, and show others how design can add value.

Start with a blank slate. Don’t just look at the current problem at hand, but dig deeper and see what the underlying challenges are, and don’t be restrained by the existing situation. Ask, “In a perfect world, how would we handle this?” then strive to make it so.

No matter what the challenge, look at all the ways a solution impacts a patient, and what that impact means for the different departments in your organization. Involve those departments in the process to develop a truly “patient-centric” solution.

And most importantly, take time. Take time to step back and look at the big picture. Take time to thoroughly consider the situation, and to explore multiple solutions. Take time to think and reflect. If you have good designers on staff, invite them in on challenges that extend beyond the “graphic design” realm and let them use their minds, training and creativity to address the challenge.

Unfortunately, some designers do not embrace the idea of big “D” Design, and are quite comfortable sticking to traditional graphic design. If you don’t have strong designers on staff, find some or look to an outside resource. While design has caught on in many industries, it’s still an underused and undervalued discipline in hospitals. Because of this, design offers a real and immediate way to improve the care you provide, giving you a competitive advantage in your market. The potential is fantastic!

This column was published in the April 2004 edition of Healthcare Marketing Report.

Engaging the Full Potential of Your Graphic Designer”

Are you fully mining the potential for added value and greater success your design team can bringto your company, your products, your services? In our world where technical features are easily copied and products and services are quickly commoditized, many of the most successful companies are utilizing design as a major part of their core strategy to create and sustain their success.

Good design is good business

Design has the power to differentiate, build a personality, attract a target audience and establish a bond with them, enhance customer experience, make the complex more understandable and create systems to enhance sales.Companies that are successfully tapping the power of good design are rising to the top. A great local example is Target Corporation. Target appears to have embraced and harnessed the power of design at the core of its being. Design pervades the company from its print and broadcast campaigns to the packaging and products they sell in their stores all the way through to the cups in their cafeterias.Design should not be confused with art or considered as merely decoration. Companies that relegate design to just the decoration role will forever be leaving opportunities unrealized. Potential will be left on the shelf. Management guru Tom Peters and super CEO Steve Jobs agree that design is a major competitive-weapon. While design certainly involves aesthetics, it also involves utility, efficiency, comprehension, connection and fulfillment. In this context, you begin to see how the process of design can be used to create not only brochures, Web sites, or logos, but to design experiences and to build sustainable competitive advantages throughout an organization.

So, now that were thinking big, how can you more effectively engage your design team to begin realizing some of the benefits of good design?

• Bring your design team in early — the earlier the better. Designers are adept at accurately defining a problem and boiling it down to its essence. They have a strong ability to visualize a problem. By the nature of their training, designers usually bring a different way of thinking to the table. A greater variety of perspectives enhances the dynamic of the discussion and widens potential.
• Let your designers do their jobs. Let them use their minds, training and creativity to develop unique solutions that add value. Don’t just view them as “hands.” Unfortunately, a common scenario is where an executive comes to the design team with a design brief already in hand that states something like “we need an eight-page brochure, four-color printed on coated gloss paper, 8 1/2 x 11 and saddle stitched.”
• If this is the level a design team is approached, the true power and potential of design is being left on the shelf. Good designers can, and should be eager to, operate on a strategic business level.
• Provide any and all research you can for your design team. Inundate them with it. This includes exposing them to all aspects of your business — from a manufacturing plant to the sales force to your clients and more. Oftentimes, the unique solution already resides within a company, it just needs to be recognized and extracted. Other times, the true root of an elusive problem may be uncovered. Research is the fuel for appropriate, effective solutions that increase value.
• Don’t isolate your design team. Whether an in-house design team or an external resource, look for opportunities to have your design team collaborate with other people in your company in ways that may be unexpected or nontraditional. If you’re lucky, you’ll not only pull more potential out of your design team, but their knowledge will be enhanced and so will that of the other employees on their work team.
• Challenge your design team to try to improve a company process. It could be anything from an assembly plant operation, to the flow of paperwork, to the cafeteria layout — anything. If you ask your team, you may be amazed at the ideas the design process can yield.

While many companies are beginning to grasp design’s full potential, a large number are still mostly uninformed. Because of this, design offers a real and immediate competitive-weapon in today’s marketplace. Its potential can be fantastic.You may already have the talent on your staff or within your outside providers. If not, take advantage of the Twin Cities’ reputation as one of the top design centers in the world. If you’re not sure where to start your search, you can call the Minnesota Chapter of American Institute of Graphic Arts at 612-339-6904 and request a copy of the Minnesota AIGA Design Resource Guide.

Resources like these will help you think bigger about design and the role graphic designers play in your organization. The untapped potential may be right outside at your office door.