Are You a Strategic Planner or a Strategic Designer?

How One Simple Word Can Redefine Our Approach to Healthcare Strategy

May 28, 2014

Healthcare Strategist, NBBJ


In a lot of ways healthcare planning has turned into a checklist profession. Accountable Care Organization? Yes, check. Patient-Centered Medical Homes? Yes, check. Chief Patient Experience Officer? Yes, check. And so on. We populate our plans with the requirements du jour rather than understand, in a holistic way, a designed way, what it all means.

My profession — healthcare planning — is only beginning to understand what design means as opposed to planning. Our plans often “sit on the shelf and gather dust,” yet people rally around designs and execute and adopt them. We typically think about designing products and buildings but have you ever considered that we should be designing strategy? Good design can be applied to strategy and its associated goals, objectives, and actions just like any other product or process. It’s a different way of thinking, and we are only now coming to understand it.

For instance, the iPhone is considered a hallmark of design because its sleek exterior and interface engage some underlying electronics and code that work seamlessly together to accomplish its purpose. The phone’s code is not physical though. While it may manifest itself physically in sounds, images, and tactile feel it is simply a set of goals, objectives, and actions designed in bits and bytes. I’m sure Apple could display that code visually in such a way that we would recognize how beautiful the underlying design is but the exterior speaks for itself.

Similarly, architects design buildings, they don’t plan them. And yet within each building is a plan, or code, if you will, for the structure to accomplish its purpose: how each individual space relates to all the other spaces, the vertical and horizontal circulation, energy consumption, access and egress and so on. Said another way, these are the goals, objectives and tasks that underlie the physical structure you see on the outside. The most successful buildings have a design that let you know right away that everything, inside and out, works elegantly together.

Why should healthcare strategic planning be thought of any differently?

Let’s compare the words plan and design visually:


Design sits at the center of a universe that is twice as big as plan. It has words like aim, purpose, intention, conceptualize, and invention at its heart. Plan lives in a small solar system with a limited set of words like program and project associated with it. According to the dictionary a plan is a set of actions that have been thought of as a way to do or achieve something. To design, on the other hand, is to plan and make decisions about something that is being built or created. While the words are often considered synonymous, there is a big difference in intent and action. Plan implies a certain amount of passivity; the plan may or may not get implemented in whole or in part. Design implies action and movement and a cohesiveness that all parts of the design work together.

And like that iPhone or building it’s possible to visualize your strategic design. Recently on my own blog I talked about creating scenarios in a much more visual context to simplify complexity and reduce uncertainty. I suggested using 3D computer modelling to accomplish this. It is no stretch to take a finalized version of the strategic design that comes from this process and produce a physical model of it on a 3D printing machine.

This is a very visual way of thinking, and although I was not trained that way — and neither were most of my colleagues — it is simply a different and better way of thinking about complex matters in a complex environment. Imagine a strategic design that you can hold in your hand. Done right it would serve the same purpose as that phone or building and your volunteers, employees, and leadership would be able to understand it almost intuitively.

So maybe it’s time we designed healthcare strategy. Regardless of the tools or the terminology, the question remains the same: what, ultimately, is the aim, intent and purpose of strategic design, and how can we fashion and move an organization forward according to that design?

Banner image courtesy of Flickr.

Visual thesaurus created using TH!NKMAP.

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