Success Stories

Case Study #1 (Healthcare)
Iowa Health System, Center for Clinical Transformation

The Iowa Health System had pursued Adaptive Design for two years as a methodology for transforming performance in MedSurge units across a 25 hospital system.   There was significant anecdotal evidence of uptake in nursing and front-line units, as well as many examples of “small wins.”  But the champions of the project felt they would not be able to quantify the return on investment in compelling ways and would thus be denied further support from senior executives at the time of their annual review of improvement initiatives.  Using our Dynamic Assessment™ methodology, we conducted targeted interviews with CCT and 12 key leaders and organized the resulting information into anecdotes, observed patterns of practice, and emerging numeric evidence of improvement.  This input energized the senior leaders, helped CCT recognize some previously unnoticed breakthroughs, began making linkages between Adaptive Design and wider systemic improvements, and elicited support for a second phase of Adaptive Design improvement work throughout the system. 

Case Study #2 (Healthcare)
Ontario Stroke System, Central East Stroke Network

The Central East Stroke Network had pursued the adoption of best practices in stroke care throughout a region north of Toronto for about 10 years.  They had achieved uptake with early adopters and forward-looking pragmatists, but had not gained attention from, or traction with, the Local Health Integration Network (the regional health authority).  Using our Innovation Strategy Framework, we helped them to identify influencers, engage them by using stories of success as well as frustration, and convene a gathering of 50 leaders from throughout the region for a retreat and followup initiative called The Mosaic of Stroke.  This process combined anecdotes from patients, families, and providers with presentations on evidence-based best practices and data from the regional stroke report card.  The blend of these inputs generated significant momentum for change and led to the LHIN’s sponsorship of the Mosaic initiative, as well as funding for developing a formal business case for realigning delivery strategies to match evidence-based best practice.

Case Study #3  (Financial Services)
Fixed Income Division, Technology Group, Fidelity Investments

The Technology Group of Fixed Income Division, Fidelity Investments, including 5 managers and 55 professionals, was struggling to solve an intractable problem they faced in supporting a major business unit of about 200 investment traders, analysts, and managers.  The CEO had mandated a “reusable components” initiative in order to streamline operations, reduce costs, and accelerate speed of transactions.  The technology group was organized according to “desks,” or lines of business, and had no prior experience in transferring knowledge across business lines.  We ran an 18-month transition and transformation project in which we helped the 5 managers make a breakthrough on this problem through just-in-time learning, advisement, and working forums.  As an outgrowth of this work (which they called Active Learning, and we thought of as “installing” the Action Learning System of improvement science), they were able to synthesize Active Learning with their pre-existing software development methodology.  As a result, they achieved the following:

  • A shift from three top-heavy, enterprise software projects to 18 three-month projects.
  • Rave reviews from the business, which was amazed that they had been able to deliver on the reusable component mandate.
  • Usability ratings spiked from 10% to 90% on major deliverables.
  • The unit achieved a growing and positive reputation in the company and was invited  to assist Fidelity Britain with their technology development.
  • The unit went from a fixed FTE ceiling of 55 to a staff of 75-80.

Video interview at Ryerson University in Ontario with Tom Bigda-Peyton, Managing Partner at Second Curve Systems.