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Geisinger

G

Interviewee

42 Practice Person

Team Advantages

Team Disadvantages

0, 3

Project Outcome

Unsuccessful

Industry

Medical

Location

Chicago

Team Risk Tolerance

Low

Team Dynamics

TeamDynamics_Indecisive

Company

Geisinger


So the brief was they had five stores and they weren't yet making any money and they had done some research that nobody in the industry was really making any money and they were saying, "So, [inaudible 00:29:08], could you help us figure out what our service offer is that's going to be appropriate and differentiate in the marketplace?" Because they were considering besides just doing a acute care things, like when a kid has a sore throat, is it Strep? Considering like should we do cosmetic things like Botox or should we do massages or should we do nutritional counseling, I mean, they had no idea what they should do to sort of just get beyond this sort of nurse in a box mentality, which clearly wasn't making anybody any money. And ultimately, people like minute clinic in Target and Walmart are going to do better at that because they've got scale. So, they knew that wasn't going to work, so that's the brief, what should our service [inaudible 00:29:55] be? We went, "Great. We can help you with that." [2996]
. So we sort of had two clients that wasn't clear upfront as the brief is done what their relationship was, they weren't quite clear to us about it, there was a little bit of sort of like ambiguity there, so that was a bad setup [3031]
It was two clients that it wasn't even apparent in the beginning, so it was the Care Works sort of head of this group, plus it was partly funded by a pharmaceutical company, and we weren't clear at the beginning how they had an agenda that was slightly different from ... So we sort of had two clients that wasn't clear upfront as the brief is done what their relationship was, they weren't quite clear to us about it, there was a little bit of sort of like ambiguity there, so that was a bad setup. [2997]
So that as the project went forward, he kept on not understanding that you do a strategy that's pure, that has a very strong point of view, versus he's dealing with, "What am I doing next week with my sign up sheets in my clinics?" So he couldn't let go of the day to day- [3032]
We had a client contact that was I think he wasn't super, super sharp in the sense he had good perspective. So that as the project went forward, he kept on not understanding that you do a strategy that's pure, that has a very strong point of view, versus he's dealing with, "What am I doing next week with my sign up sheets in my clinics?" So he couldn't let go of the day to day- [2998]
He couldn't let go of the day to day operations of his five clinics were up and running from the fact that we were looking for sort of a longer term sort of strategic direction for them. So, that sets up a very bad dynamic because you can't serve both things equally well. And then we ended up having a team that didn't function very well. [3033]
So, this is one of those things like particularly when you get into service clients that are ... I always tell my clients, "If you really want to do innovation, you have to let go of operations and focus on strategy." And having that person who just couldn't let go of the operations influenced the team, the [inaudible 00:32:42] team, and sort of held them back. And there were a couple clear moments where we had some good insights about what it means to do this sort of supportive care direction and that the nurses in these boxes were sort of doing it but were getting acknowledged for it, it wasn't part of their brand, [inaudible 00:33:02] and they said the client really bought in on the sort of supportive care direction even though it wasn't new, we sort of had some good reasoning for what it really meant. [3000]
They had different ... As things started evolving, they went different directions about what they thought was important and as opposed to reconciling those differences along with a coherent vision, they started working independently. [2999]
They had different ... As things started evolving, they went different directions about what they thought was important and as opposed to reconciling those differences along with a coherent vision, they started working independently. So, this is one of those things like particularly when you get into service clients that are ... I always tell my clients, "If you really want to do innovation, you have to let go of operations and focus on strategy." And having that person who just couldn't let go of the operations influenced the team, the [inaudible 00:32:42] team, and sort of held them back. [3035],[3034]
"No, it doesn't fit our business model, we can't go that way." [3036]
They had thought of supportive care and stuff like that but we said that this is the direction for you, it really fits with who you are, it fits with what your nurses are doing, and it fits with being in a grocery store because you have things like the props around the grocery store to use as ways to sort of talk about lifestyle changes and things like that. So, thought that that was a really good fit. Now, the problem is is that it takes you in a direction that has a different business model, it takes you on ... They were very focused on the 15 minute visit because that's their business model, supportive care takes you on a pathway of 30 and 60 minute visits, also takes you on the pathway of having maybe two people in a facility. So as we started developing concepts, the client pushed back on, "No, it doesn't fit our business model, we can't go that way." [3001]
They were very focused on the 15 minute visit because that's their business model, supportive care takes you on a pathway of 30 and 60 minute visits, also takes you on the pathway of having maybe two people in a facility. So as we started developing concepts, the client pushed back on, "No, it doesn't fit our business model, we can't go that way." [3002]
And so that's sort of like taking the insight, developing a concept, and then really following all the way through. The fact that the client sort of pushed back, the team said, "Okay, well we can't do the two nurse things, so let's go this way." So they were sort of comprising what they were doing. And the response was, by one team member, "We're still going to have to talk about supportive care, but not all the way over here." And the other one says, "Well, let's give them some value by helping them fix some of their day to day issues." And so that the fact that we ... [3038],[3037]
The fact that the client sort of pushed back, the team said, "Okay, well we can't do the two nurse things, so let's go this way." So they were sort of comprising what they were doing. And the response was, by one team member, "We're still going to have to talk about supportive care, but not all the way over here." And the other one says, "Well, let's give them some value by helping them fix some of their day to day issues." And so that the fact that we ... [3003]
Okay, so just two different clients, responses are different, so you end up with ... You know, a real innovation has to take something and really push it all the way. And you get all these factors that sort of get in the way as barriers and you end up with [inaudible 00:35:16] as hard as you can. [3039]
Okay, so just two different clients, responses are different, so you end up with ... You know, a real innovation has to take something and really push it all the way. And you get all these factors that sort of get in the way as barriers and you end up with [inaudible 00:35:16] as hard as you can. Then you end up with something that in the end, yeah, we gave them some good recommendations how to improve what they're doing but it's not going to set them on this really differentiate offer to the marketplace. Which may have been hard to do, but it's going to be differentiated, which is what they asked us for. [3005],[3004]
I did part of the up front sort of business development and worked with them because I had worked and I said rightly that I would be involved but I was quite busy and couldn't be as involved as I would've liked, I couldn't do all the field research, I couldn't be at every single meeting. I went into the field a couple days just to sort of see their offer and I was at most of the meetings but not all of them. [3006],[3007]
I think part of like compare contrast to PNC, that when they made a decision, they felt good about just moving on, made the decision, we felt good about it, we're going to move on. The Care Works people, both they were second guessing themselves all the time. You know. They couldn't make a decision and move on, they kept on returning to things that had been discussed and we thought had been decided and they kept returning to them again and bringing them up over and over and over again. They just can't leave things behind. [3009],[3008]
The Care Works people, both they were second guessing themselves all the time. You know. They couldn't make a decision and move on, they kept on returning to things that had been discussed and we thought had been decided and they kept returning to them again and bringing them up over and over and over again. They just can't leave things behind. [3040],[3042],[3041]
Well, they were senior in a sense but they ... Innovation groups have to sort of respect their sponsors in a way, they're in the service of the larger organization, so at the end, this is where they worked there at the beginning, who all the stakeholders were, they got nervous because they weren't sure whether their stakeholders in the pharma organization were going to like what we were doing. Or was this work getting them what they needed. But they never explained that to us in the beginning. So, they had sort of unseen stakeholders, unseen to us. [3043],[3010]
. One of the problems was that there were multiple conversations with multiple practices before the project ever got going, and so the client kind of, no matter what was in the actual final proposal, in their memory was all the things they had heard from everybody about what they were going to get. That was a problem. We were very poorly aligned with the client, so that was a lot of the problem. We didn't take steps even when it was clear that we were misaligned to just say, "Hey, let's get some alignment here." [2887]
Yeah, I just had one. One of the problems was that there were multiple conversations with multiple practices before the project ever got going, and so the client kind of, no matter what was in the actual final proposal, in their memory was all the things they had heard from everybody about what they were going to get. That was a problem. We were very poorly aligned with the client, so that was a lot of the problem. We didn't take steps even when it was clear that we were misaligned to just say, "Hey, let's get some alignment here." [2915],[2916],[2886],[2914]
They weren't sure how to navigate their own organization on what was going to be valuable to them, frankly. [3011]
What they thought they could get, and what we could deliver, or what was reasonable to deliver. Or where the focus should be, whether it was a whole bunch of things shallow, or one or two things deep, like alignment around issues like that. [2891],[2889],[2888],[2890]
I think was low in a sense that it was actually quite risk averse because the fact that he wasn't even willing to consider a different business model, which wasn't even that big a stretch. There are other people, players in the marketplace that had a two person staffing model and he wasn't willing to consider it because he sort of was afraid of the investment cost. So I think it was low. He was very risk averse. He really couldn't take the plunge into actually considering something radically different. He asked for it but really couldn't go there. [3013],[3012]
There are other people, players in the marketplace that had a two person staffing model and he wasn't willing to consider it because he sort of was afraid of the investment cost. So I think it was low. He was very risk averse. He really couldn't take the plunge into actually considering something radically different. He asked for it but really couldn't go there. [3044],[3045]
The brief was, "What should our service [inaudible 00:41:03] be?" But then they kept changing what they wanted. [3014]
Well, they said, "Can you help us figure out what our check in procedures should be?" It's sort of like, it's like they wouldn't let it stay at the strategic level, they kept on sort of going back in the tactical level and so again, it's sort of like they couldn't separate their current operations, what they needed to fix tomorrow, from where they should be going in the future. And so it was a constant problem for the team. [3047],[3046]
I think that it could've been budgeted bigger, I think they sort of had a budget and we sort of worked with their budget, so I think ideally it would've been a little bit more time because it is sort of a business strategy. I think that time to some degree that there's more clarity, it would've been enough time but the fact that there were so many of these issues that sort of wasted the team's time, they didn't maybe get as far as they should have, could have. [3048]
And there's history of this happening all over ... And every single time because the doctors don't trust and they hate these minute clinics. [3049]
One of the problems was it was mostly one and there was a lot of disagreement about the decisions. So the internal team was very poorly ... had very bad interaction. [2892]
So one thing that inspired us is really trying to understand what would motivate doctors to want to partner with these things and what kind of relationship and role. So I think it was really looking at the balance between the different stakeholders, I think that really sort of inspired this direction. So I think in this particular case it was really a good sort of understanding of the whole picture, of sort of the stakeholder, the relationships between the various stakeholders that could be if you thought about an offer, that really thought about those relationships to support those relationships and the communication between them. That you could have something really differentiate. So, but again, to pull it off was a radical leap because the client reaction was, "Well, it's going to take a long time to establish those relationships and they don't trust us now." Well, duh. Are you trying to do something differentiate or not? [3015],[3016]
Yeah. The project leader would make decisions that people disagreed with. [2893]
Another problem with that was there were ... the client was the Ventures Group. Somebody in the Ventures Group who was in charge of this as a start-up business, and then they also had funding from one of the major pharma companies. So there were two very, very different things that each, that the pharma company and the CEO of the Ventures, of the actual existing clinics had. There was very different goals that they had from the engagement. [2917],[2894],[2919],[2918]
Well, the client was really two clients trying to collaborate. [2895]
Really just not good. It was difficult discussions, people returning to issues that were left, couldn't move on, not clear decision making on their end, and frankly, we didn't necessarily push them to make those decisions sometimes, so it's not all their fault. [3019]
Really just not good. It was difficult discussions, people returning to issues that were left, couldn't move on, not clear decision making on their end, and frankly, we didn't necessarily push them to make those decisions sometimes, so it's not all their fault. We have to take responsibility sometimes for not framing things in a way that the decision has to be made before you move on. [3050],[3052],[3018],[3017],[3051]
Very different goals. Very different goals, where the guy who was the CEO of the existing clinics had very short term operational kinds of things that he was interested in, whereas the pharma company was really interested in this as a unique new touchpoint to see what that would mean for them in their business. [2921],[2920]
Very different goals. Very different goals, where the guy who was the CEO of the existing clinics had very short term operational kinds of things that he was interested in, whereas the pharma company was really interested in this as a unique new touchpoint to see what that would mean for them in their business. There wasn't really the time or the budget to address both of them in depth that they would need to be explored in, and so it ended up being one of these things where there was a shallow view of everything taken that just wasn't satisfying to anybody. [2897],[2896]
Yeah, they had a breakdown, which had to have an intervention but they repaired and completed the project. [3020]
They weren't talking to each other. [3021]
And then I actually intervened and facilitated a reconciliation before the end of the project that helped the team get back together and sort of acknowledge their tensions and the [inaudible 00:46:24] of their tensions and to move on and that did work. [3024]
They literally were like significant like statements like, "We can do this, we can deal with this later, but right now we just have to sort of work apart." And then I actually intervened and facilitated a reconciliation before the end of the project that helped the team get back together and sort of acknowledge their tensions and the [inaudible 00:46:24] of their tensions and to move on and that did work [3022]
They literally were like significant like statements like, "We can do this, we can deal with this later, but right now we just have to sort of work apart." And then I actually intervened and facilitated a reconciliation before the end of the project that helped the team get back together and sort of acknowledge their tensions and the [inaudible 00:46:24] of their tensions and to move on and that did work. [3023]
They literally were like significant like statements like, "We can do this, we can deal with this later, but right now we just have to sort of work apart." And then I actually intervened and facilitated a reconciliation before the end of the project that helped the team get back together and sort of acknowledge their tensions and the [inaudible 00:46:24] of their tensions and to move on and that did work. PROJECT ID [3053]
"Well, we just have to make it more actionable, we have to do more prototyping around these very near term things that they can use right away." And the other person said, "Screw that, that's not going to be valuable to them, we really need to do this." And they disagreed on how to handle the response to the client. So they started- [3054],[3056],[3055]
Well, I think it was a different, they started, since there was confusing about exactly what the final endpoint would be, whether it was more is it for helping to get what they're going to do next month or help them with their overall strategy, [inaudible 00:46:49] the team, they were mixed, so the response for the team was different. So since they were frustrated with the client, one team member said, "Well, we just have to make it more actionable, we have to do more prototyping around these very near term things that they can use right away." And the other person said, "Screw that, that's not going to be valuable to them, we really need to do this." And they disagreed on how to handle the response to the client. So they started- [3025]
Right, since the client was unclear, the team became unclear and then they disagreed and then they didn't resolve it and there was ... And I don't know the whole history or the detail about how the breakdown happened but it was, I guess, it was just sort of a bad day can lead to a worst day where something was said and then it comes into personal relationships about having perspective about. But when there's so much confusion about where you're heading, that can cause the team to have anxiety anyway. [3026],[3027]
Right, it exacerbates it, so then it became a little bit of ... You know, personal style [inaudible 00:48:07] at this point because you're not, there's already some tension, there's some uneasiness, there's some anxiety, there's a client issue, and then a personal style thing can have more importance. [3058],[3057]
Right, it exacerbates it, so then it became a little bit of ... You know, personal style [inaudible 00:48:07] at this point because you're not, there's already some tension, there's some uneasiness, there's some anxiety, there's a client issue, and then a personal style thing can have more importance. Like how people communicate or don't communicate well or how do people handle tension. Some people close up and some people will lash out. And the personal style things, they start to come up when the team isn't functioning. [3028]
So in a sense it wasn't power as much as they both knew what's right, they were both very confident that what they thought was right. [3030]
It turns out they just, they couldn't reconcile between the two of them. So in a sense it wasn't power as much as they both knew what's right, they were both very confident that what they thought was right. [3059]
Well, I would say there were a little bit because the two people having the most tension were both very experienced people, both of them had been here for 10 years or more, so they were both in their own right were experienced, either one of them could've really set the direction for this. It turns out they just, they couldn't reconcile between the two of them. So in a sense it wasn't power as much as they both knew what's right, they were both very confident that what they thought was right. [3029]
Yeah. It was certainly too small for what really needed to get done. The budget was way too small for what needed to happen. [2898],[2922]
Very low. Always bad ingredient. You'll see that, I'll give you that one for free. You don't have to analyze your data for that. [2899]
One of the problems was that we didn't even ... it was all over the place, and I think that we just didn't go back and revisit it enough. You know what I mean? [2901],[2900]
It's a great example of how we're having growing pains in the work we're doing now. It's very different kinds of work and it requires very different kinds of project plans and things like that. It was basically treated like one of our old project development projects, and that's part of why it didn't work well. [2902],[2923]
t's a great example of how we're having growing pains in the work we're doing now. It's very different kinds of work and it requires very different kinds of project plans and things like that. It was basically treated like one of our old project development projects, and that's part of why it didn't work well. [2903]
Like clients will do, they pushed for as much as they could get and there was serious scope creep and we didn't stop it. [2925],[2904],[2924]
Time was fine. The budget was wrong [2905]
That's why they were bad. We were just misaligned all the time [2906]
That's why they were bad. We were just misaligned all the time and they would do stuff like be made uncomfortable by something, and instead of directly having a conversation with us at the time they go away and write these very formal emails, which we don't respond well to. So things were just not above board and director talked about. [2926],[2927]
they would do stuff like be made uncomfortable by something, and instead of directly having a conversation with us at the time they go away and write these very formal emails, which we don't respond well to. So things were just not above board and director talked about. [2907]
People were struggling and they took it out on each other. I see this happening more and more here actually when people get uncomfortable instead of bonding together, because they're nervous they end up taking it out on each other. [2908]
People were struggling and they took it out on each other. I see this happening more and more here actually when people get uncomfortable instead of bonding together, because they're nervous they end up taking it out on each other. There was one particular team member who really did that, and then the other three team members, actually with each other, got along great. [2909],[2928],[2910],[2929]
It gets very, "If only X had done their job better we wouldn't be in this place," it's that kind of thing, which is just so the complete opposite end of the spectrum from how it should be, or how we talk about how we do our work. [2913]
When people feel uncomfortable and they feel like they're not getting to a good place work wise and they need to kind of like ... so they get testy, or they'll decide that there's a weak link on the team. It gets very, "If only X had done their job better we wouldn't be in this place," it's that kind of thing, which is just so the complete opposite end of the spectrum from how it should be, or how we talk about how we do our work. [2912],[2930],[2911],[2931]
Reference Tags
[2996] Vague goals,[3031] Communication issues,[2997] Vague roles,[3032] Anchoring,[2998] Communication issues,[3033] Alignment,[3000] Insufficient Feedback,[2999] Internal changes/challenges,[3035] Alignment,[3034] Anchoring,[3036] Status quo bias,[3001] Insufficient Feedback,[3002] Status quo bias,[3038] Alignment,[3037] Lack of real innovation mandate,[3003] Avoiding conflict about ideas,[3039] Communication issues,[3005] Lack of real innovation mandate,[3004] Vague roles,[3006] Lack of resources,[3007] Unbalanced workload pressure,[3009] Alignment,[3008] Vague goals,[3040] Alignment,[3042] Communication issues,[3041] Premature idea evaluation,[3043] Communication issues,[3010] Great example - External Influences,[2887] Alignment,[2915] Alignment,[2916] Anchoring,[2886] Communication issues,[2914] Internal changes/challenges,[3011] Vague roles,[2891] Alignment,[2889] Communication issues,[2888] Lack of real innovation mandate,[2890] Vague goals,[3013] Risk compensation,[3012] Status quo bias,[3044] Anchoring,[3045] Status quo bias,[3014] Vague goals,[3047] Alignment,[3046] Lack of organizational encouragement,[3048] Planning fallacy,[3049] Lack of trust,[2892] Indecisive leadership,[3015] Risk compensation,[3016] Status quo bias,[2893] Dismissive,[2917] Alignment,[2894] Great example - External Influences,[2919] Scope creep,[2918] Vague goals,[2895] Vague roles,[3019] Communication issues,[3050] Alignment,[3052] Communication issues,[3018] Empathetic disposition,[3017] Indecisive leadership,[3051] Internal changes/challenges,[2921] Alignment,[2920] Vague goals,[2897] Internal changes/challenges,[2896] Vague goals,[3020] Unresolved relationship conflict,[3021] Unresolved relationship conflict,[3024] Compromising conflict about relationships,[3022] Avoiding conflict about relationships,[3023] Unresolved relationship conflict,[3053] Lack of trust,[3054] Anecdotal fallacy,[3056] Forceful conflict about ideas,[3055] Overconfidence bias,[3025] Indecisive leadership,[3026] Indecisive leadership,[3027] Unresolved relationship conflict,[3058] Communication issues,[3057] Irreconcilable differences,[3028] Unresolved relationship conflict,[3030] Forceful conflict about ideas,[3059] Communication issues,[3029] Indecisive leadership,[2898] Lack of resources,[2922] Planning fallacy,[2899] Risk compensation,[2901] Indecisive leadership,[2900] Vague goals,[2902] Backfire effect,[2923] Internal changes/challenges,[2903] Hindsight bias,[2925] Scope creep,[2904] Scope creep,[2924] Vague goals,[2905] Lack of resources,[2906] Alignment,[2926] Alignment,[2927] Communication issues,[2907] Communication issues,[2908] Unresolved relationship conflict,[2909] Forceful conflict about relationships,[2928] Internal changes/challenges,[2910] Resilience,[2929] Unresolved relationship conflict,[2913] Unresolved relationship conflict,[2912] Forceful conflict about relationships,[2930] Internal changes/challenges,[2911] Lack of organizational encouragement,[2931] Lack of trust

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MADISON BARNETT
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