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The first two parts of our series on storytelling focused on the overarching narrative: the big stories we tell ourselves. In this final article, we look at smaller stories—the kind we tell every day—which can add up to a shift in mindset from the listener.
We no doubt need the large stories that place us as the hero on our journey to something greater than ourselves. But how do we get there? What do we encounter in our daily adventures at work? And how can we learn from others in our field—or even way outside it? Smaller stories make our points more memorable to the listener. Done right, they can spread throughout the organisation.
[Listen to audio version, read by David Hodes]
This is Part 3 of our series on our Storytelling series:
Part 1 | Part 2 | Part 3
When we get together in the canteen or rec room, how do we share our experiences? What almost went wrong in the plant in the last shift? What did the boss say about the upcoming visit from the global COO? What was it like to go through the new health and safety training? It’s completely natural for us to relate these experiences with a story.
This kind of ‘small s’ storytelling is oral and has the potential to ‘go viral’—just like any other kind of gossip. Leaders can use them to better engage their teams during speeches, whether in large formal settings or in a one-to-one setting. Even better, this kind of story is highly portable. The teller can make it their own.

These anecdotes don’t have the three-act structure of Hollywood. They may not even have a hero (although it could be the speaker or the person they’re talking about). They are simpler and more easy to remember when you want to illustrate a specific point. Shawn Callahan, who wrote Putting Stories to Work, has created a story framework that outlines a basic map that underlies any business story (see diagram below).

First, there’s a time or place marker—or possibly a person. Then there’s a series of connected events. This happened, which caused that, then this. When we tell stories to entertain each other, we usually use dialogue. ‘He said…then I went…’ which makes it vivid. Most of all, there’s something out of the ordinary, some surprise. Otherwise, why bother telling it? (Coincidence stories work like this, too). And finally, for the story to connect with the reader in an intended way, it must have a business point. Here’s an example.
Recently, I went to the mine over the other side of the ridge, with Arnie and Paul (not their real names). We were trying to find a way to get some funding to improve the consistency of the ore grade. No one was listening, and the ramifications were severe for the downstream processes. So, I told this story:
Once there was a very stubborn mule on a bridge, and no matter what anyone did, it wouldn’t budge. The people with their cars and carts were getting mighty frustrated, but pull as they did on the reins, that mule, stubborn as a mule, wasn’t going anywhere. Van der Merwe saunters up the road, sees the situation and asks if he might help. Everyone greeted his offer enthusiastically, but couldn’t figure out how such a slip of a man could do what proved impossible for the biggest and strongest amongst them.
Van (as he is known in South Africa), asked for a heavy 4×2 plank of wood. Armed with this, he took ten steps back. After a brief pause, he ran toward the mule and belted it across the head with all the force he could muster. The mule shuddered a little, but when the reins were taken by Van and pulled lightly to get it out the way, the mule followed behind without a trace of the stubbornness for which these creatures are renowned. The crowd roared their approval, and one amongst them asked the new hero what the secret was to his success. Van replied, ‘First, you have to get their attention.’
On one level, the story here is about Van and the mule, and I’m telling it in the moment to get Arnie and Paul to see that they might need to step back and change their approach. But I could equally build on this anecdote to tell someone else the story about what happened next. ‘I was over at the mine with Arnie and Paul,’ I might say. ‘I told them the story about Van and the mule. You know the one.’ If the listener doesn’t, I can tell that story. But then I move on to what happened next. Did they get the point? Did they come up with an idea to get the funding?
I thoroughly recommend Putting Stories to Work for its framework but also its method of gathering stories and helping seed them in the organisation. Callahan outlines different types of story that can communicate strategy, engage and inspire people, counter rumours and much more.
Here are some lightly fictionalised from my own recent experience.
Imagine Bob, a member of the engineering leadership team, who had the following experience and might recount it like this:
We were in our weekly leadership catchup on Monday, struggling to think about how we could simplify what we were trying to achieve with our strategy. We had a lot of jargon words in there, like reduction in TAT (turnaround time), OTP (on-time performance), RTS (return to service), Throughput. After we’d gone around several times, Mike piped up and said, ‘What are we really trying to do? Aren’t we saying that it’s our obligation as the engineering division to make sure that we maximise the amount of time hulls are safely available to fly?’
There was a silent pause before Maria came up with the clincher ‘Max Skytime’. And then we had it—a mantra to use from the shop floor to the boardroom to communicate our strategy. If a hull isn’t available to fly, it can’t be making money, so our strategy was entirely linked to ensuring ‘Max Skytime’. Now we all have a story to tell our teams. ‘We used to focus on a bunch of metrics that were all important but didn’t get to the heart of the problem. Our customers only care about getting airborne on time. And we in engineering know that to do that we must get our asset out into service again. While we still track all these measures, we realised we should only focus on one thing: Max Skytime.’
Sarah went to the leadership team retreat last week. The whole team was painfully aware that employee engagement scores had been on a progressive and precipitous decline in the last three years. Only 1 in 5 employees felt engaged, the vast majority were indifferent, and as much as 20% were actively hostile to the business. ‘Three years ago,’ said Sarah, ‘there had been a pretty brutal resizing exercise which was poorly planned and very badly executed.’
We’ve been trying to correct the very damaging unintended consequences ever since. But in doing so we’ve focused too heavily on the technical aspects of the processes, the organisational design and the supporting technology platforms.
What was missing is a sense of purpose. We all need to answer the big ‘why’ question. We won’t build any trust or get anywhere unless everyone feels we’re fair dinkum around why we’re making the changes we’re calling for. We’re a regional business, but we’re part of a global corporate. Our people like that—they see how we contribute to where we live, but when we step into our daily work, we are connected to the latest and greatest innovations the business has to offer.
The team ended the workshop practising what they would tell their teams on their return. Each person was able to tell Sarah’s story in their own way, bringing a much needed human dimension to the change initiative.
On Thursday, I dropped by to see the team at the end of a long shift on a major shut.
They had smashed the work for the day and knew they were making good progress on the critical path. They all just wanted to go home, have a bath, some dinner and put their kids to bed. Waiting in the crib for shift changeover, Derek asked if everyone had done their updates. Everyone moaned and groaned—it was the last thing anyone wanted to do. He then did something really simple. He asked:
‘If you were to rate today’s performance on one of our golden rules “maintain true data”, where would you place us, on a scale from one to ten?’ He went around the room. No one gave a score of more than 2. ‘What are we trying to achieve here? What did we commit to at the beginning of the shut?’ Samu was the first to speak: ‘Nine and above, boss—we’re here to win the championship.’ ‘OK, guys,’ Derek followed, ‘what do you want to do?’ And they guys all fired up their computers and closed out our reporting for the day.
The other day, I was heating up my lunch in the kitchen when Stuart and Jack walked in.
Jack was moaning about ‘all these constraints we have’ and how it was impossible to keep them all under control. Stuart said, ‘I use this “One Thing” idea.’ Jack looked at him. Stuart went on: ‘What’s the one thing you can do that would make everything else either easier or go away?’
He said that when he finds and focuses on the one thing, it’s remarkable how much he can get done. ‘The constraint is your friend, not the enemy,’ he said. ‘If it’s correctly chosen and focused on, it represents the place of maximum leverage for what you’re trying to achieve.’
Jack thought for a few seconds and smiled. ‘I like that, mate,’ he said. ‘I’ll give it a go and use it with my crew.’ I since heard he now uses it at every pre-start.
Jeremy was telling me he finds it very disconcerting when Felicity keeps bagging management and what they are trying to do to turn this place around. Her talking this way produces such a negative effect amongst the team.
Last Thursday in the canteen she told me, ‘Every time, at this time of year, they come and tell us how the market is tightening and that we will have to pull in our belts. It only means one thing—we’re going to get our bonuses cut again. It’s like no matter how hard we work, we’re always going to be a victim to the market and management’s need to show a particular result.’
Then Damien, looking up from his noodles, jumped in and reminded us: ‘Hey, Felicity. We all have secure jobs, we’re blessed with a terrific leadership team who have invested heavily in all of our leadership skills through the Alchemy program. They included us in all stages of the development of our shared vision. Whatever the final results are, we know they’ll be totally transparent and will fight our corner to get what they can for us.’
Even Jack, the team sceptic, joined in. ‘Yes,’ he said. ‘Given the current state of our industry, maybe we should be more grateful for what we have and generous towards our leadership team’s efforts to guide us through these tough times.’ Felicity opened her mouth, then thought for a few moments. ‘You may be right,’ she said. Since then, she’s kept her thoughts to herself.
Finally, recall that this kind of storytelling works like gossip. But just because you’re telling stories doesn’t mean the gossip stops. You need to get your message across. And a story is often the best way. If you’re not telling your story, your people will happily supply one of their own.
If you want to replace negative rumours flying around the organisation, simple facts may not stick. You only have to look at our current global political scene to see this in action. To displace a false story, you need more than just an appeal to reason. You need a better story.
Now read the other parts in our storytelling series:
Part 1: What’s your story?
Part 2: Telling big stories
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What’s next?
The change from standard thinking to Theory of Constraints (TOC) is both profound and exhilarating. To make it both fun and memorable, we use a business simulation we call The Right Stuff Workshop.
We’d love to run it with you. To learn more:
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[Background photo of ‘Coffee Break’ by Joshua Ness on Unsplash]
“The universe is made of stories, not of atoms.”
―Muriel Rukeyser
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Healthcare professionals are central to the patient’s progress from awareness of a therapy to successful long-term use. They identify risk, interpret evidence, diagnose conditions, discuss options, perform procedures, provide training and monitor outcomes.
Yet many medical device development programs treat healthcare professionals primarily as users to be trained or customers to be persuaded.
HCP-Centered Design takes a wider view. It examines the work healthcare professionals must perform, the system in which they perform it and the constraints that limit their ability to move suitable patients through the care pathway.
“If patient flow depends on a healthcare professional, that professional’s available capacity may determine how many patients ultimately receive the therapy.”
A medical device patient journey commonly depends on several healthcare professionals:
Each professional governs a transition in the flow of patients.
If one transition lacks sufficient capacity, information or clarity, the whole pathway slows. More marketing, sales activity or production capacity will not compensate for a shortage of specialist time or a burdensome diagnostic process.
This is why HCP-Centered Design is not simply about making an interface easier to use. It is about enabling the system of care to perform.
A healthcare professional’s work depends on information and actions supplied by others. They may rely on referrals, patient histories, pathology, imaging, electronic records, clinical guidelines and the availability of equipment or trained colleagues.
After reaching a decision, they may need to explain it, document it, arrange authorization, coordinate treatment and prepare the next person in the pathway.
A technically strong solution can still create difficulty if it:
The relevant design question is not merely, “Can the HCP use this product?”
It is, “Does this solution improve the HCP’s ability to complete important clinical work within the conditions in which care is actually delivered?”
“HCP” is not one persona.
A general practitioner, specialist, interventional physician, nurse, technician and clinical administrator encounter different stages of the pathway. Each has different responsibilities, authority, expertise and exposure to risk.
Even within a profession, context matters. An experienced specialist in a major hospital may approach the same task differently from a professional who encounters the condition infrequently or works without immediate specialist support.
Useful HCP personas distinguish factors that influence work:
These personas clarify who performs each job and what support each person requires.
The HCP journey often begins before the visible clinical procedure.
It may include receiving a referral, gathering information, forming an initial view, ordering investigations, interpreting results, deciding whether the patient is eligible, discussing treatment, obtaining authorization, preparing for the procedure, delivering care and arranging follow-up.
At each stage, ask:
The resulting journey map should distinguish processing time from waiting time. A decision may require only minutes of specialist attention while patients wait weeks to access that attention.
This reveals the practical relationship between HCP capacity and patient flow.
The Theory of Constraints directs attention to the factor limiting the performance of the entire system.
In some pathways, the constraint may be the number of qualified interventional specialists. In others, it may be diagnostic capacity, physician confidence, authorization effort, operating room access or the time required to train patients.
The constraint may also be hidden inside the HCP’s working day.
A specialist supporting a therapy must still manage other clinical duties, administration, meetings, documentation and urgent cases. The question is not simply how many specialists exist. It is how much of their usable capacity is available for the activities upon which patient flow depends.
“The scarcest resource may not be the healthcare professional. It may be the few hours of focused capacity available for the critical work.”
Improvement away from this constraint can make performance worse. Sending more referrals to an already overloaded specialist increases the queue. Adding information may increase cognitive burden. Creating another approval may consume the capacity required to treat patients.
HCP-Centered Design seeks to protect and expand the capacity that governs flow.
Policies and procedures describe how clinical work should happen. Observation reveals how it actually happens.
Healthcare professionals routinely compensate for missing information, awkward interfaces and unreliable handovers. These workarounds may become so familiar that nobody reports them as problems.
Gemba research should examine:
The purpose is not to judge the healthcare professional. It is to understand the system surrounding the work.
“A workaround is often evidence that the system has failed to support the person doing the work.”
Healthcare professionals do not simply use devices. They use them to make progress in clinical work.
An HCP may need to identify risk, reach a confident diagnosis, select an intervention, perform a procedure safely, explain options, monitor progress or recognize deterioration.
A structured job map divides this work into eight stages:
This wider view prevents the product team from concentrating exclusively on the procedure.
The greatest value may come from reducing preparation, improving decision confidence, clarifying an exception, simplifying documentation or improving the handover to follow-up care.
Comments such as “the interface is difficult” or “we need better information” indicate dissatisfaction, but do not provide sufficient direction for design.
They should be translated into measurable outcome statements, such as:
“Minimize the time required to identify which clinical information is missing before making a treatment decision.”
Or:
“Reduce the likelihood that a clinically significant change goes unrecognized between scheduled reviews.”
A broader population of healthcare professionals can then assess the importance of each outcome and their satisfaction with their current ability to achieve it.
Highly important and poorly satisfied outcomes provide a rational basis for prioritizing innovation.
“Adoption follows when a solution makes important clinical work safer, clearer or easier to complete.”
The five-step FOCUS process creates a practical improvement cycle.
Find the constraint. Determine which HCP activity or resource currently limits patient flow.
Optimise for it. Protect the constraint from avoidable work, missing information, interruptions and rework.
Collaborate around it. Align upstream and downstream teams so patients, information and resources arrive when required.
Uplift it. Add capacity, redesign responsibilities, improve technology or remove restrictive policies.
Start Again. Identify the new constraint once flow improves.
This approach allows the organization to distinguish activity from value. It also turns HCP engagement into an ongoing management discipline.
HCP-Centered Design must connect clinical reality with patient needs, technology, regulation and business strategy.
A Value Management Office can help coordinate these perspectives across the product lifecycle. Its role is to ensure that projects, resources and stage-gate decisions remain connected to patient flow and business value.
The organization should be able to show:
The goal is not simply a device that healthcare professionals can operate. It is a solution they can confidently incorporate into care and a delivery system capable of getting that solution to more patients.
Use the HCP-Centered Design assessment to determine how well your organization understands clinical work, HCP capacity and the constraints governing patient flow.
The resulting evidence should guide product design, process improvement and investment toward better products, delivered faster, with more lives changed for good.
Medical device companies devote enormous skill and investment to developing safe, effective products. Yet a technically successful device changes no lives while suitable patients remain unable to reach it.
Between a patient becoming aware of a therapy and receiving its intended benefit lies a pathway of referrals, consultations, diagnostics, approvals, procedures, training and follow-up. Every step consumes time. Between the steps, patients wait. At some points, they become confused, discouraged, ineligible or lost to the process.
Patient Centered Design must therefore address more than the design of the device. It must improve the performance of the entire system through which patients reach, receive and live successfully with the solution.
“A life-changing therapy changes no lives while patients remain trapped in the pathway leading to it.”
A typical medical device journey may include:
Companies often manage these stages as separate functions. Marketing works on awareness. Medical affairs supports clinicians. Market access addresses reimbursement. Sales works with specialists. Clinical teams gather evidence. Training teams support adoption.
The patient, however, experiences one journey.
From the patient’s perspective, a delay between two organizational functions remains a delay. A repeated test remains repeated work. An unclear handover creates uncertainty regardless of which department owns it.
Patient Centered Design begins when the organization sees and manages this journey as a connected system.
Every step contains some necessary processing time. A consultation takes time. A diagnostic test takes time. An authorization must be assessed. A procedure must be performed.
The patient’s total lead time, however, also includes the waiting between these activities.
A consultation may take 30 minutes, but the patient could wait six weeks for it. A diagnostic test may take an hour, followed by another delay before a specialist reviews the result. Prior authorization may require little actual work while adding weeks to the pathway.
This distinction matters because organizations often improve processing time while leaving the larger queues untouched. Saving five minutes during an appointment produces little benefit if the patient waits months to reach it.
Patient Centered Design therefore asks:
The answers reveal the true performance of the patient system.
Theory of Constraints teaches that the performance of any system is limited by a constraint. Improving a part of the system that is not constraining flow may create more activity without increasing results.
If diagnostic capacity is the constraint, generating more awareness may simply produce a longer queue for diagnosis. If specialist capacity is the constraint, accelerating authorization may move patients more quickly into another wait. If training after first use is inadequate, increasing procedures may produce poor experiences and avoidable follow-up demand.
“More activity at a non-constraint creates work in process. More capability at the constraint improves the system.”
The constraint is not always a physical resource. It may be a policy, an eligibility rule, missing evidence, a fragmented handover, an information delay or the cognitive burden placed on the patient.
The most important question is therefore not, “How do we improve every step?”
It is, “What currently limits the flow of suitable patients to successful use of the therapy?”
Numbers show where patients are lost. Patient research helps explain why.
Two patients with the same diagnosis may respond very differently. One may actively seek new treatment options. Another may delay action until symptoms become severe. A third may want help but lack confidence in navigating the healthcare system.
Meaningful patient segmentation considers characteristics that influence behavior:
These differences affect whether patients enter the pathway, remain engaged and successfully adopt the solution.
The Gemba is the place where work actually happens. For patients, this includes the home, clinic, hospital and all the places where they manage their condition between formal encounters.
Interviews alone may miss important evidence. People normalize inconvenience, forget workarounds and simplify their past decisions. Observation allows the development team to see what patients actually do.
Good research combines three activities.
Observe. Watch how patients obtain information, prepare, use the solution and respond when something goes wrong.
Immerse. Understand the physical, emotional and practical conditions surrounding the experience.
Engage. Ask open questions that allow patients to describe their goals, fears and frustrations in their own language.
The purpose is to discover the patient’s reality before asking them to evaluate the organization’s preferred answer.
Patients rarely want a medical device for its own sake. They want the progress it may enable.
They may want to recognize deterioration earlier, preserve independence, reduce pain, avoid repeated visits, return to work or prevent a disease from controlling daily life.
A useful job map examines eight recurring stages:
This reveals opportunities beyond the immediate use of the device. The most valuable improvement may involve helping patients prepare, confirm readiness, recognize an exception or understand what happens next.
Stories create understanding, but investment decisions require structured evidence.
Patient observations and comments should be converted into outcome statements that identify:
For example:
“Minimize the time required to recognize that my condition has changed sufficiently to require clinical help.”
Patients can then assess the importance of each outcome and their satisfaction with their current ability to achieve it.
Highly important and poorly satisfied outcomes represent genuine opportunities. This prevents teams from prioritizing attractive features that do not materially improve the patient’s life or progress through the pathway.
“Innovation becomes valuable when it improves an outcome that matters and remains poorly served.”
The Patient Centered Design pathway can be improved through a repeating discipline:
Find the constraint. Identify what currently limits patient flow or successful use.
Optimise for it. Make the best possible use of existing constraint capacity.
Collaborate around it. Align functions and partners so their actions support the constraint.
Uplift it. Add capability, remove restrictive policies or redesign the pathway.
Start Again. Once the constraint moves, identify and address the next limiting factor.
This prevents improvement from becoming a collection of disconnected initiatives. It directs scarce resources toward the factor that most strongly governs the result.
Patient insight should influence more than early product design. It should shape clinical evidence, regulatory strategy, reimbursement, manufacturing, education, market development and post-market support.
The organization should be able to show:
The goal is not simply to place the patient at the center of a diagram. It is to organize the enterprise around delivering better products faster, so that more lives can be changed for good.
Use the Patient Centered Design assessment to determine how well your organization understands its patient journeys, priority outcomes and constraints to patient flow.
The result should be more than another collection of patient opinions. It should provide evidence that directs strategy, investment and execution toward the changes that matter most.
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We’ll only use your email address for this newsletter. No sales calls