Tag Archives: Gawande

A System For Everything


Can brand creation be systematized for a StartUp?

In his recent Reith lectures, Atul Gawande’s anecdote rich narrative tells us how failures in health care are more often than not the result of failures in systems. People say it’s the failures between people (partners) that kill StartUps but I suspect it is often the failures in StartUp systems that drive this.

One of the big tech developments in healthcare was the shift at the start of the 20th century from home care to hospital care and, with this, the rise of professional doctors, nurses, operating theatres and so on. Death in childbirth had been common beforehand. Did the shift to all this professionalism and expertise lead to a reduction in deaths in childbirth? No, it did not. The reason being that there was not enough ‘Infection Control Procedures’, like sterlising equipment or a room properly…or even doctors washing their hands properly.

One might think this problem has gone away. It has not. We are told that there are six million infections caught each year by people whilst being cared for in western hospitals. Less than 5% of all health professionals wash their hands properly in Indian hospitals. The spread of Ebola is a failure of a sanitization and protection process, as the virus creeps into those tiny gaps in clothing and finds its host.

Gawande believes that the problem is that we have more knowledge and expertise than we know what to do with. We’ve created a world of over-complexity. We’ve got too smart for our own good.

But the avuncularly cozy and positive Gawande is confident was can improve things.

We cannot leave it to individuals. Individuals cannot cope with such complexity. We need to create a system that connects and manages us.

This is not only about inventing and building the system but also about executing and managing them ruthlessly. He doesn’t say this but in effect he is suggesting we use this uber-system to create a hive mind, in which the individual operates under the collective. Like the Borg. Only collective effort will allow us to deal with over-complexity.

Now are we in a position to do this though. Technology, data, knowledge give us greater tools than ever before. This is the Age of the System, he declares.

Anyone in StartUp will recognize this over-complexity. Gawande’s belief though is that not only can super-charged systems cope with over-complexity, than can accommodate even more pressure. By introducing aggressive systemization, we can do much more than we thought possible.

The specifics seem prosaic. Make behaviours the norm. Create check-lists. Identify defaults. Introduce feedback loops. He also makes two interesting cultural suggestions. One, the participants need to be managed so they have the humility to accept that even the best (the experts & bosses) fail. Two, in one very successful system the checklist was managed by the person with least power, the telephone operator, I assume, so they would not question it (unlike, let’s be honest, gobby senior staffers).
I’d be more skeptical of his specific suggestions if it were not for the fact that across the 8 major hospitals involved in the trial there was an average reduction in complications of 35%, and an average reduction in death of 47%.

So imagine the impact of strong systems in the chaotic, over-stretched, under-experienced environment of a typical StartUp. Imagine getting your UX to work with PM and producers on every type of process and workflow in the business.
Can a creative process be systematized? I’m interested in brand creation…can that be systematized?

A brand is structured. That structure, at its simplest, covers 5 things.
1. As precise a target as possible.
2. A position within the context of a marketplace.
3. The overall purpose that’s going to own that position.
4. The behaviours, personality and identity that going to execute this.
5. The traction plan that will impact the market in the strongest possible way.

(I know, it’s that simple!…Can you believe there’s whole industry based on that…;-))

To populate that structure, a series of strategic issues need to be considered. Or put in plain English, a list of precise questions need answering intelligently. It’s probably quite a long list but it’s not too long.

Answering intelligently clearly depends on the quality of the people who are answering but what matters more is the quality of the hive.

You clearly want people who are smart and, although not necessarily experts, understand and are interested in the basics. They’ve thought about brands, which ones they love, which ones they respect and why. The hive must know how to work together. To discuss. To debate. To conclude. To let it go and move on.

Coding has a system but is also creative. I think we can look at a brand in the same way. We don’t because it undermines our creative egos. But I actually like the intelligence and creativity of the system.

So if you can figure out what the precise questions are and work them through, I think any StartUp can systematize their brand creation and execution.

Or you can pay tens of thousands of dollars/pounds you haven’t got to a brand consultancy…