Thought leadership

Use Design Studios to Enhance Strategic Thinking and Action

Use Design Studios to Enhance Strategic Thinking and Action

The move into value-based contracting should stimulate c-suite executives to explore new ways to engage with their staff, physicians and board colleagues. Such engagement will introduce a new generation of strategic planning that:

  • Invites diverse perspectives and experiences about consumerism, stakeholder engagement, and superior patient satisfaction/ service excellence
  • Drives a service or product line focus
  • Optimizes clinical quality outcomes
  • Embraces cost-effective, value-for-money contracting; and
  • Cultivates sustainable population health and community health partnerships

Unfortunately, traditional fact-based business planning methods and venues are unlikely to yield the breadth and depth of strategies, creativity, investments and stakeholder ownership needed to achieve long-range organizational wellbeing. This article unveils fresh ideas for modern strategic planning conducted in “Design Studios” around scenario-based business planning and budgeting processes. (For background on scenario-based planning in a hospital setting, see an article published by the National Institutes of Health.)

This article explores three interdependent actions:

  • Building Diverse Teams
  • Building Challenging Scenarios
  • Building Design Studios




Accountable care and population health have focused leadership teams on research into the Social Determinants of Health (SDOH). Such exploration reminds us to recognize that health systems serve a range of people who bring very diverse perceptions about health. Perceptions range widely on such factors as:

  • What causes good or ill health
  • How, where and when to seek health care
  • How to comply with strategies/tactics prescribed to restore health

Organizational success depends on care plans, service features and investments into well- located and -designed care settings guided by these end-user perceptions, needs and desires. Service excellence demands service delivery that reflects the demographic and psychographic characteristics of the people served.

Service planning, therefore, increasingly must be developed by teams of providers and users that reflect diversity with respect to:

  • Training
  • Age
  • Gender
  • Ethnicity
  • Geography
  • Work experience and education
  • Live experiences

Service line design teams typically include 9-13 members who engage in periodic interactions with and gather input from focus groups. Design team members will bring insights from such segmented perspectives as public health specialists, payers, employer purchasers, patients and their family members, faith communities, and various disease, health or life-style advocacy groups. Design teams will benefit from carefully developed orientation to and education on such topics as:

  • SDOH
  • Service excellence
  • Service journey mapping
  • Budgeting
  • Community health partnerships
  • Collaborative governance, and
  • Community health needs assessments1
  • Such input will help to nurture group engagement,2 appreciative listening,3 and creative visioning4



Consider a scenario as “a story with plausible cause and effect links that connects a future condition with the present, while illustrating key decisions, events, and consequences throughout the narrative.”5 Scenario-based planning yields more actionable and effective results if they are expressed in the classic trio of: “Best Case, Worst Case and Most Reasonable Case.”6 Characteristics of effective scenarios usually include:

  • Balance plausibility with uncertainty
  • Consider trends published by experts in these 10 spheres of interest:
  1. Demography
  2. Consumer purchasing habits and attitudes for services
  3. Economics
  4. Competitive moves
  5. Health insurance payment patterns
  6. Medical technology
  7. Information systems
  8. Human resources availability
  9. Regulatory oversight
  10. Social media and communications
  • Borrow, then edit scenarios from such other service industries as rental cars, hotels, banking, and cruise lines, as well as regional economic development planners.

Remember that the best scenarios are not purchased from consultants, but generated from within your own leadership, provider, employee and patient cohorts. Engaging these diverse groups not only yields better scenarios, but because they helped define them, stakeholders are more likely to help plan and act within them.

Alternate scenarios can serve as relatively low-cost insurance policies. You are less likely to be blindsided if you've taken the trouble to imagine unwelcomed surprises. Scenarios also can identify white-space business opportunities that remain unfilled until a first-mover occupies the space that less imaginative competitors knew existed.



The “design studio” concept has entered the health sector as a means to integrate the value of diverse service design teams with scenario-based strategic thinking, planning, marketing, and budgeting. The process of planning within the “studio” borrows from the work of “Design Thinking”7 in use at the Mayo Clinic8 and Kaiser’s Garfield Center.9 While the “design studio” can use digital technology to conduct virtual group visioning and planning over long distances, the more common style embraces a specially established venue for group analysis and planning.

These design environments can take place in a community center,10 in a health system conference room,11 or in an outside park. Successful studios can use the principles and practices of interdisciplinary design Charrettes12 to focus and accelerate joint program, service, facility and healthy community planning. The process can address facilities, but also service line planning.13

As your organization maps its journey into accountable care, how can your leadership teams and board members best harness the potential of design studios and scenarios to build smarter plans and expanded, more sustainable implementation? For questions or consultation on effective uses of Design Studios, please contact James Rice, PhD, Managing Director and Practice Leader, Governance and Leadership service line, Gallagher Human Resources & Compensation Consulting practice,


1 See these resources: also this guide:

2 See:

3 See:

4 See: and also:

5 Glenn JC, The Futures Group International. Scenarios. In: Glenn JC, Gordon TJ, editors. Futures Research Methodology Version 30. The Millennium Project; 2011. p. 52 See also this guide:

6 See and also

7 See:


9 See:

10 See:

11 We established a weekend design studio is a room in the SingHealth Leadership Academy merely by taping a sign over the door “Innovation Lab”

12 See this checklist:

13 See consideration for the venue here:


James A. Rice

Jim Rice, PhD, FACHE is the Managing Director & Practice Leader with the Governance & Leadership service line of Gallagher’s Human Resources & Compensation Consulting practice. He focuses his consulting work on strategic governance structures and systems for high performing, tax-exempt nonprofit, credit union and health sector organizations and integrated care systems; visioning for large and small not-for-profit organizations; and leadership development for Boards and C-Suite Senior Leaders. 

Dr. Rice holds masters and doctoral degrees in ...

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